When the Stakes Turn Toxic

Anyone who’s bought a lottery ticket or played bingo has gambled. Gambling is any game of chance in which money changes hands. It’s common in most cultures around the world. Many people enjoy gambling as recreation without causing harm to themselves or others. Yet some people can’t control their impulse to gamble, even when it takes a terrible toll on their lives.         

For these gamblers and their families, researchers have been making progress in several areas. Scientists are learning why people have problems with gambling: how common it is, what goes on inside the gambler’s brain, which is at risk and what kinds of treatment can help.

Problem gambling is defined by some researchers as gambling that causes harm to the gambler or someone else, in spite of a desire to stop. Between 2% and 4% of Americans struggle with this condition. Problem gambling can progress to a recognized psychiatric diagnosis called pathological gambling.

Pathological gambling may affect from 0.4% to 2% of Americans. “Pathological gambling comes with a constellation of problems that contribute to chaos,” says Dr. Donald Black of the University of Iowa. “It’s associated with worse physical health, excessive smoking, excessive drinking, not exercising, not seeing primary care doctors and worse dental care. It also fuels depression, family dysfunction, crime, bankruptcy and suicide.”

Together, pathological and problem gambling may affect up to 5% of Americans. That number may rise, though. Laws in many states are creating more options for legal gambling, and internet gambling is becoming more common.

Still, gambling is often done in family settings, condoned or encouraged by parents. And the younger you start, the more likely you are to get into trouble later on. From 3% to 8% of adolescents have a problem with gambling.

Dr. John Welte of the University of Buffalo has found that, across the lifespan, gambling problems are even more common than alcohol dependence. They are also much more common in males, in young people, and in people who live in relatively poor neighborhoods. “That’s not true of the prevalence of alcoholism,” says Welte. “Alcoholism is much more democratic. So think about motives for gambling. People are hoping that winning will improve their lot. That makes them more vulnerable to developing a gambling problem.”

In a study of mostly African-American inner-city youth, Dr. Silvia Martins of Johns Hopkins University has found that about 15% have some form of problem gambling. Most at-risk were adolescents and young adults who began showing symptoms of depression at age 12. They were highly impulsive, although not hyperactive or aggressive. As the African-American boys developed into their teens and early adulthood, gambling appeared to be a separate risk factor for early fatherhood and criminal arrest.

“We are following up with these inner-city kids every single year as they enter adulthood,” says Martins.

But why is gambling irresistible to some folks and not others? Using advanced imaging techniques, Dr. Alexander Neumeister of Mount Sinai School of Medicine looked at the brains of people with gambling problems and alcohol problems. He measured the number of special receptors involved in regulating impulse control and other factors.          

“A key feature of addiction is impaired impulse control,” says Neumeister. “Abnormal function of the forebrain leads to reduced tolerance to waiting.” The resulting impatience may cause people to act without considering the consequences. “Our imaging clearly points toward the importance of impaired forebrain function in addiction.”

Pinpointing areas in the brain’s reward center, Neumeister’s team found that people with alcohol addiction and gambling problems show different functioning of these special receptors compared to healthy people. The differences were related to the severity of addiction. Other researchers are trying to develop drugs that could treat the affected areas.

Talk therapy can also help. Dr. Nancy Petry at the University of Connecticut Health Center works with pathological gamblers and people seeking treatment for drug use disorders. Gambling problems arise in about 10% to 20% of substance abusers. Petry compared the use of different types of talk therapy, including very brief interventions and cognitive-behavioral therapy CBT. CBT teaches people how to think differently about problems and then act on that knowledge.

“We found very brief interventions and CBT were effective in reducing gambling and gambling-related problems,” Petry says. “There was a significant improvement relative to usual care or standard forms of treatment like Gamblers Anonymous [a 12-step program].”

Anybody can have a gambling problem, and no one should feel ashamed or be afraid to seek treatment. “Pathological gambling is a medical disorder, not a sin or a vice,” says Dr. Carlos Blanco of Columbia University and the New York State Psychiatric Institute. “There is no stereotype. The main predictor of outcome is really motivation.”

In other words, what counts most is a strong drive or desire to take action. Blanco offers gamblers motivational interviewing, which helps them explore their mixed feelings about trying to quit gambling. This primes them to be ready and willing to begin CBT. Using both therapies together can be very effective.

If you have concerns about your gambling, ask for help. Your health provider can work with you to find the treatment that’s best for you.

Paradise Nevada

Paradise is an unincorporated town in the Las Vegas metropolitan area in Clark County, Nevada, United States. The population was 223,167 at the 2010 census. As an unincorporated town, it is governed by the Clark County Commission with input from the Paradise Town Advisory Board.

Paradise contains McCarran International Airport, University of Nevada, Las Vegas, and most of the Las Vegas Strip, including well-known hotels such as Caesars Palace, the Palms, and the MGM Grand. Therefore, many tourists visiting the Las Vegas area actually spend most of their time in Paradise, rather than in the City of Las Vegas. Despite this, Paradise remains relatively unknown, since “Paradise, NV” does not appear in postal addresses. The United States Postal Service has assigned “Las Vegas, NV” as the place name for the ZIP codes containing Paradise. Nonetheless, if Paradise were to be incorporated, it would be one of the largest cities in Nevada.

Las Vegas Valley

The Las Vegas Valley is the heart of the Las Vegas-Paradise, NV MSA also known as the Las Vegas–Paradise–Henderson MSA which includes all of Clark County, Nevada, and is a metropolitan area in the southern part of the U.S. state of Nevada. The Valley is defined by the Las Vegas Valley landform, a 600 sq mi 1,600 km2 basin area that contains the largest concentration of people in the state. The history of the Valley significantly intertwines with the history of the city of Las Vegas and one of the two primary cities as used by the census bureau in the MSA, with the other being Paradise. The valley is home to the three largest incorporated cities in Nevada: Las Vegas, Henderson and North Las Vegas.

The names Las Vegas and Vegas are used to indicate the valley, the strip, the city and are used as a brand by the Las Vegas Convention and Visitors Authority and used to denominate the entire region. The metropolitan area's population was at 741,459 in 1990. The population was approximately 2 million in 2010 estimated. The valley is an area generally defined by the Spring Mountains on the west, Sheep Mountains to the north, Muddy Mountains and Lake Mead to the east, and the Black Mountains to the south.

The area is known for its extensive gaming, shopping and fine dining offerings. Outdoor lighting displays are everywhere on the many tourist destination buildings in the area. Las Vegas, which bills itself as The Entertainment Capital of the World, is famous for the number of casino resorts and associated entertainment. Las Vegas is also home to a growing retirement community. As seen from space, Las Vegas is the brightest city in the world.

Play is a range of voluntary, intrinsically motivated activities normally associated with pleasure and enjoyment. Play is commonly associated with children, but positive psychology has stressed that play is imperative for all higher-functioning animals, even adult humans.

The rites of play are evident throughout nature and are perceived in people and animals, although generally only in those species possessing highly complex nervous systems such as mammals and birds. Play is most frequently associated with the cognitive development and socialization of those engaged in developmental processes and the young. Play often entertains props, tools, animals, or toys in the context of learning and recreation. That is, some hypothesize that play is preparation of skills that will be used later. Others appeal to modern findings in neuroscience to argue that play is actually about training a general flexibility of mind – including highly adaptive practices like training multiple ways to do the same thing, or playing with an idea that is good enough in the hopes of maybe making it better.

Some play has clearly defined goals and when structured with rules is called a game, whereas, other play exhibits no such goals nor rules and is considered to be unstructured in the literature. Play promotes broaden and build behaviors as well as mental states of happiness – including flow.

Play has traditionally been given little attention by behavioral ecologists. Edward O. Wilson wrote in Sociobiology that No behavior has proved more ill defined, elusive, controversial and even unfashionable than play. Though it received little attention in the early decades of ethnology, and instead only existed as a matter of study within human psychology, there is now a considerable body of scientific literature resulting from research on the subject. Play does not have the central theoretical framework that exists in other areas of biology.

Ethnologists frequently divide play into three general categories: Social play, locomotors play and object play. Locomotors play is the pretend playing that a very young animal participates in when alone. The jumping and spinning characteristic of locomotors play can best be seen in young goats. Researchers have theorized that locomotors play helps the cells in the cerebellum of the brain to develop connections. Types of play listed by psychiatrist Dr. Stuart Brown expand upon these basic categories to include fantasy and transformational play as well as body, object, social. The National Institute for Play describes the previous five play types, as well as the play types attunement and narrative.

The broaden and build behaviors it fosters may have even greater value for adults than children. The mental state of flow is also a major component of play, and has itself been associated with things like creativity and happiness. Brown often quotes Brian Sutton-Smith's insight: the opposite of play is not work, it is depression. 6] Examples of adult play abound e.g. the arts, but also curiosity driven science.

Tim Brown explains that a value like a bit of shamelessness during the creative process is extremely important in adult designers.

Play may allow people to practice useful habits like learned optimism, which might help manage existential fears. Play also offers the opportunity to learn things that may not have otherwise been explicitly or formally taught e.g. how to use, and deal with, deceit and misinformation. Thus, even though play is only one of many habits of an effective adult, it remains a necessary one.