By the Rev. Andrew J. Weaver and Dr. Harold G. Koenig
UMNS Commentary

The marked increase in places and ways to gamble over the past 15 years has been accompanied by a more frequent addiction to gambling among older adults.

The faith community must be informed about the negative effects of such gambling.

Signs of gambling-related problems are not well known, nor does the general public understand that gambling can be addictive. We live in a society that spends more than $500 billion annually on some form of gambling - more than we spend on movies, sporting events, concerts and theater combined.

Pathological gambling is the diagnostic term for a gambling addiction. According to the American Psychiatric Association, it is "persistent and recurrent maladaptive gambling behavior" that continues despite adverse consequences that disrupt a person's life.

Approximately 2.5 million adults in North America (between 1.6 percent and 1.9 percent) suffer from pathological gambling, with an additional 5.3 million adults (3.9 percent) at risk for the disorder. By comparison, the rate of cocaine abuse or dependence is estimated at 0.2 percent.

In a survey of 343 adults ages 60 years and older attending senior centers and other community activities, 6.4 percent were classified as problem gamblers and an additional 3.8 percent as pathological gamblers.

Pathological and problem gambling among older adults has destructive consequences including stress, alcohol abuse, loss of income and assets and increased psychiatric problems.

Addicted older gamblers are much more likely than older adults without a history of gambling to have disorders associated with alcohol (53.2 percent versus 12.8 percent), nicotine (43.2 percent versus 8 percent), illicit drugs (4.6 percent versus 0.7 percent), mood (39.5 percent versus 11 percent), anxiety (34.5 percent versus 11.6 percent), and personality (43.0 percent versus 7.3 percent).

From activity to addiction

Like alcohol, gambling is a social activity for most people. For some older people who are widowed or live away from relatives, gamblers and the people who work in gambling establishments become their source of social support. Thus, gambling activities become part of a much larger social interaction that may meet deep psychological needs. However, it is devastatingly addictive for a significant minority.

Most compulsive gamblers say they seek the "high" of betting through increasing the amounts of money they wager. They tend to "chase" the losses of one day with increased betting on the next. Experts argue that gambling for some individuals is no less potent than heroin or cocaine and that gambling is the fastest growing addiction in the United States.

Access to organized gambling has exploded. In 1988, only two states had large-scale casino gambling; now 28 states have it. Forty states and the District of Columbia operate a lottery, and some form of gambling is legal in 48 states.

Advertisements for online gambling sites appear all over the Internet, and hundreds of Web sites offer online gambling for real money. Online bettors gamble at the rate of about $10 billion a year and that number is growing fast.

Religion protective factor

Researchers are finding that religious involvement can be a protective factor against problem gambling. In a nationwide sample of U.S. adults, religious attendance was inversely associated with the risk of problem gambling.

Sociologists at the University of Texas found results in a statewide survey suggesting that religious attendance and belief in the Bible are inversely associated with the frequency of playing the state lottery, as well as the amount of money spent on the lottery.

In two other studies, among individuals in Nevada and Australia, the frequency of gambling and the amount of money gambled was inversely related to the level of importance of religion for the person and the frequency of attendance at religious services.

Seeking treatment

Treatment of pathological gambling is often patterned after the treatment of alcohol and drug addictions. Like drug abusers, compulsive gamblers tend to deny the problem and avoid finding help.

Gamblers Anonymous, or GA, is a 12-step group that encourages members to admit their problem and gives group support to help participants gain control over their addiction. GA members recognize the loss of reality brought by compulsive gambling and confront their own distorted thinking.

Family members seeking group support can join Gam-Anon, which is modeled after Alanon.

Compulsive gamblers must stop living in the fantasy world of the addiction and confront the reality of the consequences of their gambling.

Cognitive and behavioral therapies can be used to reframe thinking patterns and change habits that promote gambling behavior. Patients are taught to identify and record situations that trigger the compulsion to gamble and recognize the distorted thinking that they can win against the odds. These treatments have been tested and shown to work.

Gambling is a real problem that has serious negative consequences for many elderly people. It is important that clergy and church members be informed about the dangers and how to offer guidance in finding help.

Weaver serves as a pastor and clinical psychologist living in New York City. Koenig is professor of psychiatry and associate professor of medicine, and co-director, Center for Spirituality, Theology and Health, Duke University Medical Center, Durham, N.C.