Center tackles pathological gambling

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Across my desk last week came the 2001 annual report of the National Center for Responsible Gaming. The report summarized the organization's activities last year toward promoting research and education on gambling-related disorders. An examination of this document reveals, once again, the continued commitment of both Indian casinos and the entire gaming industry to study compulsive gambling behavior and treat those afflicted with it.

Founded in 1996, NCRG is a non-profit group whose self-described mission is to "address pathological and youth gambling through research and public education." The group, based in Kansas City, Mo., has taken on a leading role in the still-emerging science of studying the behavior of pathological gamblers from a psychological and medical perspective.

Indeed, it was not until a 1997 study, funded by NCRG and undertaken by Harvard Medical School, that the prevalence of pathological gaming behavior, found to be exhibited by 1.1 percent of the population, was reliably estimated. None other than the National Academy of Sciences lauded this landmark study as the "best current estimates of pathological and problem gambling among the general U.S. population."

NCRG "boasts the largest number of funded grants devoted to gambling research of any organization, including the National Institute of Health," said Dr. Linda B. Cottler, professor of epidemiology [the study of cause, distribution and control of disease in populations] at the Washington University School of Medicine in St. Louis. "The NCRG should be commended for stepping up and taking responsibility for a large research effort that is unparalleled in any field in science today."

NRCG's bylaws stipulate that at least 50 percent of its directorship must come from outside the gaming industry. Indeed, the group's board is comprised of university-based researchers from the U.S. and Canada, legal and behavioral specialists and regulatory officials, in addition to representatives of several gaming equipment and casino operating companies. Phillip Martin, Chief of the Mississippi Band of Choctaw Indians, represents the Indian gaming sector on the board.

Donors to NCRG from Indian country include the Mississippi Choctaws, Pueblo of Acoma, the Mohegan Tribe, the Mashantucket Pequots and the Pueblo of Sandia.

One of NCRG's primary functions has been to fund studies at the Institute for Research on Pathological Gambling and Related Disorders, located at Harvard Medical School in Cambridge, Mass. Among several projects tackled in 2001, the Institute worked with Harvard's college alcohol study to investigate the gambling patterns and preferences of college students across the country. Data from this survey will be analyzed this year.

NCRG also collaborated with the Massachusetts Council on Compulsive Gambling to develop an intervention guidebook for problem gamblers "unlikely or unable to get professional treatment," and initiated a real-time study of compulsive gambling urges, in which participants record such compulsions as they happen rather than in retrospect.

The organization also seeks to fund investigations into gambling disorders by other individuals and groups. During 2001, some 60 proposals were received; of these four were selected for funding after a stringent review process. These new projects, all slated to occur this year, include a "focus on the genetics of gambling disorders, measures for studying treatment outcomes, and the prevalence and nature of gambling disorders among the elderly and schizophrenic patients."

"We are very proud to have supported cutting-edge research that will help us understand and treat gambling disorders," said Maj. Gen. Paul A. Harvey (Ret.), NCRG chairman, in a recent press release. "Furthermore, we are gratified that [some] of the most prestigious academic journals have confirmed the rigorous review process that we used to select these projects for funding."

NCRG-funded research projects during 2001 were varied and thorough; results were reported in such publications as the American and Canadian Journals of Public Health, the Journal of Gambling Studies and Seminars in Clinical Neuropsychiatry. Among these was a preliminary study of the drug naltrexone, which found that 75 percent of those taking the drug experienced reduced gambling urges. Researchers cautioned, however, that further study of this drug, already in use for treating alcohol and narcotics dependence, is necessary.

Another project, called "one of the most ground-breaking neuroscience studies funded by the NCRG," studied neural responses of gamblers using brain imaging. Researchers found that money, an "incentive unique to humans," produced brain activities similar to those associated with other non-financial awards. This study found that "dysfunction of neural mechanisms and psychological proceses crucial to adaptive decision making and behavior may contribute to a broad range of impulse disorders such as drug abuse and compulsive gambling." In other words, pathological gamblers may experience similar brain functions to those of alcoholics, drug addicts, and persons with other dependency-related and behavioral disorders; thus treatments for problems similar to these may help the problem gambler.

Yet another study discovered that there could be a genetic component to compulsive gambling behavior. Researchers discovered that "genes influencing a range of brain functions play an additive role as risk factors for pathological gambling." Thus, gambling addicts may be driven by genetics, at least in part.

While a great deal of this research may be over the heads of us laymen, the fact remains that NCRG has become an indispensable player in searching for the causes and prevalence of disordered gaming and treatments for those caught in the clutches of this affliction. The Center has laid the groundwork for further ground-breaking research in a field that has only recently come to the public's attention.

"Research from the NCRG has already helped to bring the study of pathological gambling into a new era of rigorous empiricism," said Dr. Ken Winters, associate professor of psychiatry at the University of Minnesota. "Its portfolio of funded projects is both deep and broad, encompassing epidemiology, measurement, etiology [the study of causes or origins] and treatment. The NCRG has been so impressive so quickly that perhaps its biggest challenge for the future will be to maintain the high standard of excellence to which we are accustomed."

NCRG's web site may be accessed at www.ncrg.org.