If the casino industry can defend itself against gambling addiction by pointing to neurobiology, it might also be argued that it has learned how to profit from addiction. Natasha Dow Schull, a cultural anthropologist and assistant professor at MIT, and a prominent critic of the gaming industry, points out that casinos are booming thanks in large part to increasingly sophisticated and highly addictive slot machines and video poker machines. These machines are the gaming industry's cash cow -- they occupy more than 75 percent of casino floors -- and one of the most efficient systems that humans have ever devised for delivering a dopamine rush to your brain while extracting money from your wallet.
Schull has studied the interface between slot machines and the players who throng to them. As she explains, the old one-armed bandits are gone: Players were wasting too much time pulling the lever. Now push-button and touch-screen games are the rule, where a hardcore customer playing at top speed can play a game every five seconds. When you consider the slot machine makers, says Schull, "It's clear their ideal customer is the addict. They have a term, 'player extinction,' which means you lose all your money. They're talking about this as a goal!"
Schull has also tracked the work of the NCRG since its founding in 1996. In her forthcoming book, "Machine Life: Control and Compulsion in Las Vegas," she dives into the experience of gambling addicts, and argues that the industry acted deliberately to defuse the threat it poses by funding science that casts them in an unflattering light.
"The NCRG is committed to the idea that most 'normal' people aren't at risk of developing a gambling problem," says Schull. "They're trying to show that all addicts share a common pathway, which involved the reward system of the brain. This really helps the industry because the idea is, if these people were not to gamble, they would find something else to be addicted to. They come into the world with the brain disposition of an addict, so you can't blame casinos."
Schull says the industry has successfully defined the terms of gambling addiction; it's telling that we speak about problem gamblers, she says, but not problem machines, problem environments, or problem business practices. Currently, Schull is working in the young field of "neuroeconomics." She says that brain scans and genetics studies are producing fascinating data, but can't fully explain the complicated problem of gambling addiction. "Doing this research, I've become a behaviorist in a weird way," she says. "I've come around to thinking that if you put any rat in a cage, under the right circumstances, you can addict it. Some of us have greater liability than others, but that doesn't mean that it's not on a continuum."
The gambling treatment field has warily accepted the statistics produced by Howard Shaffer, director of the Cambridge Health Alliance's Division on Addictions. He found that 1 percent of American adults meet the criteria for "pathological gamblers" in any given year, as defined by the psychiatry bible, the Diagnostic and Statistical Manual of Mental Disorders. That 1 percent is the figure casino executives frequently cite, and that the NCRG highlights on its Web site.
However, critics say that the industry's embrace of the 1 percent statistic hides the full brunt of gambling addiction. "The industry's ability to downplay the social costs has been a continual frustration," says Henry Lesieur, a psychologist at the Rhode Island Hospital's gambling treatment program. "As if one suicide isn't too many, or as if divorces mean very little." Lesieur says he also sees plenty of tragedies among the 2 to 3 percent of adults who qualify as "problem gamblers," meaning they don't have enough symptoms to qualify as pathological gamblers.
Lesieur originally sat on an advisory board for the NCRG, but resigned in 1997 over concerns about the industry's influence over the research. Lesieur says that by conservative estimates, 30 percent of the profits from gambling machines come from problem gamblers. Yet NCRG and the institute have avoided such sensitive topics. "You don't see any research into the addictive nature of different games, and why people who play video machines seem to get addicted faster," Lesieur says. The gambling addicts who play the machines exclusively bottom out very quickly -- typically, within a year of beginning their habit, he says.
Lesieur says that he sees three different types of problem gamblers in his counseling center. The first set, he agrees, do seem to be genetically predisposed, and respond too strongly to the stimulus of gambling. The second group consists of social gamblers who get carried away with the excitement of betting big, and lose more money than they intended. However, these people usually rein themselves in once they feel the consequences.
Then there are people who are depressed and anxious, he says, people who are struggling with a dramatic life change, like a divorce or a new disability, and who gamble for distraction and a temporary rush. "If you go gambling when you're depressed, you're putting yourself at enormous risk, because you're using gambling to treat your depression," he says. The majority of the people who walk through his office door fall into this third category, he says. "They haven't been able to tie all alcohol use to genetics, and the same thing's going to happen to gambling," he says. "If you look for biological markers, you're only going to find the first type."
Despite their concerns about how the institute's studies are paid for and broadcast by the gambling industry, critics don't want the funding for brain scans or genetics studies to dry up. "The institute will probably say to you, 'No one else wants to fund this work, this is important work,'" says David Blumenthal, director of the Harvard-affiliated Institute for Health Policy, and an expert on academic-industrial relationships "'We're trying to understand how the phenomenon of addiction occurs, and you want to stop us from doing that.' There may be some truth to that."
Regardless, Blumenthal adds, the studies are inherently compromised as a result of being funded by the casino industry. "My opinion is that it's unwise to accept those grants. No matter how scrupulous the investigators are, they're always open to suspicion. And if you have results that are positive to the industry, it looks even more dubious. So in a way, it's harmful to the industry."
The ideal solution, says Blumenthal, would be for the federal government to step in and give a big pile of money to the NIH for research on all aspects of gambling addiction, from nature to nurture. "If the institute is funding really good research, what should happen is that research will rise to the top under a public system," says Blumenthal. "We'll get to the same point without the stigma of industry association."
In fact, in 2007, several members of the House of Representatives introduced a bill that would give the National Institutes of Health $20 million for research on gambling addiction. "It would be the most money ever given to the NIH for gambling research," says Keith Whyte, executive director of the National Council on Problem Gambling, which supports the legislation. "The NCRG was specifically invited by the sponsor of the bill to support it, and they declined," says Whyte. "That was disappointing to us because they talk about 'the NIH model' all the time."
The bill is currently stuck in committee and appears to be going nowhere. For the gaming industry, that seems to be a lucky break, as it can continue to battle in court and state legislatures with NCRG research on its side. And that leaves little room for other views of gambling addiction. "When research is being funded by the industry, through NCRG, there aren't many surprises," Lesieur says.
About the writer
Eliza Strickland is an online staff writer for Discover Magazine.
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