As a 9-year-old in Powell, Wyoming, Gary Knopp hustled pinball. In junior high, he spent his lunch breaks fleecing high school students at a nearby pool hall. As the years went by, he grew into an expert poker player. The only part of the game he never mastered was knowing when to walk away. "I was so compulsive, I never could quit when I was ahead," Knopp says. "I'd play until [my money] was gone."

Today, Knopp, 49, is the executive director of the Montana Council on Problem Gambling and a nationally certified gambling counselor. Although he hasn't gambled in years, the misery is still fresh in his mind.

In his former life, he made a decent living as an insurance salesman -- but all of his money ended up in other people's pockets. One day, he realized he was $350 short on his mortgage payment. Instead of antagonizing yet another creditor, he decided to take his bank account to the poker table. Before the night was over, he had lost everything, including an extra $300 that he'd borrowed that evening.

"I was panic-stricken," he says. "When you've exhausted all your resources and you've exhausted yourself mentally, you don't know whether to jump off a cliff or get some help."

As long as there's money to be won and lost, people will gamble. And as long as people gamble, some will go too far. According to the latest surveys, nearly 7 percent of American adults have had a gambling problem at some point in their lives, says Marc Potenza, MD, PhD, director of Yale University's Problem Gambling Clinic.

The surveys define "problem gambling" as any instance in which gambling disrupts a person's life. For many people, the disruption adds up to little more than a few arguments with a spouse or a temporarily anemic bank account. Others suffer something much closer to a debilitating illness. The most common term for this is "compulsive gambling." Psychiatrists also use the term "pathological gambling."

Either way, it describes gambling that's so out of control it has a profound impact on a person's well-being. Roughly 1 percent of Americans are considered to be compulsive or pathological gamblers. Without professional help, they'll put everything on the line. And, like Knopp, they'll play until it's gone.

Pathological gambling isn't a breakdown of morality or a sign of personal weakness. Like other addictions, it's rooted in brain chemistry. Ongoing research into the chemical imbalances behind gambling will undoubtedly open up new avenues for prevention, treatment, and recovery. Compared with drug addictions and alcoholism, however, an understanding of what causes gambling addictions is still decades behind the curve, according to the National Research Council.

Booming industry

While research on gambling has crept along, gambling opportunities have exploded. According to government statistics and the American Gaming Association, 37 states now allow casinos, bingo, or other games of chance, and 41 states allow lotteries. (Hawaii and Utah are holdouts.) The American Gaming Association reported that legalized gambling grossed $34 billion in 2007 alone, with a quarter of the US population visiting casinos.

In Knopp's current hometown of Billings, Montana, dozens of family restaurants have recently been converted to "casinos" offering video poker and keno machines. Perhaps not coincidentally, the town is also experiencing a boom in pawnshops and check-cashing services.

These days, a person doesn't even need to leave the house to gamble. Type "pathological gambling" (or "problem gambling" or "compulsive gambling") into an Internet search engine, and the first thing that pops up is a link to an online casino. You can simply enter your credit card number and start making bets. Before you know it, you're enjoying "Vegas-style action" -- complete with Vegas-style losses.

Many observers worry that the explosion in gambling will inevitably lead to an explosion in the number of gambling addictions. While such problems seem to have increased in recent years, it's hard to prove direct cause and effect, Potenza says. One thing's certain: For people who already have a gambling problem, all of those flashing "casino" Internet ads certainly aren't helping. "It's very much like any other addiction," he says. Just as an alcoholic may struggle not to drink during an office party, a problem gambler will have trouble ignoring the ever-growing opportunities to place a bet, he says.

Powerful pull

Knopp, for one, hardly notices the countless video poker and keno machines in his town. But he was never the type to sit in one spot and feed money into a machine. He was hooked on the action surrounding a poker table, and he still feels the pull. "If I look at a poker table, my stomach gets really fluttery," he says.

Of course, gaming machines have their own appeal. According to Potenza, such devices -- like video poker machines -- may be more addictive than any other type of gambling. They are especially likely to attract people looking for an escape. For people coping with anxiety, depression, or just plain boredom, a little time alone with a machine can be a release. It can also be a trap.

"You have to hand it to the people who make the machines," Knopp says. Players get just enough payouts to encourage them to keep betting, he says. Logic tells them that they can't beat the machines, but a big payday always seems just one more play away. "They start to chase their losses, and that's when things get really expensive," he says.

Knopp is especially concerned about the lure of Internet gambling. "It's horrifyingly scary," he says. "Anyone who is computer literate can go into his room and sit there until everything is gone." Even if Montana and other states suddenly outlawed casinos -- a move called for by several anti-gambling coalitions -- people could still lose their savings in cyberspace, he says.

Signs of trouble

In short, laws alone won't put an end to problem gambling. The disease has to be eradicated one person at a time. As with any addiction, recognizing the problem is the first step. To help people spot trouble, Gambler's Anonymous has come up with a list of 20 questions, including "Has gambling ever made your home life unhappy?" and "Did you ever borrow to finance your gambling?" (The complete questionnaire is available on the organization's Web site.)

Recognizing a gambling problem is important. Recognizing a case of pathological gambling can be a matter of life and death. A report in the Journal of the American Medical Association lists these important signs of a serious gambling disorder:

Getting help

Once a gambler recognizes the problem, it's time to get help. For some, this seemingly small step can be an arduous journey. Knopp first realized he had an addiction in his early 30s. Still, he waited several years to seek treatment. He found help in an unlikely place: One small ad in the classifieds. He called the number, met a counselor, and pulled his life together.

That's the short story, anyway. The long story includes many harrowing moments when his future remained in doubt. "The first day, I checked my watch at five, when the poker table opened. I checked it again and five seconds had passed. Then 10 seconds. Then 10 minutes. Eventually, it would be too late to go, and I'd feel relieved. It went on like that for about two weeks."

As gambling opportunities have expanded over the years, so have the resources for recovery. Many organizations and individual counselors offer group therapy, cognitive behavioral therapy, and other treatments proven to help with gambling problems. Today, anyone who needs help can simply pick up the Yellow Pages. He can also contact national organizations like Gambler's Anonymous or The National Council on Problem Gambling, Inc. (contact information is listed below.)

Gambling used to be Knopp's life. Now fighting it is his mission. Thanks to him and thousands of counselors like him, problem gamblers across the country are able to overcome their addictions. It takes hard work to beat the habit, but it's well worth the effort. The stakes are just too high.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was a staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.

Further Resources

Gambler's Anonymous

888/424-3577

http://www.gamblersanonymous.org

National Council on Problem Gambling, Inc.

202/547-9204

http://www.ncpgambling.org/

References

Last updated September 29, 2008
Copyright © 2002 Consumer Health Interactive