Maybe there‘s a little addiction, disorder in all of us

Addiction and Recovery

By Bob Gaydos

   
Opioids and alcohol get most of the attention, although marijuana, currently undergoing a reputation rehabilitation, has been grabbing plenty of headlines lately. But if you spend any amount of time studying the issue, it doesn’t take long to wonder if there isn’t an addiction, compulsion, behavioral disorder — call it what you will — for every human on the planet.

    Some conditions are more serious than others, but all

either involve the brain’s reward system or relieve anxiety, stimulate compulsive use and bring with them an opportunity for negative consequences. Consider the following an inventory of sorts, a look at some of the substances people use or behaviors they engage in, perhaps to excess. Maybe someone you know shows some of the signs of trouble.

Medically recognized substance use disorders

    Alcohol Use Disorder: Alcohol is a depressant. Alcohol use disorder is more common among adult men than among women, but the gap is narrowing. It typically develops at a young age. Severe use is commonly referred to as alcoholism.

Caffeine Intoxication: Heavy intake of caffeine resulting in symptoms including restlessness, nervousness, insomnia, gastrointestinal disturbance, rambling thoughts and speech, cardiac rhythm disturbances.

Cannabis Use Disorder: Highest among 18- to29-year-olds. Often the first drug used and often used with other drugs. Prevalence decreases with age.

Hallucinogen Use Disorder: These substances alter perception. Phencyclidine — “angel dust” or PCP — produces feelings of separation of mind from body.

Inhalant Use Disorder: Sniffing glue. Inhalant substances are volatile hydrocarbons, toxic gases that are released from glues, fuels and paints, that can have psychoactive effects. Occurs primarily among ages 12 to 17.

Opioid Use Disorder: Opioid drugs include heroin and prescription pain-relievers such as oxycodone, codeine, morphine, and fentanyl. According to the American Society of Addiction Medicine, opioid-related overdoses are now the leading cause of death in Americans under 50 years of age and prescribed opioids are the “overwhelming initial source” of addiction.
    Sedative, Hypnotic, or Anxiolytic Use Disorder: Addiction to sleeping pills and anti-anxiety medications (Valium, Xanax, Librium). These are brain depressants. Rates are highest among 18- to 29-year-olds.
    Stimulant Use Disorder: This group include amphetamines, Ritalin and cocaine. These drugs are commonly prescribed for the treatment of attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. Cocaine use in the U.S. is highest among those aged 18 to 25.

Tobacco Use Disorder: Nicotine in tobacco acts as a stimulant for the central nervous system. Studies show that 68 percent of adult smokers want to quit and 50 percent of smokers have tried.

Behavioral disorders

Binge-eating disorder (overeating disorder): Uncontrolled eating, often accompanied by purging (bulimia).

Gambling disorder: Because of the quick feedback, it can provide reward symptoms to the brain much like alcohol or cocaine.

        Gaming disorder: It has been recognized officially by the World Health Organization, but is still under study in the United States for classification as an addictive behavior. Other behaviors under study include smartphone use, Internet gambling, pornography, eating and shopping.

Compulsive behaviors

        These can include such things as hoarding, shopping, sex, eating, gambling, exercise, even talking compulsively. While the behaviors may not provide the pleasure reward of an addiction, they serve to relieve anxiety and stress and, if unchecked, can have serious negative consequences in a person’s life.

What else to know

        Simply put, an addiction is a repetitive use of a substance or engagement in a behavior because of the rewards message the substance or behavior transmits to the brain, despite numerous negative consequences the activity produces in the person’s life. Tolerance increases with time. The person may not even be aware of the damage being done by the behavior, or may continue in spite of it. At some point, the substance or behavior may dominate the addicted person’s daily life. It is highly likely that these conditions are accompanied by other mental health conditions, such as anxiety or depression.

    Science has been unable to come up with one cause of addiction, nor can it predict who will become addicted. However, there are numerous risk factors that can be recognized, some of which may be avoidable, some not. Genetics/family history play a significant role in determining vulnerability as do environmental factors, including growing up in a dysfunctional family and early exposure to substances or abuse. The presence of other mental health issues can also contribute to susceptibility to addictive behavior. Even physiology may play a role since men seem to be more susceptible to addiction than women.

That said, there are a number of conditions that can predict the presence of an addiction. The following list is adapted from one used by the Mayo Clinic. Substitute the specific substance or behavior for the word “drug.”
    — Feeling that you have to use the drug regularly — daily or even several times a day.

— Having intense urges for the drug that block out any other thoughts.

— Over time, needing more of the drug to get the same effect.

— Taking larger amounts of the drug over a longer period of time than you intended.

— Making certain that you maintain a supply of the drug.
    — Spending money on the drug, even though you can't afford it.
    — Not meeting obligations and school, family or work responsibilities, or cutting back on social or recreational activities because of drug use.
    — Continuing to use the drug, even though you know it's causing problems in your life or causing you physical or psychological harm.
    — Doing things to get the drug that you normally wouldn't do, such as stealing.
    — Driving or engaging in other risky activities when you're under the influence of the drug.
    — Spending a good deal of time getting the drug, using the drug or recovering from the effects of the drug.
    — Failing in your attempts to stop using the drug.
    — Experiencing withdrawal symptoms when you attempt to stop taking the drug.

Generally, two or three symptoms suggest a mild disorder, four or five a moderate one and anything more, a severe disorder.

The good news is that there is a variety of treatment available for all these conditions. If a problem is suspected, don’t try to deal with it alone. Consult with a health professional (doctor, psychologist, social worker, addiction specialist) and begin the road to recovery.

The hidden disease: Addictive gambling

Addiction and Recovery

The hidden disease: Addictive gambling

By Bob Gaydos

It is estimated that about 9 million adults
 in the U.S. have a serious gambling problem.

Mary (not her real name) discovered gambling about 40 years ago when she started going to casinos with her husband. Last January, now a widow, she self-excluded herself from the Monticello Casino and Raceway (also known as the racino), near where she lives. She can be arrested if she tries to get in. She did this because, despite her Social Security check, her pension and half of her deceased husband’s pension, “I had no more money to write a check.”

Mary is a compulsive gambler.

Her story is not unique. Seniors, especially senior women, are major players at racinos. “It’s a social outlet,” she says. And a convenient way to gamble. Of course, her gambling addiction didn’t just materialize overnight after 40 years. There was bingo in addition to the casinos. And lots of lottery tickets. It finally became obvious. When her husband was alive, she explained, “He controlled the money.” Lonely, and without any restrictions, her gambling progressed.
“What really killed me,” she says, “is that I lost more than I won and still had to pay income tax.”

Joyce, who doesn’t mind using her real name, has been addicted to drugs for 35 years. “I didn’t realize I had a gambling problem,” she says. “I kept buying Lottery scratch-offs, hoping to get enough money to get more drugs. I stopped using drugs January 15. I realized in talking to Carol that I had a gambling problem, too.”

Carol Ingrassia is coordinator of the Bettor Choice program at the Catholic Charities Monticello Campus (formerly the Recovery Center). She is the only counselor with Catholic Charities, at all its campuses, currently credentialed to deal with addictive grambling.

Jeff Skaar, director of operations at the Monticello campus, says five staff members are enrolled in credentialing classes at SUNY Orange, with five more to follow, so there will be trained gambling counselors at each Catholic Charities location. The state requires credentials as an Alcohol and Substance Abuse Counselor (CASAC) to add a G for gambling to the title.

This effort to add trained gambling counselors to the staff is a response to the much-anticipated opening of a casino in Sullivan County. But the Bettor Choice program, which Mary and Joyce utilize, has been around for 10 years. In that time, the state has added more Lottery games (the number one problem with problem gamblers), Quickdraw has become a staple in bars and diners and sports gambling has become increasingly popular. OTB has had its heyday.

With all that enticement to gamble, one might think there would already be a good supply of gambling counselors, but Skaar says, “Gambling counseling didn’t take off like the state anticipated, so it cut the funding.” But it kept adding Lottery games and now has approved five new casinos. “We’re hoping,” Skaar says, “that the state will recognize its role in providing local services near local gambling sites,” That’s key, he said, because, while people will travel to casinos from everywhere, services for problem gamblers won’t be available everywhere.

The Bettor Choice program currently has 10 clients. They have weekly individual meetings and one group meeting, as well as lectures. Mary heard about the program in a talk at a local health fair, part of Catholic Charities’ public outreach to let people know what help is available. She said the program worked for a while, then she went on vacation and gambled again. That prompted her to ban herself from the Racino and reacquaint herself with Bettor Choice.

Joyce, 55, is from Newburgh. She is in residential treatment in Monticello for her drug addiction, a three-to-six-month program. “Gambling is a trigger for my drug addiction,” she says. Such co-existing addictions are not uncommon. In addition to learning the triggers for their gambling, participants learn tools to help them adjust their behavior. For example, Joyce says, “Don’t carry money. Or, walk with friends to go past stores selling lottery tickets.” These are especially key at the beginning of recovery. Mary has had to find other activities with friends and at church to fill her time.

Catholic Charities gives a gambling screening test to all persons who come to its residential treatment center. “Lots of people who come to rehab are reluctant to admit to a gambling addiction,” Ingrassia says. “There’s a hierarchy of addictions. The legal ones -- alcohol and gambling -- are at the bottom. Addicts are less likely to admit to them.”

In fact, gambling is referred to as the “hidden addiction.” It’s legal. People like it. No one wants to admit he or she can’t handle their money. Compulsive gamblers tend to look down on people with other addictions, even though the damage they cause can be catastrophic to those close to them.

“It’s an immediate rush,” Skaar says. Even when they lose, “they feel there is one thing that will save them and the one thing is money. In gambling, there’s the belief that I’m going to get even and my troubles will be gone.”

The reality is that, too often, money doesn’t save them and, instead of their problems being gone, their family and their family’s money are.

Unfortunately, the “hidden addiction” also has a not-so-easy-to-find solution. Skaar says he has met with the people who run the Racino to let them know the Bettor Choice program exists. The state has a hotline that appears on every lottery ticket (Look hard; you’ll find it) and is included in every Lottery commercial. It’s also on every machine at the Racino. Still, Skaar hopes the state will do more, notably make facilities available statewide to help problem gamblers.

“People suffer in silence,” Ingrassia says. “Their bottom is lack of money.” She adds, “There’s a very high suicide rate among problem gamblers.”

Bob Gaydos is a freelance writer and editor. rjgaydos@gmail.com

FYI

-- Definition. Those who study and classify such behavior use the terms: Problem gambling; Compulsive gambling; Pathological gambling; Gambling disorder; and Gambling addiction. It’s all a matter of degree and whom you ask.

-- The National Council on Problem Gambling estimates that 2 to 3 percent of adults in the United States (about 9 million people) have serious problems with gambling. Another 3 million meet the criteria for “pathological” or “compulsive” gambling.

-- 48 states have some form of legalized gambling; 43 states have lotteries.

-- Catholic Charities (Recovery Center): 845-794-8080.

-- Gamblers Anonymous: Ingrassia says the 12-Step group has had difficulty keeping a meeting going in Sullivan County. The only meeting in the immediate area is at Vails Gate 4 Corners (next to the Firehouse). Mondays, from 7 to 9 p.m.

-- Gamblers Anonymous info: www.newyorkga.org;

or (855) 222-5542

-- New York State Hopeline: 1-877-8-HOPENY; for help with gambling and substance abuse problems. Under the auspices of the State Office of Alcohol and Substance Abuse Services: https://www.oasas.ny.gov/Gambling/index.cfm

-- New York Council on Problem Gambling: http://nyproblemgambling.org/.

Gamblers Anonymous 20 questions

---

1.	Did you ever lose time from work or school due to gambling?	Yes	No
2.	Has gambling ever made your home life unhappy?	Yes	No
3.	Did gambling affect your reputation?	Yes	No
4.	Have you ever felt remorse after gambling?	Yes	No
5.	Did you ever gamble to get money with which to pay debts or otherwise solve financial difficulties?	Yes	No
6.	Did gambling cause a decrease in your ambition or efficiency?	Yes	No
7.	After losing did you feel you must return as soon as possible and win back your losses?	Yes	No
8.	After a win did you have a strong urge to return and win more?	Yes	No
9.	Did you often gamble until your last dollar was gone?	Yes	No
10.	Did you ever borrow to finance your gambling?	Yes	No
11.	Have you ever sold anything to finance gambling?	Yes	No
12.	Were you reluctant to use "gambling money" for normal expenditures?	Yes	No
13.	Did gambling make you careless of the welfare of yourself or your family?	Yes	No
14.	Did you ever gamble longer than you had planned?	Yes	No
15.	Have you ever gambled to escape worry, trouble, boredom, loneliness, grief or loss?	Yes	No
16.	Have you ever committed, or considered committing, an illegal act to finance gambling?	Yes	No
17.	Did gambling cause you to have difficulty in sleeping?	Yes	No
18.	Do arguments, disappointments or frustrations create within you an urge to gamble?	Yes	No
19.	Did you ever have an urge to celebrate any good fortune by a few hours of gambling?	Yes	No
20.	Have you ever considered self-destruction or suicide as a result of your gambling?	Yes	No

According to GA, most compulsive gamblers will answer 'yes' to at least 7 of these questions.

bobgaydos.blogspot.com

Gambling: The 'Hidden Addiction'

By Bob Gaydos

They call it “the hidden addiction.” There’s no physical sign of it. Nothing is ingested. You can’t overdose on it. People with the problem can often go a long time before anyone close to them becomes aware of it. By then, it is often too late to prevent the devastating consequences.

Problem gambling leads to stealing, loan sharking, suicide, domestic abuse, homicide. It destroys families, leaving loved ones feeling shocked and bewildered, not to mention angry and betrayed. Homes, businesses, jobs, savings, relationships all disappear as the compulsive gambler drags those most important to him or her down the desperate path to getting even.

We don’t hear much about that aspect of gambling these days, what with virtually every state trying to figure out a way to balance its budget by allowing more ways for people to gamble legally. Indeed, as opportunities to gamble have increased in New York, with racinos and seemingly a new lottery game every week, and as politicians talk about allowing more full-fledged casinos, the funding for education, prevention and treatment of problem gambling in the state has been slashed to a lip-service level.

According to the New York Council on Problem Gambling, a not-for-profit independent corporation dedicated to increasing public awareness about the problem and advocating for support services, New York allots about $1 million for the effort. The state agency responsible for dealing with compulsive gambling, the Office of Alcoholism and Substance Abuse Services, states on its web site, “Roughly one million New Yorkers are dealing with problem gambling.” So that’s about a dollar per problem gambler, the price of a scratch-off ticket. Your odds of success are better buying the ticket.

Still, there is help available. Sullivan County, in the Catskill Mounains, is one of only 15 in New York that have a facility offering an outpatient treatment program for problem gambling. The Recovery Center in Monticello primarily treats alcohol and substance abuse issues (as do the other 14), but it also has five certified alcoholism and substance abuse counselors trained to help problem gamblers and their families.

Izetta Briggs-Bollings, CEO of the Recovery Center, also supervises its gambling treatment program. She notes that while gambling games have become ever more seductive, “to keep you coming back,” a similar effort has not been made to make casinos more accountable for protecting their customers from their worst instincts, the way bars are expected to recognize and stop customers who have had too much to drink. She’d also like to see the state devote a penny out of every dollar raised through legal gambling to the education and treatment of problem gambling.

E., who lives in Sullivan County, is among those who have sought help for her gambling compulsion at the Recovery Center. Her problem started at the racino in Monticello, she says, but “it didn’t stop.”

“There were stresses in my life,” she says, “but when I’m there, they disappear. There’s excitement going in, pain going out.” At some point, though, she decided, “I wanted to live, to look my mother in the eye again.”

Shame is one of the primary stumbling blocks to compulsive gamblers seeking help. E. says she knew she could get help at the Recovery Center. “There’s a stigma attached to it,” she says. “A lot of gamblers say they won’t go into the Recovery Center for treatment ‘with those addicts’.” Today, she’s glad she’s not one of those gamblers.

The center offers an outpatient program -- “The “Bettor” Choice Program -- with individual counseling, group counseling and family counseling. Carol Gillespie, the counselor who runs the group, says it has 10 members, about half of whom have another addiction, which is not uncommon. She says most people who come for help, prefer individual treatment over group, again, because of shame.

The center has tried, with little success, to keep a Gamblers Anonymous meeting going. Shame, again. Problem gamblers don’t want to be seen going into a center that treats addicts (who, ironically, do not have similar reservations), even though the meeting has been held in an adjoining building. Gillespie says she is willing to help anyone trying to start a Gamblers Anonymous meeting, anywhere in the area, so gamblers can receive the support others receive in 12-step programs.

“In the big picture,” says Robert DeYoung, clinical coordinator and addiction specialist, “education, treatment and prevention saves millions.” Such efforts are often targeted at young people, for obvious reasons. But DeYoung says, “I don’t think people realize how many senior citizens gamble.”

“Gambling is like an affair,” he says, “and the lover steals all the money.” And the gambler’s family often finds out too late because the gambler hides the problem by controlling the money -- taking care of bank accounts and investments, credit cards, paying the bills, taking care of the mail. Like the alcoholic hides the booze, the problem gambler hides the money, desperately seeking to “manage” a life wholly out of control.

* * *

Gambling facts and figures

• 5 percent of adults, 18 and older, have a gambling problem
• Adult males are three times as likely as adult females to have a problem
• Adolescent males are four times as likely as females to have a problem
• Most frequent problem areas for adults: lotteries, sports betting, cards
• 20 percent of adolescents are at risk for or have a gambling problem
• 22 of the state’s 62 counties have a problem gambling treatment program
• New York is the only state without dedicated funds from the gambling industry for problem gambling services

New York Council on Problem Gambling

Where to find help

• For treatment, information, or to set up a Gamblers Anonymous group: The Recovery Center: 845-794-8080, Ext. 191; the center is located at 396 Broadway, Monticello.
• For information from OASAS: 1-877-8-HOPENY, 24 hours a day, seven days a week
• For Gamblers Anonymous meetings: gamblersanonymous.org.

bobgaydos.blogspot.com or rjgaydos@gmail.com