one last spin

Our present project is the production of a high-quality documentary about issues around gambling in the world today. A highly professional and experienced production team is currently engaged in research and planning. The film will centre around the gambling life of Martin Paterson who many of you will recognise as one of the most vocal campaigners demanding urgent and radical reforms to the gambling industry. We’ll also hear from other campaigners and people whose lives have been seriously affected by digital gambling devices. Adding their voices will be academics who specialise in gambling research. There is a new page on this site for the documentary, and we’ll be posting regular updates.

 

 

Addiction and Society

The worldwide misery caused by addiction is immense, striking millions of people. Not only the ‘addict’ but those close to them are devestated. In addition, there are huge economic costs to society and billion pounds costs from crime.

Also, beyond the identification of the most extreme forms of addiction, millions more are affected by less intense effects (including those on a ‘slippery slope’). For example, there is a tremendous toll on those who drink too much without being recognised as ‘addicts’. One unlucky bet from a regular gambler could result in financial ruin and its implications.

For those who seek recovery there are many sources of help (and it is worth remembering that many recover without intervention). Some succeed, some succeed partially, some die. In the wider social and political, medical and support spheres, ‘addiction’ continues to be a central focus of debate and research.

It is generally recognised that more needs to be done. There are insufficient facilities that provide recovery options. Mental health services often relegate ‘addiction’ to being of less than primary concern. In society at large, while things like smoking addiction are accepted as important, the many other killers are less thought about, or thought about very differently. Often, for instance, heroin addiction is thought by many to be associated with moral and character defects. A key right-wing philosophy puts all the emphasis on ‘individual responsibility’. It is, sadly, very common to hear people say things like, ‘It’s their own fault. Nobody made them drink, take drugs, gamble etc.’

Anybody who has made the barest inspection of addiction studies knows that the end result of addiction is the product of many factors. Some of these include:

• Individual susceptibility via genetics,  peer group behaviour, mental health, poverty, cultural capital, education.
• Availability of harmful products.
• Multiple and complex needs including the first group above, housing, unemployment, prison and crime, lack of family support.
• Normalisation by industry and culture as a whole of harmful behaviours.
• Lack of support services and lack of effective strategies for many people.
• Stigmatisation. This hangs like a dark cloud over all discussion. Even recovered addicts themselves, usually unaware of how fortunate they are not to have faced any of the difficulties mentioned above, have been known to ‘blame the addict’ (while promoting their own self-satisfied moral strength).
• Education has been recognised as an important factor in ameliorating future harms. Alcohol and gambling industries present themselves as concerned about that high percentage of people who are addicts (and from whom most of their profits come), supporting charities and research. They stress that their products are to be enjoyed as ‘fun’ (‘When the fun stops, stop’ is the gambling industry’s slogan). In educational institutions, there have been initiatives in recent years but these tend to be very patchy and under-evaluated: some amount to little more than a few lessons, or a lecture.
• Advertising, especially for football gambling, has come in for criticism and many argue that it should go the way of tobacco advertising. Promotion by famous paid sports personalities has also been criticised especially for its effect on young people.
• While the psychology of addiction is extremely complex, it is fairly simple to understand why so many people turn to drugs (and, remember, alcohol is a hard drug) to alleviate misery, to numb the pain. While it’s not surprising that this connection is found strongly in people who have the least going for them, it’s very important to remember that there are many varieties of psychic suffering, and addiction curses many high up on the social pecking order.
• There is an increasing worry that something in culture and society is causing a stark rise in unhappiness and mental health disorders. Such conditions are breeding grounds for addiction. Many people are ‘self-medicating’ to escape misery, depression and anxiety.

I’ve purposely included in the above some value judgments because these are, like stigma, very common within any discussion of addiction. If you believe that the scourge of addiction and its devestating effects on millions of people can best be addressed by emphasising the responsibility of individuals to change their ways, I’d only disagree 90%. There is, and should be, a role for personal responsibilty, powerless people have to be given that power. But along with that, and along with intense attention to recovery, we need to address as well as possible the factors which encourage addiction in the first place. It’s not one or the other, that would be silly. Neither is it rocket science. If society regulates our food and medicines, the air we breathe, health and safety, then we can ask whether the regulatory frameworks in place for alcohol and gambling are adequate.

It’s not a question of banning or being anti-industry or anti-anything. Regulation is not a very exciting word but it’s crucial. There is a growing movement, for instance, including police officers and politicians, to legalise and regulate street drugs. Such a policy has been found to lessen drugs harm in countries like Portugal. But that’s a different story, and mentioned here only to throw in an other factor to what should be an ongoing debate.

 

 

 

 

Response to DCMS Gambling 2017/18 Consultation

The following is from the response of The Machine Zone Community Interest Company‘s response in January 2018 to the Department of Culture, Media and Sports final consultation prior to decisions about FOBT stakes and othe rgambling related issues such as advertising.

 

For relative brevity, we here comment analytically on aspects of connected issues. A few representative sources of evidence are cited but it is assumed that previous consultation evidence is familiar.

While there has been a great deal of attention from many individuals and sectors to B2 machines, it is usually implicitly understood that Fixed Odds Betting Terminals cannot be seen in isolation but figure in complex relationships with the rest of the gambling and betting landscape. Whether terms of reference allow or not, the FOBT debate has become an ongoing discussion about gambling as a whole, particularly about all electronic gambling machines, digital devices and online gambling, gambling promotion, gambling harm, regulation and control versus business and personal freedom, and so on.

 

One important reason that FOBT gambling relates to the wider field is that many of the features of FOBT machines and their availability are common across gambling devices. We believe that much is to be learned from the research into FOBTs for applying to other areas. In any case, like many people with an interest in the issues, we implicitly identify FOBTs with concerning aspects of the present and developing gambling and betting industries.

 

EVIDENCE

 

The term ‘evidence-based’ when attached as a modifier to policy or practice has become part of the lexicon of academics, policy people, practitioners and even client groups. Yet such glib terms can obscure the sometimes only-limited role that evidence can, does, or even should, play.

http://www.ruru.ac.uk/pdf/Rhetoric%20to%20reality%20NF.pdf

While we recognise the crucial role of evidence, we see the term as problematic.

1. Evidence gathering includes access to data, and this is by no means complete.
2. It is unrealistic to expect many responding to the consultation to engage at a level deemed by terms of reference as ‘evidential’ or ‘analytic’. This raises the question of methodologies of evidence seeking, and more importantly, the basic assumptions, values, attitudes and orientations unerlying the evidence-seeking process. One aspect of this is that a hierarchy of evidence may pertain with quantative, statistical, academic discourses dominating rather than being part of the process. There is a lack of good qualitative research. Most concern about electronic gambling machines arises from user experiences yet this is perhaps written off as ‘merely’ anecdotal. This should be a prime research focus. Nancy Dow Schull who spent 13 years on site in Las Vegas looking at gambling behaviour and machine design argued that there is a need for in depth inte rviews etc to provide evidence impossible to collect quantitatively (Nancy Dow Schull, Addiction by Design: Machine Gambling in Las Vegas). We recognise necessary caution in looking at evidence from other cultures and environments but nevertheless beieve there is much to be learned, particularly from Australian research. In particular, to date there has been at best only very scant phenomenological/anthropological research at the sitse of gambling practice. Clearly there are many difficulties to such an approach, but this simply signals the possibility that research to date is far from complete in arriving at adequate understandings and much more needs to be done in the future.

 

3. With regard to the present enquiry/consultation, there is no agreed or well formulated definition of what counts as evidence. Who will analyse and interpret a wide range of submission based on ‘evidence’; what basis will such analysis and interpretation be taken upon, with what expertise, peer review, avoidance of preconceived ideas etc?

 

Often, calls for evidence in politics are rhetorical. Look out for calls for ‘robust evidence’ or ‘rigorous evidence’, phrases used by committees, indivudaul parliamentarians, interest groups, industry. As noted above, there will be different understandings of what sort of evidence is appropriate. This is not peculiar to the FOBT consultation process. For instance, many educational charities boast solid evidence bases, yet when they are examined, it is found that this conceals more than it reveals; in ‘gambling education’ in school aged students, the complexities are often ignored and the ‘evidence’ is spurious or based on very limited ambitions.

 

4. ‘Evidence based policy’ has become a government mantra in recent decades. It has also become a subject to be researched in academic and professional contexts, as well as internally in parliament. It is certainly not ‘transparent’ although claims based around it implicitly or explicitly attach unwarranted authority. Very many policies stemming from evidence based research and consultations have proved to be ingenuous, wrong and dangerous. We believe too, with the Goldsmith Fair Game (2013) report, that in any case, government policy is not decided by evidence alone.

 

 

5. Confusion around, and rhetorical usage of ‘evidence’, leads to competing narratives. For instance, from the BMJ:

http://jech.bmj.com/content/early/2017/09/29/jech-2017-209710

6. As with tobacco, the deleterious harmful effects of FOBT gambling were discovered not by academics but by human consequences. (It was insurance actuaries who made the links in the case of tobacco). There has been a countless number of individual stories of the dreadful consequences following use of electronic gambling machines. Since research is lacking, and since a great stigma around gambling addiction prevails so that the number of people ‘going public’ is small, we may legitimately assume that the actual human consequences are unseen across populations. Bankruptcy, mental health problems, relationship breakdown, suicide may be attributed to other factors than gambling to ‘protect’ reputation.

 

7. Underlying values led to liberalisation of gambling by the Labour government. Some of these values pertain today. These values include, partly, a dependence upon growth in the sector for tax revenues. There are also libertarian values around personal freedom, minimal state intervention, and light-touch regulation. Central to the values which generate policy and research is the commitment to business freedom.

We believe that the deleterious impact of modern gambling is a public health issue. We think that gambling should be treated every bit as stringently as alcohol, tobacco and illegal drugs. The underlying values of welfare and health protection need promotion. This will lead to a rearrangement of foci in evidence seeking.

 

 

 

 

CONTEXTS

 

1. The digital revolution has taken everyone by surprise. All aspects of society are affected. In every sector, adaptation and future orientation are challenging. In the case of the gambling and betting industries, adoption of digital products seems ‘ahead of the game’. This is coupled with legal and regulatory liberalisation, and associated responses from public, government, regulators, researchers and public health.

 

We are concerned that in examining the content and discourses of relevant political and regulatory bodies in terms of the current debate, responses and forward planning seem to be reactive. Further, there seems to be a dominant narrative of future monitoring, postponement of core policy and an expectation that the gambling and betting industries will develop as they will, and the preferred response is to take ‘action’ upon singular cases of excess (such as FOBTs).

We would prefer to hear a much stronger sounding set of policies and strategies for the future, which demonstrate awareness of, and set out proposals to tackle, the growing problems associated with gambling and betting.

 

2. While weight is properly given to business freedom, personal choice and responsibility and economic factors, the public health approach to problem gambling seems unduly relegated as of lesser importance.

 

3. It is probably the dominant narrative in public thinking that ‘addicts’ are responsible for their plight, and/or ‘addicts can/should receive treatment. Although the present process of consultation examines other factors such as machine design, convenience and accessibility, clustering, our analysis suggests that such factors do not presently receive sufficient attention, and that their is undue and unhelpful focus upon the ‘pathology’ of the individual.

 

4. The acronym RET (research, education and treatment) is frequently mentioned as a monolith, hence the acronym, and we understand this block signifies various important and potent approaches to minimising ‘problem gambling’. We say more about RET below, but point out here that the random lumping together of three highly important and distinct areas both minimises their importance by becoming a passing reference and acts to reinforce the diversion of attention from the contexts of machine design, promotion, marketing, convenience and accessibility, cross-industry corporatism etc.

 

5. There is a strong public distaste for the harms done by FOBTs. This has translated into an equally strong distaste for all gambling with the Gambling Commission reporting that 23% of the public believing it would be better if gambling were banned altogether. http://www.gamblingcommission.gov.uk/PDF/survey-data/Gambling-participation-in-2016-behaviour-awareness-and-attitudes.pdf

 

‘ADDICTION’

 

Sometimes called addiction, problem gambling, pathological gambling. An objection is that such terms summon up negative stereotypes. What is certainly true is that they delineate the individual subject. The player, gambler, person becomes the sole bearer of ‘something wrong’. As the Goldsmith Report (Fair Game, 2012) claims:

By categorising a small minority of people as

‘problem gamblers’, the state and the industry are

able to continue to promote gambling as a safe

and legitimate form of leisure and entertainment

for the ‘normal’ majority. Images of problem gamblers

in our data are many. They include those

labelled as losers, weirdos or simply those who

don’t gamble well, but most are flattened out and

decontextualised accounts of problematic people.

Industry’s views of problem gamblers, in particular,

are often deterministic and derogatory. They are

seen as people who are unable to control their behaviour.

Some described treatment as a waste of

money, and people with gambling problems as

‘problem people’.

Problem gamblers are problem people. They

are drug addicts, criminals, they are unable to

control their impulses and this is why it is impossible

and pointless trying to prevent them from harming themselves.

 

Much research, acknowledging this reservation, sees ‘addiction’ as occurring on a continuum. While the results of gambling may be severe for those with a problem, those around them and society at large, the compulsion to gamble is better seen in terms of strength so that an individual may at some times resist, at other times be overwhelmed. This is important because environmental cues obviously are key to eliciting responses, attenuating inhibitory power. A visual representation of ‘problem gambling’ such as that below suggests that there are largely ignored populations who are at great risk, and individuals who can move between levels.

Centre for Addiction and Mental Health, Toronto, 2005

 

We suggest that conceptualising gambling behaviour on such a spectrum alerts us more precisely to the scale of gambling harms with different intensities, and prevents us from imagining that ‘the problem’ is with a minority population of pathological gamblers.

Yet dominant narratives, certainly from the industry, continue to emphasise that levels of harm are very low, and that those who suffer are ‘ill’ (and would suffer whatever forms of gambling and betting are available). The percentage of the population cited as ‘pathogical gamblers’ hovers around 1% in the UK although this disguises variations. In Northern Ireland, for instace, the figure is quoted as 2.3%.

The industry and others say that these figures are stable over time. This suggests that many years of research, education and treatment have had little or no effect in tackling the ‘problem of problem gambling’.

More seriously, the figures quoted refer to the national adult populations. Yet:

 

           Industry apologists argue that no more that 1 or 2 percent of the population  meets the diagnostic criteria for pathological gambling, with perhaps 3 or 4   percent qualifying  for the less severe “problem gambling.” But, as Schüll points out, those figures are for the general population. “The percentage of  pathological and problem gamblers among the gambling population is a good  deal higher, and higher still among regular(or “repeat”) gamblers—20 percent, by some estimates.”

As the APPG’s consultations showed, there is much evidence that a very high number from this revised figure are characterised as multiply disdvantaged,  and betting companies appear to cluster their premises where the most vulnerable live.

 

PUBLIC HEALTH

 

Even if one accepted the 1% figure as meaningful, one has to factor in the number of people affected such as family, economic detriment and health service uptake. As a matter of fact, when some politicians and industry spokespeople talk of the economic implications (tax revenue, profits, employment etc) of curtialing gambling opportunities, these wider costs are often ignored. These factors are well rsearched (with accompanying differences of interpretation) and already figure in the consultation process.

It may, nevertheless, be instructive to compare ‘problem gambling’ rates with other mental health disorders, using the more conservative figures.

 

Problem gambling                             1-3%

Bipolar 1                                                1%

Schizophrenia                                     1.1%

Alcohol Dependence (England)      1.4%

 

 

We suggest that major mental health disorders are not all treated equally in terms of research, priority and treatment. The connotative weight of ‘addiction’ may play a part but it seems ironic that with so much focus on the ‘pathological individual’, research, the state, the industry, and health services offer much less attention and support to what is clearly a major health issue.

The move to make problem gambling a public health is issue is backed, of course, by the Royal Society for Public Health, may health professionals and researchers. The Royal College of Psychiatrists and the British Medical Association as organisations back the move as do countless doctors.

As a public health issue, prevention is seen as crucial to ameliorating gambling harm, and this health strategy involves the full cognisance of the harmful nature of gambling products such as electronic gambling machines. In a piece in The Lancet (January 2018), several researchers argued that

The harms of habitual and disordered gambling are many, and adversely affect   individuals, families, employers, and communities. While the development of  gambling disorder by players of electronic gambling machines (EGMs) involves   complex interactions between multiple factors (eg, decision-making processes,  availability of gambling outlets), there is growing recognition of the role of  machine design in the progression of the disorder.^1,2 We allege that EGMs are                            intentionally designed with carefully constructed design elements (structural characteristics) that modify fundamental aspects of human decision-making and  behaviours, such as classical and operant conditioning, cognitive biases, and dopamine signals.

In other words, the industry exploits human psychological attributes. They conclude:

As a public health issue where we witness threats to health and wellbeing through dangerous products, we expect the same attention to gambling as has been given to tobacco, alcohol and other industries. This entails strong curtailment of specifically identified dangerous products (here electronic gambling machines); the tackling of ‘normalisation’ that follows from promotions, advertising, opportunity and convenience; facilitating independent research with no financial input from industry, this to build on the growing body of research which is highlighting product design, industry strategies, etc.

Public health should not in any way be funded by industries which damage public health. John Catford draws attention to why:

 

Receiving alcohol and gambling funding is particularly compromising for health and social agencies, sport and fitness organisations, universities and research groups. The time has come for those values-based organizations that already have agreed not to accept funding from Big Tobacco to extend this to Big Booze and Big Bet. And for those who have not done so—to do the same.

1. compromise the objectivity and independence of the research and the maintenance of integrity and standards by creating a conflict of interest for researchers;
2. foster poor quality or compromised research which may then produce biased and erroneous results favourable to the interests of these industries;
3. create a dependence on this form of research funding which may then inhibit other independent research and inquiry;
4. reduce the ability of researchers to publish the outcomes of research in reputable, high-quality journals which may have policies which preclude industry-funded research;
5. restrict groups from receiving other funding from reputable funding bodies, which will then damage and restrict growth of research performance;
6. indicate to the public, professional groups, and government—by associating with these industries—that organization endorses the activities and products of these industries;
7. create a more favourable climate for these industries so that regulators will not need to enforce or further restrict the promotion of alcohol and gambling to youth and vulnerable people;
8. compromise the organization’s reputation, mission, core commitments and values.

https://academic.oup.com/heapro/article/27/3/307/754330/Battling-Big-Booze-and-Big-Bet-why-we-should-not

 

As with every aspect of the ‘debate’, however, framing ‘problem gambling’ as a public health issue can make for neat concepts but it is not straightforward and by no means guarantees a significant leap forward (and no more do monolithic concepts such as Research, Education and Treatment).

 

RESEARCH, EDUCATION AND TRAINING

 

 

 

As noted above ‘RET’ is often bundled into a convenient concept of its own, and often mentioned only in passing.

Or prime concern is that all three areas, each of which is crucial, are too frequently conceived in terms of ‘the pathological individual’.

This reinforces the diversion of attention from the impacts of machine design, environments, convenience and availability, targeting by industry of the mos vulnerable, promotion, marketing and advertising. The reliance upon funding from the gambling and betting industries is no more acceptable than research, education and treatment accepting funding from alcohol and tobacco industries.

There has been a solid output from concerned academics and professionals about how industry funding skews agenda for research. We would wish to see levies and some taxation from the industry ringfenced to contribute to totally independent research initiatives.

Treatment for gambling disorders is woeful, this exacerbated by funding cuts which impac on local authority comissioning services. A much deeper reason for treatment neglect is that, despite its evidentially manifested severity and prevalance, it simply does not figure highly in any government priorities. Ongoing debates about the paucity of mental health services are amplified in the case of gambling disorder.

Education includes campaigns comparable with other public health projects. There is limited evidence that ‘teaching’ players greater awareness about machine features, odds risk etc reduces harmful play in laboratory conditions. Very little evidence suggests that public education has any beneficial effect.

In schools and other educational institutions there is a very chequered history of drugs and alcohol education. These days, such education is seen as part of personal, social, health and economic education (PSHE) but this itself lacks national coherence and delivery. Research has shown what works best in such education. As importantly, it shows what is ineffective or counterproductive: alarmingly such latter education which includes scare tactics, lecturing, talks from ‘recovered’ addicts continues. In the case of gambling education, as in ‘treatment’, there is a low awareness of gambling. However, with state encouragement and initiative, coupled with developments in PSHE, we believe it possible and desirable to include gambling education in state funded education. In whatever case, educational initiatives relating to, or funded by, the industries are unacceptable because the powerful implicit message is that the gambling environment is a safe source of entertainment for the many and that it is the ‘few’ who already have problems who run into danger: as noted above, such messages, combined with that of ‘social responsibility’, may act as good PR for industry, but in any case contriutes to the continuing obfuscation about reality.

 

FUTURES

 

FOBT issues are well documented, but internet and app platforms are increasing access to gambling due to the exponential increase in smart phone and tablet computers across Wales. These technological changes are leading to change in social regulation of gambling as a public behaviour, as well as facilitating targeted and unregulated advertising to potentially vulnerable individuals. Trends indicate that these may include older adults and underage children.

An Investigation into the Social Impact of Problem Gambling in Wales (2017) https://pure.southwales.ac.uk/en/publications/an-investigation-of-the-social-impact-of-problem-gambling-in-wales(8b5df31f-4e41-4308-ad28-90617ba9d3ec).html

 

As we introduced our response, the digital environment has taken us by surprise. There are many opportunities and many dangers. The use of the word ‘exponential’ in the above quotation is precise. FOBTs are just one example of exponential digital gambling growth. Betting shops are beginning to install Self Service Betting Terminals, digital facilities which provide an ‘all in one experience’. Such terminals mirror the micro-environment of the digital phone, tablet or other device. In an increasingly promoted gambling environment, young people especially are at great risk.

Clamping down on FOBTs, reduing maximum stake to £2, adjusting machine designs such as removing ‘replay’ button, lengthening time between bets etc will be of benefit to some users; more importantly it will send out a strong message of intent about the dangers of digital gambling. This should be backed up with what are currently very inadequate areas of research, education and treatment.

There have been many things to learn from the FOBT debates, not least the need to be alert proactively to the future of digital gambling and the need for far more solid bases for regulation and harm prevention across the coming gambling industry’s products.

 

 

 

The Hidden ‘Hidden Addiction’

GAMBLING is called the ‘hidden addiction’ for several reasons. The main one is that you cannot ‘see’ it in the way that you can see a substance addiction, although even here it’s true that many functioning or highly functioning addicts will hide their state. Gambling addiction has a low public profile; there is generally more ignorance about ir than substance addictions. In service provision for helping those with severe gambling issues, there is little in the way of national strategy and provision, just one NHS clinic in the UK. GPs and probably most psychologists and psychiatrists lack experience of it. Only 5% of people with gambling problems seek help, only 1% receive it. These figures are much lower than, for instance, those for alcohol addiction.

Addiction is a mental health issue. Unfortunately, addiction is often made separate to mental health. Service providers talk about ‘mental health and addiction’ for example. This is despite the fact that the majority of people with addictions also have other mental health problems such as depression, bipolar, anxiety or a second addiction. In this confused state of affairs gambling addiction receives less than the attention it requires. A current statistic is that 0.7% of the polulation have severe gambling problems but in Northern Ireland and Wales the figure is higher. Add to this estimates of less severe but significant and ‘at risk’ gamblers and the figure rises to 5% of the population. Other mental health conditions are classed on scales of severity. Depression for instance is roughly mild, moderate or severe, though other ratings such as Beck’s identify four degrees.

Gathering data for epidemiology of addiction is notoriously difficult, and more so in the case of gambling addiction. While stigmatised heavily still, there is less stigma around substance addiction than gambling. Individuals are more reluctant to reveal a gambling addiction, and it is often harder to spot by those close to them. That is, of course, util the ‘rock bottom’ is reached in most cases. Some people will, though, modify gambling behaviour with lesser shocks.

All mental health problems can affect anybody in society, rich or poor, young or old, educated or not, male or female. However such a statement needs interpreting carefully. In public discourse we tend to hear most from the better educated, usually those with more material assets and cultural capital. It is well known that middle class people are better equipped to access scarce mental health resources. This, of course, is a generalisation and as such can never apply to individuals with unique life stories and contexts.

However, as in the the body politic as a whole, those most voiceless tend to be the more deprived in society. Deprivation can include material, educational and cultural capital. There are unquestionable demographic strata linking deprivation with mental health problems. While those we are likely to hear from most about the impact of gambling addiction provide vital testimonies, we need to be aware that many who suffer the results of gambling have little or no access to having their stories heard.

We are not surprised that bookmakers and their electronic gambling devices cluster in deprved areas. It’s important to recognise that the money lost to gambling by many is phenomenal given the mean disposable income available. Proportionally, like regressive taxation such as VAT, a loss of as little as £50 can lead to a spiral of debt, loss chasing and other negative consequences. It has been repeatedly pointed out the design of machines is responsible for gambling behaviours in those who can least afford to play. The proliferation of machines, not just in bookmakers, but in arcades, pubs and bingo halls, provide enticement to play fast and hard. Whether the stake is £2 or £30 or £100, the impact of any losses will be directly proportional to the circumstances of the player.

It’s true, of course, that as well as slots, similar dangers accrue to online casino-type games. Here, interestingly, research suggests that the heaviest player population is young professional classes. It’s early day sin data gathering but the take-up of online gambling opportunities seems more than likely to increase. With the normalisation of betting and gambling – and this includes not only advertisements on tv around sporting fixtures but lotteries from big charities – a major worry is about children’s behaviour in the future. May of them may already sitin a family setting when watching a football match and their father or sister may be more interested in the time of the first corner, or the score at half time rather than the game itself. In this, as most things, parental guidance and some educational input are important.

It is often pointed out that most people bet and gamble responsibly, which is true. The tension thus arises between regulatory practice and personal freedom (business freedom too).

It does seem, though, that some electronic gambling machines by their very design encourage dangerous gambling habits, firstly in those who already are vulnerable via pre-existing problems, and secondly by enticing new users who become ‘hooked’ on the experience. If ‘reponsible gambling’ is to mean anything, a good share of the responsibility must rest with those who provide the machines. No matter how low the stakes become, if the design does not change the money will keep pouring in from those who can least afford it, the voiceless and largely hidden population suffering the ‘hidden addiction’ affecting the populace as a whole.

 

Addiction and Personal Responsibility

OF ALL the many terrible attributes of addiction one which can be the most painful is being not understood and being blamed for one’s own misfortune. Stigma against all mental health problems abounds in our society. It can heap on an ill person the vicious taunts of those who state or imply that she or he is worthless, scum, a moral weakling, something unclean. Indeed an addict is weak but not in those ways. More weak in the way that anyone who is ill becomes weak. Bullies, of course, choose weak and vulnerable people as their targets.

Imagine giving someone with an alcohol problem a bottle of whiskey as a present. Then imagine that the person who drinks the stuff becomes very ill, maybe even dies. Then the fool who gave them the alcohol says in defence, “Well, they didn’t have to drink it. I didn’t make them. They could have given it to the local church as a prize in their raffle.”

It is unfeasible to think that substances like alcohol or other drugs will ever go away, and addiction is likely to always be a problem. But to deliberately and knowingly provide someone who is the vulnerable state of addiction with a product that is deadly to them, while not illegal, is morally reprehensible. The fact that you cannot stop the production and distribution of alcohol and other hard drugs does not remove your responsibility, your moral responsibility, to do whatever you can to limit access by those in danger. Any decent person would surely be appalled if just that was being done by high street business brands.

The very nature of addiction is that it robs a person, disowns them, of their power of responsibility. It literally embeds neural pathways which disrupt inhibition while enhancing compulsive excitation circuits. There are thousands of research studies about the nature of addiction, but those in recent years which use brain scanning are pointing more and more to precise neural substrates which are involved. Whether addiction is ’caused’ by social factors, adverse childhood experiences, culture, experiential learning, genetics or some combination of these is not the point: the result is the same.

While the good news is that many, probably the majority, of people with addiction can and do recover – often with no support from agencies or health providers – the fact is inescapable that people who are totally at any given time pierced by addiction are vulnerable to exploitation. To say that society should provide opportunities for individual recovery is a good thing. But it is a very bad thing for society to turn its back on the merest whiff of business or industry deliberately exploiting human misery. It is the responsibility of every citizen to fight such evils.

A Life Pervaded by Addiction: an interview with Joe

The common phrase ‘problem gambler’ is thrown about very casually as if the compulsive gambling behaviour that so many experience (about 5% of the UK polulation including the 0.7% of life threatening cases). Too often a person is defined as an ‘addict’ or a ‘problem’. People do have problems and addictions but to identify them buy labellig them only in these terms is dehumanising and wrong.

The way we all too often label people needs challenging. Hence we have anti-stigma campaigns. There are many such campaigns around mental health. People should not be labelled for many reasons: one is that it lessens or belittles them; another is that it isolates people by their being seen as ‘different’; a third is that negative labelling deters people from seeking help and support.

This interview with Joe reveals a life of suffering from compulsive gambling. Rather than facts and statistics, academic studies, medical discourses, we think it is essential and in many ways more powerful and relevant to listen to the unique, individual voices of people who face the danger of being boxed into a dehumanising label and stereotype.

What’s also brought out in this interview is that problem gambling involves far more than individuals who gamble. It includes the environment and culture. It also includes the design of gambling machines in our digital age – specifically, in Joe’s case, fixed odds betting terminals and online gambling.

How prevalent is addiction?

Following on from the previous post, our coffee discussion turned to the prevalence of addiction in the UK. We were both coming from a belief that it reveals an astonishingly large number of people in trouble. We believe it is a massive social problem that is not getting the attention it requires.

Later reflection considers the following:

• There is a problem understanding what may be referred to as addiction. There is a very large number of people whose addictions have resulted in actual or potential life ruin involving finance, employment, social status, relationship breakdowns, a range of severe physical and metal health problems, and death.
• However, there are many more cases where people are nearing these severe states. There are many whose drinking or other substance dependence are working slowly to take years off their lives. Nicotine addiction is an an obvious case. This applies to behavioural addictions such as gambling also, and statistics for these groups are hard to achieve if at all.
• Unknown numbers of people are addicted to over the counter painkillers or prescribed medicines. Unknown again is the number of people illegally ordering prescription only addictive medication online.
• There is a range of other addictions which are now taken seriously by researchers and treatment providers such as eating disorders, sex addiction and internet addictions.
• Many ‘normal’ behaviours share characteristically common features of addictions. Compulsive shopping, perfectionism, workaholism for instance have similar neural substrates to all addictions.
• A research paper has suggested that 47% of Americans are addicts in some sense.
• Statistics for all addictions taken together in the UK are hard to come by. Limited statistics are available separately, e.g. for alcohol, opiates, marijuana (usually treated as psychological dependence),  gambling, amphetamines, heroin, cocaine.
• It is extremely difficult to gather statistics. Since many addictions are to illegal substances and do not get reflected in medical interventions for instance, the true scale of actual addictions to a substance or behaviour can only be estimated.
• Nevertheless, what figures there are contribute to an understanding of the prevalence of addiction. 9% of men and 4% of women are dependent upon alcohol. In Scotland there are 50% higher rates. The Gambling Commission also reflects geographical variation:

• Such figures cannot disclose current trends nor the breakdown of specifics of for instance, types of alcohol behaviour, methods of gambling. As for gambling, since it is increasingly done at home using online technology, only sources such as publicised personal catastrophes, some suicides, treatment statistics are available. The stigma associated with addiction is that even many severe cases will be attributed to financial ruin or depression etc.
• For every addict at the extreme negative end of the spectrum, many more people will be affected, especially children and families. The problems of addiction therefore affect very large swathes of the population.
• Besides the immense personal costs and suffering, society as a whole spends many billions of pounds because of addiction. These costs relate to health, crime, lost productivity and the welfare bill.
• We aren’t remotely expert or knowledgeable but believe the true rate of addiction is extremely high. It needs much more urgent focus by policy makers across government services and within government, especially:

1. Researching and acknowledging the scale of the issue as a whole rather than by reference to particular addictions.
2. Identifying social, environmental, business contributions to addiction and curtailing them. For instance, prohibiting products designed to entice vulnerable people or induce people towards addictive behaviour, such as fixed odds betting terminals, advertising, online design; minimum unit pricing for alcohol.
3. Raising awareness among professionals and ancillaries; ensuring destigmatisation among support providers and workers.
4. Not allowing loss of government revenues to be used as an excuse to prevent public harm.
5. Acknowledge once and for all that addictions represent one of the nation’s main mental health disorders. Integrate metal health services, educate staff, resource much greater treatment provision.
6. Roll out public health promotion and advertising.
7. Rethink drugs policy. Seek best practices globally for decriminalisation or legalisation. Emphasise treatment over punishment.
8. Immediately produce policies and strategies to support the many people who suffer dual diagnosis disorders.

Addiction Musings (1) Introduction

We’re beginning a series of posts ‘musing’ about addiction. Musing rather than thinking too hard, as the subject is so vast and split into thousands of specialist research specialities. Not to metioned the all too often ignored experiences and ideas of people who have personal acquaintance with addictions.

Words – any words – can be highly misleading. The word ‘addiction’ does not refer to a thing that can be seen or otherwise sensed, weighed, measured. It is helpful to think of it as just a signpost to hundreds of different states which are often barely understood by addicts themselves or expert specialists. No one has, and no one ever will, come up with a unified ‘theory of addiction’ because unlike, for instance, things that can be weighed or measured or seen in a microscope, there are no tight borders around the term. Everything is blurred. In everyday life people talk about being ‘addicted’ to such-and-such a television series or type of biscuit. Such usage of the word belittles the suffering of  severe addiction states.

On the other hand, it is accepted as a fact that not only substance dependence but behaviours can be characterised medically as addictions. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition which is one of the main diagnostic manuals used by psychiatrists identifies ‘gambling disorder’ as a clear-cut case of addiction.

Increasingly mentioned in the media are things like ‘internet addiction’, ‘smartphone addiction’ and ‘social media addiction’. Serious research has yet to suggest whether these are ‘true’ addictions – but they certainly have many of the characteristics of addictions.

An interesting case of possible addiction relates to climbers for whom climbing is one of the most, if not the most, important part of their lives. They have reported ‘withdrawl symptoms’ of depression and anxiety if injury prevents their activity. It’s well known too, that many love exercise and the gym so much that they would feel bereft without them. Activities such as exercise and climbing are known to relese chemicals i the brain which produce a ‘feel good’ factor and in some cases, especially when combined with risk, a definite high or ‘buzz’.

On this site we mean by addiction a condition which involves compulsive activity over which an indidual feels they have little or no control, and which produces extremely negative consequences. Negative consequences involve physical and mental health, financial problems, relationship breakdowns and other serious problems – including, of course, death. In some cases, people suffering with addiction will be ‘in denial’ and not realise or admit the devestating consequences of their behaviour; equally, many are only too aware yet feel they cannot stop the compulsion. Invariably, the lives of those close to somebody suffering from addiction are seriously affected too.

More people than today used to talk of a ‘demon’ within, such as ‘the demon drink’. Interestingly, the word addiction in mediaeval times was used to describle priests’ giving themselves up to God. Addiction was a contract, and in Roman times a slave would be ‘addicted’ to a master. We still talk about being enslaved by addiction.

There is still a great deal of stigma around those suffering with addiction (and other mental health ailments too). It is seen by some uninformed people as a character weakness or a moral flaw. In reality addiction is a mental health condition that requires every bit as much understanding, research and treatment as, for instance, depression or anxiety.

In fact, depression and anxiety are often the primary disorders which lead people to ‘self medicate’ or take part in risky behaviours in an attempt to alleviate suffering: addiction may follow (and when it does it usually makes the original conditions worse).

Addiction can strike anybody irrespective of age, gender or social class. While it is true that some addictions correlate with factors such as deprivation, poverty and social exclusion, many addictions do not. There are plenty of teachers, police officers, doctors, nurses, politicians, judges who succumb to alcohol. Online gambling prevalence is highly correlated with middle class professionals. Away from ‘skid row’ stereotypes, thousands of ‘respectable’ people are becoming addicted to over the counter painkillers and prescription only drugs obtained illegally (mainly online).

Current research shows that 9% of men and 4% of women are physically dependent upon alcohol. That is a staggeringly high figure and it may well increase.

Addiction is not, then, something which happens to a few unfortunates or degenerates. It is almost certain that somebody reading this now is on the road to addiction if not already there. And it is completely certain that everybody knows someone suffering from addiction be it at home, at work, among friends. And for each of these people, many more will be suffering too – from their addiction.

 

Young Men and Gambling Problems

Good article in The Guardian. Click here to see full piece.

 

Men of my age often feel trapped between one group of people telling us to “man up” and another suggesting that our plight is less grave than that of others. Indeed, many will probably shrug when they learn that a new study suggests that a quarter of men between 18 and 24 have a gambling problem. Yet it does not take a genius to see a link between gambling and millennial males’ current place in society. We are a group lacking hope – and gambling is just one symptom.

My demographic is gambling for a number of reasons – some of them innocent – but economics and mental health are crucial. Of course, the cause of minority groups are generally more pressing than that of millennial men – we should not feel uneasy about asking not to be forgotten, while advocating other progressive issues. It is coherent to champion both.

Pioneering books such as The Pinch and Jilted Generation show that, generationally speaking, our prospects are being damaged by a toxic mix of debt, unemployment, demographic factors, globalisation and rising house prices. But as a gender, young males’ mental wellbeing is quietly in crisis. We can over-politicise gambling but, as it becomes increasingly normalised, it can appear an easy, supposedly masculine escape – one that’s advertised wall-to-wall during sport on TV.

Site Launch

Great to be able to offer the world our new site. It’s a very close look at Fixed Odds Betting Terminals. We see this as a case study for learning about politics, industry, psychology and much more. Plus, of course, there’s lots of controversial conflict around the machines that can be found in evry high street, and are often referred to as ‘the crack cocaine’ of gambling.