Marlene D. Warner, Executive Director The Massachusetts Council on Compulsive Gambling

1. Massachusetts State LotteryYour Role in Keeping Gambling Fun: Addressing Responsible and Problem Gambling Marlene D. Warner, Executive Director The Massachusetts Council on Compulsive Gambling 617.426.4554 marlene@masscompulsivegambling.org

2. Goals and Objectives • Recognize difference between gambling for entertainment and when it’s a problem • Understand how and why that has happened for that individual • Feel comfortable in the approach • Know tools and resources to offer to someone • Build relationship and comfort with colleagues when discussing this issue

3. Why Responsible Gambling Matters • Provides a set of values and principles to guide your work at the lottery. • Gives confidence to players that MA Lottery keep their interests in mind. • Builds public trust in the integrity of the lottery.

4. Introduction Exercise • Name • Length of time at the lottery • Finish sentence, “Besides working or spending time with my family, I am happiest when…”

5. Language is important • Gambling vs. Gaming • Responsible Gambling or Social Gambling • Problem gambling, pathological gambling, compulsive gambling, gambling disorder, or gambling addiction

6. Definitions • Gambling:“… risking something of value on the outcome of an event when the probability of winning is less than certain.” • (David A. Korn & Howard J. Shaffer, Journal of Gambling Studies, Winter 1999, Vol. 15 - #4, pg. 292)

7. Definitions • Problem Gambling: is the term used to cover the entire range of harmful gambling involvement. That is, gambling that results in some kind of negative impact on the person’s life or on the lives of the gambler’s family, friends, and/or • co-workers. It can be an occasional impact or an ongoing and serious situation.

8. Definitions • DSM-5 definition of gambling disorder: “Persistent and recurrent maladaptive gambling behavior that disrupts personal, family or vocational pursuits.”

9. Gambling Disorder Rates • Research indicates that between 2%-3.5% of the U.S. adult population has experienced adverse consequences from gambling in their lifetimes (Kessler et al., 2008; Petry et al., 2005). • Special populations often have more of a problem: age, race/ethnicity, job type, etc

10. Findings from Gambling and Problem Gambling in Massachusetts: Results of a Baseline Population Survey. (2015) Volberg, R. A., et al.

11. Levels of Gambling Continuum of Problems Unhealthy Gambling Healthy Gambling In Treatment No Gambling Gambling w/ Severe Adverse Consequences Gambling w/ No Adverse Consequences Gambling w/ Some Adverse Consequences

12. DSM-V Criteria In Substance Related and Addictive Disorders Section A. Persistent and recurrent maladaptive gambling behavior as indicated by 4 or more: • often preoccupied with gambling • needs to gamble with increasing amounts of money to achieve desired excitement • repeated unsuccessful efforts to control gambling • restless or irritable when trying to cut down or stop • after losing, often returns another day to get even

13. DSM-V Criteria • lies to others to conceal extent of involvement with gambling • has jeopardized or lost significant relationship, job, educational or career opportunity due to gambling • relies on others to provide money to relieve a desperate financial situation caused by gambling • B. The gambling behavior is not better accounted for by a Manic Episode.

14. High Risk Categories • Child of a person with a gambling disorder (or other addiction) • Belief that skill is involved • An early big win • Feeling that one must chase gambling loss with more gambling • Early age of onset (8.5 years for people with gambling problems; 11.5 years for people without pg) • Large first bets • Otherwise addicted or mental health disorder • Everything to win and nothing to lose

15. Characteristics of Low Risk Gambling • For fun or recreation, never for financial gain • Knowledge that over time nearly everyone loses • Socially with family and friends, not alone • Limited time – frequency and duration • With predetermined limits for losses • Acknowledging that knowing a lot does not make you a better gambler

16. Three Phases of Problem Gambling

17. Winning Phase The Winning Phase • Experience a "big win" or a series of smaller wins that result in excess optimism • Feel an unrealistic sense of power and control and are excited by the prospect of more wins. • Continually involved in high-risk bets.

18. The Losing Phase Losing Phase • May brag about past wins, but in the immediate situation, they're losing more than winning. • More likely to gamble alone • When not gambling, they’re more likely to spend time thinking about how and when they’ll gamble next. • Concerned with how they’ll raise more money, legally or illegally. Start borrowing money. • Dominant pattern of losing. Making the next bet becomes more important than the winning of any previous bets. • As the losing continues, they start lying to family and friends and feeling more irritable, restless, and emotionally isolated. • May be developing some serious financial problems. • Likely to start chasing their losses, trying to win back what they lost.

19. The Desperation Phase • May now make bets more often than is normal, in more desperate attempts to catch up and "get even." • Gambling is now out of control and associated with deep remorse, with blaming others, and with the alienation of family and friends. • May engage in illegal activities to finance their gambling. • May experience a sense of hopelessness and think about suicide and divorce. • Other addictions and emotional problems may also intensify during this phase and drag them down. Desperation Phase NEXT

20. Case Carter is a middle-aged man who usually plays scratch tickets a few times during the week. Last week he was there every night and today he yelled at the guest next to him for jinxing his system. He started loudly complaining about “all the winners being sent elsewhere.” When you walked over to see what was going on he you heard him say, “What’s the point anymore anyway? We’re going to lose the house and my wife will probably divorce me when she finds out. I’m a dead man walking.” Which of the three phases of problem gambling do you think Carter is in? • Winning • Losing • Desperation

21. Case Greg is 23 years old. He works full-time at a local sporting goods store. He goes to the bar to play Keno about twice a week with friends. He likes the atmosphere – good music and great people. It helps him relax. And the extra money is great! Last week he won $1,000.00! This week he has gone twice with friends and twice by himself. He feels like his next win is just around the corner! Which of the three phases of problem gambling do you think Greg is in? • Winning • Losing • Desperation

22. Be Aware • What was the person acting like when he came in? • How long did it take for her behavior to intensify? • Was there a specific moment when you noticed a change and what caused that? • What else do you know about this person? How can that be used to assess the situation?

23. The 4 Levels of Responsible Gaming • Level 4: Continuous improvement • Level 3: Planning and implementation • Level 2: Self-assessment and gap analysis • Level 1: Commitment

24. Principles of Responsible Gambling • Sales • Advertising, marketing and communications • Research • Employee Training • Game Design • Remote gaming channels • Player education • Treatment Referral • Stakeholder engagement • Reporting, measurement and certification • Security

25. Responsible Gambling Tips • Play for entertainment, not for money. • Set money and time limits for gaming and stick to them. Part of entertainment budget; make sure they can afford to lose it. • Gambling is your choice. You shouldn’t allow yourself or others to pressure you to play. • Take a break and participate in other forms of entertainment. Gambling should be a fun but limited part of a well-balanced lifestyle; not necessary to have fun. • You should avoid gaming when you’re upset, lonely, angry, depressed, or stressed. • Gambling is not advised for those in recovery for addictive disorders or dependencies.

26. MA Lottery Responsible Gambling Resources • You • Your colleagues • Your supervisor • GameSense (check out www.gamesensema.com)

27. Questions?