As Joe S. Even as he began recovering from his heart disease, the illness that was still destroying his life, Mr. Research Money at Stake. Although Mr. And the answer will likely have major implications for research money into compulsive gambling and for employers and insurers that have resisted paying for intensive inpatient treatment.
Organizations like the American Psychiatric Association, Gamblers Anonymous and the National Council on Problem Gambling have adopted a medical explanation of problem gambling, some describing a physical high and withdrawal that for some bettors is similar to that experienced by drug addicts.
They say it is important that compulsive gambling be recognized as a legitimate disease, arguing that it will spur greater research into the addiction, improve care and treatment and improve the public's perceptions of compulsive gamblers, making it easier for many of them to seek help. She said that because gamblers often appear to be healthy and functioning, many people feel little sympathy for their plight.
Yet other researchers remain skeptical and argue that labeling problem gambling as an illness tends to excuse people who gamble excessively from being responsible for their behavior.
Despite the years of research on gambling, she said no one truly knows why some gamblers can't control themselves while the vast majority are able to. Abt said. She added that treating pathological gamblers could grow into a highly profitable industry if problem gambling was more generally recognized as a true addiction, particularly by health insurance companies that have been reluctant to pay for expensive inpatient care for gambling.
Similarly, Mitchell S. Rosenthal, president of Phoenix House, a national drug-treatment program, said there was a disturbing tendency today for people to excuse troublesome behaviors as a disease. Such questions are unsettling to many advocates for compulsive gamblers. Officials of Gambling Anonymous and the National Council on Problem Gambling note that since the Diagnostic and Statistical Manual of Mental Disorders, the field's widely accepted guide to mental disorders, has listed pathological gambling as an "impulse control disorder.
The manual, which is published by the American Psychiatric Association, states that pathological gambling is characterized as a "chronic and progressive failure to resist impluses to gamble, a gambling behavior that compromises, disrupts, or damages personal, family, or vocational pursuits.
The manual further describes pathological gambling in terms of its associated features like being overconfident or easily bored and notes that people often develop problems with drug abuse, suicide attempts and nonviolent crimes. Lesieur, an expert on compulsive gambling and chairman of the department of criminal justice for Illinois State University.
He said research has shown that pathological gamblers are more likely to go into trance states while gambling, and they are more prone to withdraw when they try to suddenly end their gambling. Many researchers, Dr. Lesieur said, have found that some compulsive gamblers have abnormally high levels of endorphins in the blood when they gamble, creating a sort of euphoria like that of a runner's.
And studies are being conducted to learn whether there is a genetic precondition to problem gambling, much like it is generally believed to exist for alcoholism. He acknowledged that many people view problem gambling as a bad habit, but said, "You can start out gambling as a bad habit, but there can come a point where the disease process sets in. Further complicating the picture for problem gamblers is the response they often get from health insurance companies when they submit claims for their treatment.
Donald R. Thoms, director of the Gamblers' Treatment Center of St. Vincent's North Richmond Community Mental Health Center on Staten Island said: "We are probably where alcoholism was in its development 15 to 20 years ago when treatment was struggling with insurance reimbursement.
Of his center's weekly caseload of 65 to 70 patients, about half have insurance that covers the cost of counseling, said Mr. Empire Blue Cross and Blue Shield, a major health insurance carrier, does not specifically cover complusive gambling, a company spokesman said. Other officials noted that while some insurers offer coverage for gambling treatment, many corporations that provide coverage for their employees do not extend the coverage, in an effort to control costs.
Richard Kunnes, chief operating officer of Aetna Life and Casualty, said that some insurers that do cover gambling treatment, including his, favor treatment on an outpatient basis, such as weekly sessions with gambling counselors. Some treatment centers have resorted to identifying their patients' gambling problems by their related ailments that insurers are more likely to recognize as diseases, said Betty George, executive director of the Minneapolis Council on Compulsive Gambling.
George said. The reason this is being done is so they will get paid for treating their clients. Experts say that from 1 to 3 percent of all adult Americans have gambling problems. And they say the numbers are increasing as more and more cities and states turn to legalized gaming, like lotteries and casinos, to fill yawning budget gaps.
People who describe themselves as problem gamblers say they find it hard to resist the allure of the action, of risking a bet and breathlessly hoping against the odds to win and then bet again and again. They often talk about losing homes, dashing careers and even becoming suicidal while chasing the gambler's high. For Joe S. As proof, he turned to his tortured memories of late That was the time he began his final plunge into what he now calls the "desperate stage" of his 30 years of gambling.
Convinced that he was dying despite his successful heart bypass operation, Mr. In 15 months, more than a million dollars passed through his stubby, working-class hands and into the clutches of illegal bookmakers, through the parimutuel windows of off-track betting parlors and horse racing tracks and into the bottomless coffers of Atlantic City and Las Vegas casinos.
All the while, Mr. In many cases, the impulse to wager becomes overwhelming and uncontrollable. And, he said, he would do almost anything, including embezzling from the payroll of the company in which he worked, to get the money to make the next bet.
In less than two years, Mr. After serving nine months of his sentence, he was released under a special program that requires him to remain under care for his pathological gambling, he said. Epstein, a gambling counselor at the John F. View on timesmachine. TimesMachine is an exclusive benefit for home delivery and digital subscribers. To preserve these articles as they originally appeared, The Times does not alter, edit or update them. Occasionally the digitization process introduces transcription errors or other problems; we are continuing to work to improve these archived versions.
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