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What makes people start gambling may also be a function of availability. A 1999 study ordered by the U.S. Congress found that people who live within 50 miles of a casino have two times as much risk of developing a gambling problem as those living farther away. And the growing popularity of electronic gambling only makes things worse. In one study, researchers at Brown University found that while gamblers take an average of 312 years to develop a problem when they're playing traditional games like cards, slot-machine players fast-forward their addiction, getting hooked in just over a year.
So what can be done to get problem gamblers to quit? Medication, in theory, may help. Psychologists like G. Alan Marlatt of the University of Washington are interested in the potential of so-called opioid antagonists, drugs that might partially disrupt the neurochemistry that produces feelings of well-being, thus denying gamblers the kick they seek.
More effective may be the 12 Step protocol used by Alcoholics Anonymous. Gamblers Anonymous groups meet all across the country, stressing abstinence and providing a community of ex-gamblers to offer support. Marlatt is worried that abstinence may be less effective with young gamblers and is exploring cognitive techniques that instead teach kids to recognize the triggers that get them to gamble too much. The states may also have a role to play. Illinois has instituted a self-exclusion program in which gamblers can put their names on a voluntary blacklist, allowing casinos to eject them from the premises, require them to donate their winnings to a gambling-treatment program and, in some cases, charge them with trespassing.
Like Marlatt's moderation strategy, however, the Illinois program takes a measure of self-discipline that may be the very thing compulsive gamblers lack. "In addiction, they call it chasing the high," says psychologist Carlos DiClemente of the University of Maryland, Baltimore County. "In gambling, it's called chasing the big win. And that's where self-regulation goes down the tubes." Better, say DiClemente and others, to simply to put down the cards or dice or cup of coins for good. As battle-scarred gamblers are fond of saying, the only way to be sure you come out ahead is to buy the casino. --With reporting by Melissa August/ Washington, Helen Gibson/ London, Noah Isackson/ Chicago, Coco Masters/ New York and Jeffrey Ressner/ Los Angeles