1. Problem Gambling in Rhode Island: Who, What, Where and How Much? WITH Recommendations for Public Policy October 2, 2002 Bob Breen, Ph.D., NCGC Licensed Clinical Psychologist Director, Rhode Island Gambling Treatment Program Rhode Island Hospital, Dept of Psychiatry

2. Rhode Island Gambling Treatment Program (RIGTP) Located at RIH Psychiatric evaluation Individual psychotherapy for gamblers or family members. Family therapy. Educational Support Group Outreach

3. Part 1: Problem Gamblers Seeking Treatment in Rhode Island 2001-2002 Clinical and Demographic Characteristics

4. Demographics of 204 Problem Gamblers Seeking Treatment in Rhode Island Male: 54%, Female 46% Caucasian: 92% African American: 3% Hispanic: 2% Asian: 2% Other: 3% Average Income: $42,157

5. Age of 189 Rhode Island Problem Gamblers Average Age: 45.5 (17 - 74)

6. Age and Gender in RI Problem Gamblers (N=189)

7. Psychiatric Disorders in Rhode Island Problem Gamblers (%) (Total number of patients is 136)

8. Correcting a Common Misconception about Problem Gamblers Problem gamblers generally concentrate on one, and only one, primary form of gambling. This is contrary to the popular notion that a problem gambler will “bet on anything”.

9. What Type of Gambling is the Biggest Problem in RI? (treatment seeking)

10. Where RI Problem Gamblers Lost Their Money (Proportion of Losses in Previous 12 months)

11. Financial Damages In RI Problem Gamblers (RIGTP) Financial Damage includes: 1) Current, outstanding debt directly due to gambling (credit cards, personal loans, equity loans, etc..) PLUS: 2) Value of assets sold to directly finance gambling or pay gambling debts (E.G.: stocks and bonds, IRA’s, jewelry, even homes).

12. Financial Damages In RI Problem Gamblers ($1000’s)

13. Problem Gambling Severity in RI In the Previous 30 Days, Problem Gamblers had: Gambled on an average of 12 days Lost an average of $2,990.00 Average South Oaks Screen (SOGS) = 13.11 (range = 0 to 20, over “4” indicates pathological gambler) Average Gambling Severity Index (GSI) =0.69 (range = 0 to 1, with 1= maximum severity)

14. Is Treatment Effective? At the RIGTP (RIH) we follow-up all treatment seekers at 6-month intervals. Follow-ups are “blind” and are conducted by a trained, independent interviewer by telephone. Even treatment “drop-outs” and “refusers” are followed up. We now have follow-up data on 66 patients at 6-months, and 11patients at 12-months

15. Effectiveness of Therapy for Gamblers (6-to-12 months)

19. % Abstinence from Gambling (Prior 30 days at follow-up)

20. Part 2: VLT’s: Are they “Addiction Delivery Devices”?

21. Subjects 174 Problem Gamblers seeking treatment in RI 62 developed problems through “traditional” types of gambling, e.g.., cards, dice, horses & dogs, sports. 112 developed problems through electronic gambling machines (VLT’s).

22. Progression of Problem Gambling (cont.) The question: How long from initiation to full-fledged DSM-IV diagnosed pathological gambling?

23. Progression of Problem Gambling (cont) For VLT players it took an average of 1.27 years (15 months) to get from “social gambling” to pathological gambling. For “traditional” gamblers it took about 4.16 years. The amount of financial damage between the two groups isn’t different, meaning that the VLT players did the same financial damage in 1/4 the time.

24. Speed of Progression of Problems in RI Gamblers (years)

25. How Much of VLT Profits Come from Problem Gamblers? 1998: Nova Scotia Dept. of Health Survey –screened over 18,000 adults –16% of regular players were Problem Gamblers –Problem Gamblers accounted for 53% of VLT profits in Nova Scotia –Problem Gamblers play average of 189 minutes compared to 30-60 minutes for non-problem. –Problem Gamblers make up 48-58% of those playing the machines at any one time.

26. How Much of VLT Profits Come from Problem Gamblers? 1999- Australian National Productivity Commission Report –random stratified sampling –over 10,000 interviewed. –42% of VLT revenues were attributed to problem gamblers. –the average problem gambler lost 17 times more on VLT's than non-problem patrons

27. Responsible Gambling Software Is on the market and has been for some time. It can be easily loaded onto existing VLT’s Features: –players can set their own limits for losses, time, or credits –random time outs with messages, quizzes and information Features are OPTIONAL!

28. Game Planit Interactive Corp. Roger Horbay Ph.D., President Toronto, CA 519-846-1905 www.gameplanit.com

29. Summary and Recommendations

30. Current RI State Funding for Treatment ($millions)

31. Recommendations Moratorium on ANY expansion of gambling –no additional VLT’s –no new casinos Unless and Until: 1) Independent Regulatory Office is funded, appointed and empowered.

32. Recommendations (cont.) 2) Player tracking technology enabled. 3) Players must be registered. 4) Professional Mental Health Liaison on- site. 5) Responsible Gambling Software added to all VLT’s.

33. Recommendations (cont.) 6) no gambling by employees 7) mandatory open-door for on-site research. 8) Limit cash access. 9) Moratorium should continue until the above recommendations are implemented and the RESULTS EVALUATED - at least several years.