Gambling has been in the news this week, due to some controversies about the funding of its treatment. But how is gambling addictive, and what are the controversies with funding counselling? Mark Sainsbury and I talked about this on Radio Live this week. (Click here for audio of this weeks interview)
The recent changes to the Psychiatric “Bible” the DSM 5 have for the first time classified gambling as an addiction. But to really understand how gambling addiction works it’s important to understand the difference between low intensity gambling and high intensity gambling.
Intensity is defined by the length of time that elapses between when a bet is made, and the result. Lotto and raffle tickets for example, are low intensity: casino gaming and poker machines are high intensity, the result with pokies is almost instantaneous.
The other problem with gaming machines is that they are programmed and continually refined to be as engaging (or addictive) as possible. This is an economic reality, if you’re in the business of making money from gaming machines it’s important to maximise their efficiency.
Largely this is about manipulating the frequency of the wins: in behavioural language the “reinforcement schedule”. Manipulating how frequently and in what pattern the wins occur is the key to “engagement”.
Given all of this, and the damage that clinicians on the front line see as a result of problem gambling, it’s to be ethically expected that health clinicians would lobby to reduce the impact of unhealthy products. Think of it like heart surgeons and GP’s expressing concerns and lobbying government about smoking.
Unfortunately though, our Government and the Ministry of Health have decided that we are only paying for the ambulance (or the hearse) at the bottom of the cliff.
Tobacco and alcohol are taxed at point of sale with the health system generally picking up the tab for treatment and public education about it’s dangers, Gambling however is funded more directly via the gambling levy. This is paid by all licensed gambling providers to specifically fund treatment for problem gambling.
And that direct funding means gambling providers are going to have no interest in funding public education and lobbying; from a business perspective it’s like paying for negative advertising.
It’s also true in this interview the Associate Minister of Health Peter Dunne concedes that the Ministry are only going to pay people to provide treatment, not lobbying and activism, and that’s why the Problem Gambling Foundation lost it’s contract.
But you know what? Over the last five years gambling in New Zealand has decreased. The percentage of those that do gamble has remained the same, and largely on pokies and casino gaming. But overall, we’re gambling less.
I guess in the absence of the Problem Gambling Foundation’s ethical, and science driven concerns we’ll just have to see if that trend continues.
I wouldn’t put money on it.