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The Yale Alumni Magazine is owned and operated by Yale Alumni Publications, Inc., a nonprofit corporation independent of Yale University. The content of the magazine and its website is the responsibility of the editors and does not necessarily reflect the views of Yale or its officers. |
In the hit song “The Gambler,” Kenny Rogers had this advice for listeners: “You got to know when to hold 'em, know when to fold 'em; Know when to walk away, know when to run.” Most gamblers know when to leave the card tables, slot machines, lotteries, and other legal games of chance on which Americans wagered more than $50 billion last year. But, says Marc Potenza '87, ‘93PhD, ‘94MD, an assistant professor of psychiatry, “nationwide, we’ve seen a dramatic increase in the number of people with gambling problems in the past several decades.” Consider these odds, says Potenza, director of Yale’s Problem Gambling Clinic. In 1998, 86 percent of the adult population reported gambling at some time in their lives—the figure was 68 percent in 1975—and experts estimate that up to five percent will experience difficulties. (One national survey put the cost to society at $5 billion annually.) While there have been casinos in Las Vegas since the 1930s, the modern gambling era began in 1964 when New Hampshire legalized a state lottery. Since then, three dozen states have followed suit, and now, from the office Super Bowl pool to multimillion- dollar Powerball jackpots, it has become in most locales almost as easy to place a bet as it is to breathe. A lottery helped Connecticut provide funds for Yale in the early 1700s, but the state got into the gaming business in a big way more recently with the introduction of off-track betting, jai-alai, lotteries, and the opening of two Indian-operated casinos. While all of these have generated large amounts of revenue, they also had significant human costs. “The Connecticut Council on Problem Gambling opened a hotline in 1994, and they now receive over a thousand calls a year,” says Potenza. Not much was known about these individuals, so in 1997, Potenza, then a resident fellow in psychiatry, began the clinic, a joint effort between Yale and the Connecticut Mental Health Center, as a way to coordinate research into the biological causes of problem gambling and effective ways to treat a condition that, increasingly, is seen as a mental illness rather than a moral weakness. “Pathological gambling, the most severe form of this addictive disorder, affects about 1 percent of the general population of this country; that’s about the same percentage of adults diagnosed with schizophrenia and bipolar conditions,” says Potenza. In the PGC, Yale researchers have worked with powerful imaging techniques to determine where in the brain the gambling urge takes shape, and the clinic was chosen as one of only four treatment sites in the country to test the effects of drugs and behavorial therapies in helping gamblers kick the habit. Potenza and his colleagues have also conducted work that reinforces the notion that gambling is an “addiction without a drug” and investigated, using information generated by calls to the hotline, the differences between men and women with gambling problems. (In a paper published last September in the American Journal of Psychiatry, the PGC researchers showed that while men are more likely to get into trouble with “face-to-face,” strategic games like poker or blackjack, women’s gambling problems tend to involve “escape-oriented,” nonstrategic forms such as slot machines.) The psychiatrist notes that while these investigations show promise, a cure remains elusive. Progress is slow because gambling is a complex and all-too-human activity. Says Potenza: “It taps into some of the core behaviors—the assessment of risks, rewards, and punishments—we do on a daily basis.” |
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©1992–2012, Yale Alumni Publications, Inc. All rights reserved. Yale Alumni Magazine, P.O. Box 1905, New Haven, CT 06509-1905, USA. yam@yale.edu |
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