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Liz Benston

Problem Gambling Researchers Garner Awards

1 December 2004

A psychologist in Australia who has identified different types of compulsive gamblers and a Rhode Island psychiatrist who has studied how gambling addicts respond to drug treatment have received top honors from a casino industry-funded research center.

Alex Blaszczynski, director of the Gambling Research Unit at the University of Sydney and head of medical psychology at Westmead Hospital in Sydney, has received the Senior Investigator Award from the The National Center for Responsible Gaming in Washington, D.C. Jon Grant, an assistant professor of psychiatry and human behavior at Brown University's Medical School and chief of impulse control disorders at Butler Hospital in Providence, R.I., has received the Young Investigator Award.

The recipients of the third annual Scientific Achievement Awards were selected by an independent committee of researchers and other experts working in the field of gambling addiction studies.

Boyd Gaming Corp. of Las Vegas made a 10-year pledge of $875,000 in 1996 to kick start the National Center for Responsible Gaming, which has so far raised more than $13 million from casinos and other individuals and issued more than $8 million in grants to fund research on compulsive gambling. In 2000, the center established the Institute for Research on Pathological Gambling and Related Disorders at Harvard Medical School's Division on Addictions.

The awards are aimed at raising public awareness for the relatively young but growing field of problem gambling research, said Christine Reilly, executive director of the Institute for Research on Pathological Gaming and Related Disorders.

"There's not a lot of attention paid to gambling research to begin with," Reilly said. "This lets the public know the field of gambling studies is emerging and that there are some really terrific people working in the field."

Nearly one third of all research on pathological gambling has been published since 1999, she said. "There's been an explosion of research in this area but it's still nowhere near the research that's available on alcohol abuse, a field that's much older."

Blaszczynski's research has spanned a variety of topics and has changed how people approach problem gambling, Reilly said. Grant has made a difference in treating patients, which is all the more impressive given that he is only 40 years old, she said. The Senior Investigator Award carries a $5,000 cash prize and the Young Investigator receives $2,500.

"It's difficult for people who are senior to switch gears if they've been (studying) substance abuse," for example, Reilly said. "This field is not going to thrive unless we have a lot of young researchers."

Grant, who treats hundreds of gambling addicts each year, co-authored a 2001 study that was the first to assess the results of treating compulsive gamblers using a variety of different medications. He published a similar review of drug treatment methods in 2002.

The studies concluded that the drug naltrexone appeared to be the most effective treatment for the majority of gambling addicts.

Naltrexone is approved by the Food and Drug Administration to treat alcoholism and drug abuse but isn't widely prescribed, Grant said. The drug is similarly effective with gamblers in that it blocks gambling cravings and also reduces the rush or "high" that problem gamblers get when they bet, he said.

"The euphoria is too great and the cravings are too great" for addicts to handle, he said. "It's an endless cycle. This drug allows people to resist their drives."

Past studies on treating alcoholism with naltrexone were mixed, with some saying the drug was ineffective and others saying it worked, Grant said.

Grant said his research involved higher doses of the drug, which was "quite effective" on gamblers.

While medication is important, Grant said his patients also receive therapy and that he monitors their livers for toxic buildup, a potential side effect of the drug.

Grant recently received funding from the National Institutes of Health to develop a new therapy for gambling addicts aimed at helping them gain control over their behavior.

Blaszczynski has co-authored a variety of studies aimed at examining what motivates compulsive gamblers, including research on suicides and superstitions held by gamblers.

In a survey of Australian gamblers published this year, Blaszczynski found that problem gamblers held more superstitious beliefs than normal gamblers and that such beliefs were associated with more intense gambling sessions.

In a 1999 study, Blaszczynski attempted to split problem gamblers into three distinct groups to study and treat them more effectively.

Some gamblers aren't typically predisposed to gambling problems and tend to have a distorted sense of their odds of winning and make bad judgments, the study found. Emotionally vulnerable gamblers, on the other hand, are anxious or depressed prior to gambling and have a history of poor coping and problem-solving skills. A third category of gambler demonstrates impulsive, antisocial behavior and attention deficit disorder, it said. This group typically begins gambling at an early age and has a wider array of behavior problems including drug abuse, suicidal tendencies, irritability, low tolerance for boredom and criminal activity.

"People may (become compulsive gamblers) from different paths and need different treatment," Blaszczynski said in an interview.

Critics of the Responsible Gaming center say it has a cozy relationship with the casino industry and that casinos are fearful of studies that could create legal problems or put them in a bad light. The center disputes the claims, saying funds are directed by independent experts and that the research survives an arduous, peer-reviewed process used in other fields of medicine.

Grant said the center has a good reputation and that the research it funds is known for being balanced. The group is helping to make people aware of the illness, he said.

"This is a very serious public health problem," Grant said. "I think it's going to be the tobacco problem of the next decade. I think there are a lot of people who (are gambling addicts) but a lot of primary doctors don't screen for it yet."

In a research paper published this fall, Blaszczynski and other researchers said problem gambling studies need the buy-in of governments, consumers and casinos and that research must be independent.

"Research should be used as a tool to guide policy decision-making regardless of whether it is advantageous to the industry," it said.

The industry is "quite concerned" that research could put them in a position of liability, said Blasczcynski, 55. Still, he said, criticizing the industry for being morally reprehensible and for funding research before the results are in is counterproductive for addicts.

"Complete prohibition creates more harm than good. We need to work to minimize harm," he said.