“Some of my patients refer to the casinos as ‘the club,’ as their form of the country club,” says Suzanne Graupner Pike, Ph.D., CEO/president of the San Diego Center for Pathological Gambling, where half her clients are older than 60. “The buses travel to the senior centers and pick these people up, give them a $10 coupon and free lunch, and take them to spend the whole day at the casino.”

Pike said older people who develop addictions tend to use gambling as a way to escape their everyday problems: loneliness, the loss of a spouse, the stressful demands of family. “The gambling sets up a smoke screen, so that the underlying issues don’t have to be dealt with,” says Pike, who has been treating problem gamblers since 1995.

Step One

Identifying Problem Gamblers Gamblers Anonymous says most compulsive gamblers will answer yes to at least seven of these questions.    1. Did you ever lose time from work or school because of gambling?  2. Has gambling ever made your home life unhappy?  3. Has gambling affected your reputation?  4. Have you ever felt remorse after gambling?  5. Did you ever gamble to get money with which to pay debts or otherwise solve financial difficulties?  6. Did gambling cause a decrease in your ambition or efficiency?  7. After losing, did you feel you must return as soon as possible and win back your losses?  8. After winning, did you have a strong urge to return and win more?  9. Have you often gambled until your last dollar was gone?  10. Did you ever borrow to finance your gambling?  11. Have you ever sold anything to finance gambling?  12. Were you reluctant to use “gambling money” for normal expenditures?  13. Did gambling make you careless of your own or your family’s welfare?  14. Did you ever gamble longer than you had planned?  15. Have you ever gambled to escape worry, trouble, boredom, or loneliness?  16. Have you ever committed, or considered committing, an illegal act to finance gambling?  17. Has gambling caused you to have difficulty in sleeping?  18. Do arguments, disappointments, or frustrations create within you an urge to gamble?  19. Did you ever have an urge to celebrate any good fortune by a few hours of gambling?  20. Have you ever considered self-destruction or suicide as a result of your gambling?

Getting seniors to admit they have a problem can be difficult because they prize self-sufficiency and are reluctant to give up control of their money. “There’s a great deal of shame because these are folks who have managed money all their lives, survived recessions, and are horrified that their adult children or the community will find out they fell into a gambling problem,” says Whyte, whose national problem gambling helpline fielded 255,000 calls last year.

Among Latinos, the issue of family embarrassment can stand in the way of treatment, says Shirley Beckett Mikell, director of certification and education for NAADAC, The Association for Addiction Professionals.

“It’s not accepted to share your secrets outside the family,” says Mikell, an addiction counselor for over 33 years who advocates more culturally sensitive approaches to treatment. “Once you start to explore your feelings and concerns with people who are not family members, you have created a sense of shame about the family.”

For this reason, group approaches such as Gamblers Anonymous—through which participants work to overcome their addictions by practicing the 12 steps adopted from Alcoholics Anonymous and by sharing details of their gambling activity—may not be as appealing to Latinos, says Mikell. Because shame within the family represents a greater barrier to treatment among Latinos than in the general population, says Mikell, involving family members in treatment is especially important. She recommends asking about the availability of family therapy and outpatient treatment (rather than inpatient treatment that separates patients from their families) in choosing a treatment provider.

Adds Pike: “The gambler starts having these thoughts—‘This is my lucky day, this is my lucky number,’” Pike says. “The gambler’s fallacy is that ‘If I continue to gamble, I will win it back.’ Because there has been a big win in every gambler’s past, and that has a tremendous effect on the brain.”
 
Negative emotions such as helplessness, guilt, shame, and anger can trigger the gambling urge, experts say. Problem gamblers cope with these emotions by attempting to replace them with the positive feelings that gambling generates in the brain. In the case of “escape” gamblers like my mom—those who favor slot machines and more solitary forms of gambling—the brain enters a trancelike state that allows the problems of everyday life to recede. “Action” gamblers prefer games such a poker or sports gambling, craving the adrenaline rush that comes from competition.

There Is Hope
The good news is that it’s possible to successfully treat gambling addiction with a combination of psychotherapy and medications or through 12-step programs based on Alcoholics Anonymous.

In therapy, psychologists work to “retrain” the brain by substituting other thoughts or activities when the urge to gamble arises. The UCLA Gambling Studies Program has published a self-help workbook for problem gamblers, asking its users to identify the positive and negative effects of gambling along with other pleasurable activities to replace the destructive activity. These activities can include listening to music, exercising, and engaging in other diversions that allow a person to ignore the gambling craving. Over time, the craving fades as the brain learns to find pleasure in other ways.

Recognizing the Clues Among Older Adults Mary-Ellen Siegel, co-author of Behind the 8-Ball: A Recovery Guide for Families of Gamblers, suggests keeping an eye out for these behaviors:  Gambling at the beginning of month, when Social Security and pension checks arrive  Lack of interest in family events or celebrations  Neglecting minor car or home repairs  Neglecting bills such as telephone, utilities, and rent  Lack of interest in old friendships  Secrecy or double talk about the extent of trips to casinos or bingo parlors  Assets disappearing (such as jewelry, heirlooms, or silverware)  Unaccounted time away from home  Unexplained moodiness, depression, preoccupations, stresses, or worries  Unwillingness to attend to basic personal care needs such as dental work

Medications aimed at easing depression, anxiety, and obsessive -compulsive behavior, in conjunction with psychotherapy, can also help control the urges, says Dennis McNeilly, associate professor of psychiatry at the University of Nebraska Medical Center and a specialist in the field.

One of the most widely available sources of help for problem gambling is Gamblers Anonymous, a fellowship with meetings (including some in Spanish) in all 50 U.S. states and 49 countries. Because of its pledge of anonymity, Gamblers Anonymous doesn’t track participation or success rates, but more than 1,000 meetings are held weekly worldwide and that number, says Karen H., GA’s international executive secretary, is “definitely growing.”