Treatment Options Scarce for Gamblers

By MATEA GOLD

Dec. 15, 1998 12 AM PT

TIMES STAFF WRITER

INDIANAPOLIS —

For the first time in years, maybe ever, a handful of gambling addicts are feeling lucky.

They’re not holed up in a casino or picking losers at the track. They’re living in the old psychiatric ward of an Indianapolis hospital, where some of the best minds in the compulsive gambling field have joined to create Trimeridian, an innovative residential treatment center.

The only thing the patients of Trimeridian are betting on these days is their future. Among them, a 38-year-old Cincinnati truck company worker named Bruce, who was squandering his money, marriage and mind on longshots.

“I understand now I have a disease, but suffering is optional,” he says during one therapy session at the new center. “I almost feel I’ve been exorcised.”

But millions of others remain possessed, because places like Trimeridian--created exclusively for problem gamblers--are in woefully short supply.

Although there are an estimated 4.4 million compulsive gamblers in the U.S.--and more venues than ever for them to play out their addiction--there is almost nowhere for them to seek shelter from the cyclone leveling their lives.

“I think the public at large sees someone with a gambling problem as a bad person, not a sick person. Someone who’s weak, not someone with a disorder,” says Joanna Franklin, executive vice president of the National Council on Problem Gambling. “This is a legitimate mental health concern. It costs the nation billions of dollars when these gamblers are not treated.”

Although there are about 10,000 treatment programs around the country for substance abusers, fewer than 150 centers minister to bettors. And just a few of those are geared solely for habitual gamblers, who medical experts say suffer physiological cravings similar to those of alcoholics and drug addicts.

Complicating matters, there are only about 1,000 therapists and counselors nationwide certified to provide gambling treatment, schooled in the unique nature of the addiction. Often, insurance companies don’t cover the costs of therapy.

“Compulsive gambling is where alcoholism was 40 years ago in terms of acceptance of the disease,” says I. Nelson Rose, an expert in gambling law and history who teaches at Whittier Law School in Costa Mesa.

The majority of compulsive gamblers are on their own, seeking help--when they choose to do so--mostly through Gamblers Anonymous meetings, which are sparsely available in some parts of the country.

Because the societal cost of compulsive gambling has yet to be fully explored, little public money has been committed to assist these addicts, whose numbers equal those of hard-core drug users.

The federal government, which finances a host of agencies to battle the drug problem, spends nothing on compulsive gambling. Fewer than half the states provide any money for treatment, education or prevention--about $18 million nationwide, a tiny fraction of the more than $18 billion states reap in gambling revenues.

“States which promote gambling and others benefiting from it have a responsibility for the casualties,” says Beverly Hills psychiatrist Richard J. Rosenthal, a compulsive gambling specialist.

In California, help outside Gamblers Anonymous is limited to half a dozen counselors certified in gambling therapy, and a six-bed treatment center in Orange County called Heartskober Manor. The state Council on Problem Gambling runs a 24-hour help line and counselor training program with about $75,000 in donations solicited from card clubs, racetracks and Indian casinos.

“We have zero funding from the state, cities or counties. Not a penny,” says state council President Tom Tucker. “It’s absurd. If there’s nowhere to get help and there’s no safety net, where do you go when you hit the bottom? What do you do?”

Industry Money, Potential Pitfalls

With so little attention and money directed toward compulsive gambling, the savvy casino industry has stepped in with cash, a strategy that some addiction experts worry could co-opt treatment professionals and soften the debate.

The National Council on Problem Gambling launched its national hotline with the help of a $100,000 grant from Harrah’s, one of the industry’s more progressive firms. About a third of the council’s annual budget now comes from casino interests, and its new executive director was formerly director of research for the American Gaming Assn., the industry’s lobbying arm.

Many of the National Council’s 33 state chapters also are underwritten by the industry. Some members say that, although they appreciate the help, the money has complicated their central mission: to dramatically broaden awareness of gambling’s lurking dangers.

The Nevada Council on Problem Gambling was once so poor it held meetings at a kitchen table and got its first answering machine when a member won it in a bowling tournament. Now, the council is headed by a former Golden Nugget executive and has a budget of nearly $225,000. Council directors include executives from the Bellagio, Boyd Gaming and the Tropicana casinos.

The money and personnel have enabled the Nevada group and others to train therapists, expand referral services and better advertise the assistance they provide. But some say the industry’s involvement also has had a chilling effect on the Nevada council’s more outspoken members.

During board meetings, for example, the presence of casino representatives has muted discussions about the definition of compulsive gambling, the rate of addiction and questionable industry marketing practices, some members contend.

Given the industry’s money and representation on the board, the council’s mental health faction does not always feel free to speak its mind, according to longtime member Ed Atchison. The casino interests, he says, “want to be careful how they describe problem gambling, how serious it is, how dangerous it is.”

The Illinois Council on Problem and Compulsive Gambling recently went so far as to reject casino money because of what it interpreted as interference and intimidation. Last year, the council was almost entirely financed by $160,000 from the state’s riverboat operators.

The controversy erupted after the council’s outspoken executive director, Christopher Anderson, publicly criticized the casino boats for being too liberal with credit and allowing hard-luck gamblers to dig themselves deeper into debt. He says the Illinois Casino Gaming Assn. promptly accused him of “biting the hand that feeds him.” Soon, he says, he was notified in writing that the council’s funding for the new year would be on a month-to-month basis, with a 10-day termination clause.

Outraged, Anderson says the council severed its casino ties, closed its offices to save money and moved into his living room.

“Everyone out there with casino money is obligated to stroke the casinos,” Anderson says. “To the extent that any of us accept dollars from the industry . . . without the expectation that there are strings attached, then we’re the fools.”

David Belding, president of the Illinois casino association, acknowledges that some members were upset with comments Anderson made to the media regarding suicides among riverboat bettors. But he denies any retaliation.

“That’s just not the case,” says Belding, senior vice president of Circus Circus, which runs the Grand Victoria riverboat in Elgin. He says the casino association decided to throw its financial support behind a private firm because it “was doing a better job of providing care.”

Offering Optimism at Trimeridian

To help fill the gaps in treatment, Indianapolis’ Trimeridian was born in October, fathered by successful health-care entrepreneur Douglas Stickney and hailed by many as a model for the future.

The idea came after a chance meeting in an Indianapolis restaurant with the wife of former football star Art Schlichter, a compulsive gambler who served time for passing bad checks to finance his habit. In tragic detail, Mitzi Schlichter told Stickney how gambling had shattered her family.

Seeing the humanitarian and financial potential of a program devoted exclusively to chronic gamblers, he enlisted some of the nation’s premier experts to lend their expertise and credibility.

They included Henry Lesieur, president of the Institute for Problem Gambling; Loreen Rugle, who headed a pioneering gambling treatment program at a Veterans Affairs medical center in Ohio; and Dr. Richard J. Rosenthal, a Beverly Hills psychiatrist who wrote the clinical criteria for diagnosing pathological gambling.

Together, Trimeridian’s team has 100 years of clinical experience--a remarkable wealth of knowledge in a field chronically understaffed.

Like the vast majority of substance abuse rehab centers, Trimeridian relies heavily on the 12-step approach created by Alcoholics Anonymous and adapted by recovery groups for other addictions. Adherents admit they are powerless over their disease and come to believe that a “higher power” can relieve their obsessions.

But Trimeridian’s experts concluded that many gamblers need a broader, more holistic approach to purge their deeply ingrained belief that wagering is the only salvation from debt and destruction.

The center charges $500 a day for treatment usually lasting up to two weeks. But Trimeridian officials say no one will be turned away because of inability to pay.

Patients at the 21-bed facility receive individual and group therapy as well as classes about compulsive gambling, cognitive thinking and spirituality. They discuss coping skills and financial planning and are taught how to channel the energy they spent on gambling into more productive and calming activities, such as tai chi and journal writing. Counselors work with family members to explain the illness and help them develop a plan for when the gambler goes home.

Trimeridian also uses an unusual art therapy exercise to force patients to come face-to-face with themselves. Using strips of plaster-soaked gauze, they make molds of their faces and then reflect on what they see.

A 53-year-old factory inspector named John says such penetrating exercises have so far saved him from slipping over the edge.

Hooked on barroom video poker for the last eight years, John lost so much money he had to declare bankruptcy and move in with his daughter and her family.

The losses swept over every facet of his life, including his relationship with his 12-year-old granddaughter. In the past, he would take her out for breakfast every Saturday morning. In recent months, however, he was waking up broke and depressed, too humiliated to face her. So he put off the outings, week after week.

In late October, a panic attack sent him to the emergency room, where staff referred him to the center, housed in Methodist Hospital in downtown Indianapolis.

“I tried to stop on my own,” John says. “Ain’t no way to do it. You’re just lying to yourself. . . . When you gamble, all you figure you’re losing is the money. But then you start realizing there’s more at stake. I had a heart attack, ulcers, a panic attack. That’s what gambling can do to you.”

One fall morning, John sits in a therapy session, about to participate in an exercise intended to show what compulsive gambling can--and probably will--do to you.

Leading the session is Trimeridian’s clinical services director, Rugle. She asks participants to take eight pieces of paper, writing on each one of the most important things in their lives. She tells them that, for the benefit of the exercise, she now is their higher power and they must do what she says.

For several minutes, the patients scribble in silence.

She then asks Bruce to share one of his writings.

“Giving back to others,” he says.

“OK, as your higher power, I have the ability to take that away,” she says, removing the paper from his hand. “You no longer can give back. How does that feel?”

Bruce shakes his head, frowning. He says he feels his recovery would be jeopardized if he cannot selflessly offer himself to others. He slumps in his chair.

“John,” she then says, “what’s on your list?”

Warily, he looks up.

“Visiting a sick sister,” he says.

“OK, I’m taking that away,” she says.

Gradually, Rugle takes all that is most meaningful in the men’s lives: their family members, their homes, their peace of mind. Although just an exercise, the losses feel real, too real, just as they did when the men were gambling.

Rugle turns again to John and holds out her hand for one of his last pieces of paper. He crumbles.

“It’s my granddaughter,” he says. “You can’t have her. You can’t have her, and I want the rest of them back too.”

He rocks in his chair, clutching the paper, crying. Bruce pats his shoulder. The room is silent but for John’s sobs.

“I know this is hard,” Rugle says. “I ask you to give it to me for now.”

Still crying, he slowly relinquishes the paper.

Rugle faces the patients.

“If you make gambling your higher power, as you have done in the past, this is what you lose. But today you are here in recovery.”

She then returns the papers, one at a time.

“Gambling is a very powerful false higher power, and it’s always waiting for you,” she says. “That means working on it every day. . . . With focus, you can have these things you value and cherish. But they can be taken away as easy as I did.”

John holds his papers tightly.

“These are mine,” he says, wiping his eyes. “It’s going to be hard to get them away from me again.”

Times staff writer David Ferrell contributed to this story.

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About This Series

For seven months, Times staff writers David Ferrell and Matea Gold traveled the country examining the phenomenal growth of legalized gambling and its profound social consequences. Their three-part series, “Going for Broke,” provides a revealing look at the gambling industry and at the tragic lives of some of those who help it thrive.

SUNDAY: Compulsive gambling is one of our most overlooked and troubling problems--a crisis, some would say. Millions of gambling junkies are suffering financial and familial ruin, costing society in the process.

MONDAY: With billions of dollars at stake, the gambling industry is determined not to duplicate the blunders of Big Tobacco in battling critics. To that end, Gambling Inc. is waging a multimillion-dollar war for the hearts--and money--of the public.

TODAY: Although compulsive gambling has been recognized as an illness, there is virtually no place for sufferers to seek help. Government funding for treatment is almost nonexistent, as are specialized recovery centers--except in downtown Indianapolis, where a new program is showing promise.

The entire series will be available today on The Times’ Web site at: https://www.latimes.com/gambling

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Where to Go for Help

For information about problem gambling and referral services:

California Council on Problem Gambling

121 South Palm Canyon Drive, Suite 202

Palm Springs, CA 92262

(760) 320-0234

24-hour help line: (800) GAMBLER, (800) 322-8748

Web site: https://www.calproblemgambling.org

e-mail: ca@ncpgambling.org

National Council on Problem Gambling