When the Stakes Turn Toxic

When the Stakes Turn Toxic

Anyone who’s bought a lottery ticket or played bingo has gambled. Gambling is any game of chance in which money changes hands. It’s common in most cultures around the world. Many people enjoy gambling as recreation without causing harm to themselves or others. Yet some people can’t control their impulse to gamble, even when it takes a terrible toll on their lives.         

For these gamblers and their families, researchers have been making progress in several areas. Scientists are learning why people have problems with gambling: how common it is, what goes on inside the gambler’s brain, which is at risk and what kinds of treatment can help.

Problem gambling is defined by some researchers as gambling that causes harm to the gambler or someone else, in spite of a desire to stop. Between 2% and 4% of Americans struggle with this condition. Problem gambling can progress to a recognized psychiatric diagnosis called pathological gambling.

Pathological gambling may affect from 0.4% to 2% of Americans. “Pathological gambling comes with a constellation of problems that contribute to chaos,” says Dr. Donald Black of the University of Iowa. “It’s associated with worse physical health, excessive smoking, excessive drinking, not exercising, not seeing primary care doctors and worse dental care. It also fuels depression, family dysfunction, crime, bankruptcy and suicide.”

Together, pathological and problem gambling may affect up to 5% of Americans. That number may rise, though. Laws in many states are creating more options for legal gambling, and internet gambling is becoming more common.

Still, gambling is often done in family settings, condoned or encouraged by parents. And the younger you start, the more likely you are to get into trouble later on. From 3% to 8% of adolescents have a problem with gambling.

Dr. John Welte of the University of Buffalo has found that, across the lifespan, gambling problems are even more common than alcohol dependence. They are also much more common in males, in young people, and in people who live in relatively poor neighborhoods. “That’s not true of the prevalence of alcoholism,” says Welte. “Alcoholism is much more democratic. So think about motives for gambling. People are hoping that winning will improve their lot. That makes them more vulnerable to developing a gambling problem.”

In a study of mostly African-American inner-city youth, Dr. Silvia Martins of Johns Hopkins University has found that about 15% have some form of problem gambling. Most at-risk were adolescents and young adults who began showing symptoms of depression at age 12. They were highly impulsive, although not hyperactive or aggressive. As the African-American boys developed into their teens and early adulthood, gambling appeared to be a separate risk factor for early fatherhood and criminal arrest.

“We are following up with these inner-city kids every single year as they enter adulthood,” says Martins.

But why is gambling irresistible to some folks and not others? Using advanced imaging techniques, Dr. Alexander Neumeister of Mount Sinai School of Medicine looked at the brains of people with gambling problems and alcohol problems. He measured the number of special receptors involved in regulating impulse control and other factors.          

“A key feature of addiction is impaired impulse control,” says Neumeister. “Abnormal function of the forebrain leads to reduced tolerance to waiting.” The resulting impatience may cause people to act without considering the consequences. “Our imaging clearly points toward the importance of impaired forebrain function in addiction.”

Pinpointing areas in the brain’s reward center, Neumeister’s team found that people with alcohol addiction and gambling problems show different functioning of these special receptors compared to healthy people. The differences were related to the severity of addiction. Other researchers are trying to develop drugs that could treat the affected areas.

Talk therapy can also help. Dr. Nancy Petry at the University of Connecticut Health Center works with pathological gamblers and people seeking treatment for drug use disorders. Gambling problems arise in about 10% to 20% of substance abusers. Petry compared the use of different types of talk therapy, including very brief interventions and cognitive-behavioral therapy CBT. CBT teaches people how to think differently about problems and then act on that knowledge.

“We found very brief interventions and CBT were effective in reducing gambling and gambling-related problems,” Petry says. “There was a significant improvement relative to usual care or standard forms of treatment like Gamblers Anonymous [a 12-step program].”

Anybody can have a gambling problem, and no one should feel ashamed or be afraid to seek treatment. “Pathological gambling is a medical disorder, not a sin or a vice,” says Dr. Carlos Blanco of Columbia University and the New York State Psychiatric Institute. “There is no stereotype. The main predictor of outcome is really motivation.”

In other words, what counts most is a strong drive or desire to take action. Blanco offers gamblers motivational interviewing, which helps them explore their mixed feelings about trying to quit gambling. This primes them to be ready and willing to begin CBT. Using both therapies together can be very effective.

If you have concerns about your gambling, ask for help. Your health provider can work with you to find the treatment that’s best for you.

Red Dog Poker

Red dog, also known as red dog poker or yablon, is a game of chance played with cards. It is a variation of acey-deucey or in-between. While found in some land casinos, its popularity has declined, although it is featured at many casinos online. Confusingly, there are other card-based games of chance by the same name that are unrelated to the rules described here.

The deck used to play red dog is the standard, fifty-two-card variety. The game may be played with anywhere from one to eight decks, with an increasing number of decks decreasing the house edge — the house's advantage begins at 3.155% with one deck, but falls to 2.751% when eight decks are used. This is in contrast with some other casino card games, such as blackjack, where a higher number of decks used will increase the house edge.

The game only uses three cards at a time, which are ranked as in poker, with aces high. Suit is irrelevant. A wager is placed, and two cards are placed face up on the table, with three possible outcomes:

If the cards are consecutive in number for example, a four and a five, or a jack and a queen, the hand is a push and the player's wager is returned.

If the two cards are of equal value, a third card is dealt. If the third card is of the same value, then the payout for the player is 11:1, otherwise the hand is a push.

If neither of the above is the case for example, a three and an eight, then a spread is announced which determines the payoff a 4-card spread, in this example, and a third card will be dealt. Before dealing the third card, the player has the option to double his bet. If the third card's value falls between the first two, the player will receive a payoff according to the spread; otherwise the bet is lost.

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Razz Poker

Seven Card Stud Low

Seven Card Stud Low (Razz) is played with a standard 52-card deck. Aces are low and straights and flushes have no effect on the low hand. The lowest five-card poker hand is Ace, 2, 3, 4, 5.

Each player is dealt two cards face down (hole cards) and one card face up. There is a round of betting (check, bet, call, raise, or fold). Each remaining player is dealt one card face up. There is a second round of betting. Each remaining player is dealt a second card face up. There is a third round of betting. Each remaining player is dealt a third card face up. There is a fourth round of betting. Each remaining player is dealt a final card face down (hole card). There is a fifth (final) round of betting. The player with the lowest five-card poker hand wins the pot. In the event of a tie, the pot is split equally.