The following is an article I submitted to a substance use disorder (SUD) secular website. They chose not to print because the focus was not specific to SUD. As I have struggled recently to write a blog piece I am going to take the opportunity to print the article as I think it might add some background to why I write this blog and might be of interest from an educational perspective.
THE HIDDEN DISEASE, UNTIL…
Gambling Disorder (GD) has many similarities with Substance Use Disorders (SUD) Since 2013 GD has been categorized with SUD in the, Diagnostic and Statistical Manuel (DSM-V) as the only behavioral disorder in the grouping. The change was based on the body of research on GD as opposed to other behavioral disorders. GD had been recognized in the previous DSM under a different name as an Impulse Control Disorder. I am in recovery from both SUD and GD. My disorder of choice was gambling with a history of on an off gambling for over 40 of my 69 years on this earth. I used drugs for about 14 years with long-term abstinence from drugs. I write that history as I will juxtapose some of my story into the following.
Some similarities GD has with SUD include: tolerance, withdrawal, preoccupation, repeated attempts to control/cut back/stop use, negative consequences to family and societal systems (work, school, community, legal…), lying, isolation.
Why the “Hidden Disease” moniker? I have asked Police Officers if they ever stopped anyone under the influence of gambling. I get a few chuckles now and then which leads to my next question whether there is a statute on the books against driving under the influence of gambling. Of course there is not. I then share my personal experience of driving home in a snow storm after losing all my money in a state of shock. Along with shock I was at time experiencing suicidal ideation. I have many anecdotal stories from friends, clients, mutual aid members to add to the concern of people driving under the influence of gambling.
Why would I ask that of law enforcement if not only to get a chuckle? My hope is that in the context of a comprehensive introduction to the disorder I will add a level of awareness which would allow for a conversation to happen. The conversation might happen during a traffic stop. The conversation might happen during a domestic violence call. If law enforcement is aware of the disorder they can target their conversation and give out resources. Maybe intervene in a suicide situation.
Gambling Disorder is said to have the highest suicide rate among the disorders it is grouped in with. 20% suicide attempted or completed suicides and a 50% rate of suicidal ideation. It is an out loud secret among some gamblers that one way to
save your family some shame and to get your family insurance money is to have a one car accident. A sad example of driving under the influence.
Some of the differences between GD and SUD are stark. I’ve heard of, and think of, an 80/20 balance of similarities and differences. I think as individuals with cross-addictions, clinicians, sponsors, family members, employers…it is important to understand the 20% difference.
I started gambling at the age of 13. I went from a bright enough kid to being in the bottom quarter of my class. I quit school activities during my freshman year of high school. I am fairly certain if I was drinking and/or drugging I would have caught notice of some adult. I did not. When ESPN decided that poker was a sport a whole new cohort of gamblers was created. Professionals left their areas of expertise to play poker, to become a “professional”. Parents were thrilled their children were playing poker in the basement and not doing drugs/drinking. When their children started showing signs of addictive behavior they went out and got drug/alcohol testing devices. Their children would smile, say good idea, and take a test that they knew would not show their gambling even when the signs their parents were observing were part of an addictive cycle.
You cannot see it, smell it, test for it, it is hidden until it isn’t; at least in the normal observational ways we find our loved ones and friends being affected by the SUD. In adults it sometimes has the feel of infidelity. For those reasons, without knowledge of the disorder and ways to converse, GD can stay hidden longer than SUD.
Some of the other differences are: no threshold, magical thinking, it is possible to win at the end of the night, there are few regulations on losses with the possibility to lose generational money in any given outing, and no direct attributable medical events. An example of thresholds are the limits the body/brain has on the amount of drugs and/or alcohol that can be ingested in some form, such as, blood poisoning, psychotic breaks, directly attributable medical events. I have yet to meet someone going to buy drugs or liquor while wearing their lucky tattered t-shirt under a suit because they believe their drug of choice will be of better quality. Gamblers are a superstitious lot who will wear that t-shirt on every Tuesday of baseball season or bring a troll doll to place on a slot machine. They tend to believe in systems that are at best cognitive distortions and at worst their one last chance.
I will never diminish the devastation that drugs/alcohol wreaks on individuals, families, society including the financial costs. I have walked with, from in close and from afar, too many people on their journey to dying from drugs/alcohol. I say that as I am going to write about the devastation GD can have without some of the safeguards/regulations that SUD has and do not want to, I repeat, diminish the previously mentioned devastation.
You do not need to have a SUD or a GD to create life changing events in any given moment with drugs, alcohol, gambling. The above mentioned physical thresholds for SUD along with Dram Shop Laws and law enforcement patrolling the roads give some protections to individuals and society. There are no such regulations in the U.S. for gamblers. A gambler might commit many lies, lies of omission, crimes to place a bet. People are allowed to place a bet without any assessment of suitability or protection for families and friends. I have many ideas on point-of-sale protections for individual and families. Some include having an application process to gamble, financial and knowledge based suitability, and my favorite-spousal approval for any marital property put at risk. I want to make it as difficult as possible for someone to lose generational money in any given time period. And let’s remember for some that generational money is only a fantasy that they have been sold by manipulative marketing. What many people are losing is their rent money, their paychecks, their co-pays for their own or their children’s needed medication.
What to do if a GD, or some pre-clinical form of GD, exposes itself. My first exposure to treatment was a psychiatrist. I did not find recovery or stop gambling. That is not a judgment of the psychiatrist. I was still in a space between pre-contemplation (I do not have a problem you do) and contemplation (I might have a problem and maybe I will do something about it). When I found myself in a devastation stage I found Gamblers Anonymous (GA). Gamblers Anonymous was the third 12-step group formed. In Illinois 1-800-Gambler and Gamblers Anonymous are two first steps that can be taken. The 800 number will refer to treatment providers.
GA was founded by a member of AA who also had problems with his gambling. The second member was an atheist. Even though he left soon after the group started the steps were adapted mainly by removing God from some of the steps. God is not mentioned in Recovery Steps 3, 5, and 6 or in Unity Step (AA Tradition) 2. The other noticeable changes were to Recovery Steps 2 and 12. In Step 2 “sanity” was changed to “a normal of thinking and living”. In Step 12 “had a spiritual awakening as the result of these steps” was changed to “made an effort to practice these principles in all our affairs”. There is not an extensive institutional written history in GA as in AA. I have not been able to learn the history and thought process of the changes.
As opposed to the many secular opportunities for recovery from SUD until recently I had not known of specific opportunities for secular gambling recovery. I have friends that have had success in Smart Recovery. Along with some friends we have started a Secular Humanist Recovery Meeting for gamblers. We use the Alternative 12-Steps as our step guide. We incorporate the wisdom of humanity as we explore our recovery through a lens of secular humanism.
Brian Meister MS CADC ICPG-1 Smart Recovery Certificate, Due to my gambling, first as part of my addictive cycle where education was not important and then because of a career as a gambler (I was a broker in the options arena for three decades), I did not focus on my education. I received a BS at age 48, a MS at 60, and three different certificates at 65, 67, and 69. I spend much of my time in recovery groups (some that I started). I have a very small client base. I have worked in the field as a Gambling Counselor, a speaker on gambling related issues, and as a facilitator of trainings. I did most of that work at Nicasa Behavioral Health Services in Lake County Il. I plan on a journey of self-examination, service, fellowship, and family for whatever time I have left…