WHETHER GAMBLING can be addictive and whether there is increased addiction when people gamble on slots and engage in casino-style gambling is a perennial question among policy-makers. The issue, as generally understood by the public, is whether there is a phenomenon called "compulsive gambling" that makes some people literally unable to stop gambling.
The difficult fact to face for those who believe in and those who "treat" compulsive gambling is that, as with all enjoyable activities, there are those who do not exercise self-control. In less therapeutic times, they were called irresponsible.
The American Psychiatric Association (APA) lists pathological, or compulsive, gambling as a psychiatric disorder with vague diagnostic criteria and with no way to verify any of them. Most of the criteria listed in the organization's latest Diagnostic and Statistical Manual (DSM) are circular; that is, one is considered "hooked" (the vague, nonmedical word actually used in the manual) if one presents five or more of 10 criteria.
These criteria include gambling for the wrong reasons ("escaping from problems"); demonstrating socially unacceptable behavior while gambling (lying "to conceal the extent of involvement with gambling"); and being unpleasant (irritability "when attempting to cut down or stop gambling").
There is only one criterion of pathological gambling offered by the APA referring to the individual's inability to stop, and it provides no method of verifying that a person cannot stop.
Over the years, a variety of measures have been proffered to certify whether a person is a compulsive gambler. They include the South Oaks Gambling Screen and, more recently, the Diagnostic Interview Schedule, used in a frequently quoted article in the Journal of Gambling Studies published at the end of last year. Dr. John Welty, the author of the article, told me he believed that the measure was valid because it was tethered to the DSM criteria.
It is interesting to note that this study has been used to erroneously argue that gambling consequences hurt minorities more than whites. This depends on how one interprets the evidence: Blacks were actually found to gamble less than whites, but more frequently and more heavily when they did gamble.
So why do some believe that gambling controls people? One reason is that "pathological gambling" has been medicalized. Even some supporters of slots concede that there is a problem with the "sickness" of gambling too much.
In Maryland, the Ehrlich administration's slots proposal originally stipulated -- one assumes for the purpose of gaining the votes of timid supporters -- that $500,000 or more would be set aside for a state agency to treat compulsive gambling. There is no medical pathology involved, however, and there is no neuropathological change causally linked to gambling.
There will always be those who wish to solve problems caused by the human condition by outlawing behaviors, whether it's drinking or gambling. Gambling in moderation is one of life's joys, as evidenced by the millions who gamble prudently. Whether gambling is through the lottery -- apparently no longer of concern to America's would-be nannies -- or through slot machines, compulsive gambling is simply a myth.
The frustration of arguing the proposition that compulsive gambling is a myth is this: So many people who have become accustomed to the term "compulsive gambling" believe that to say it is a myth is to deny that there are people who destroy their lives through heavy gambling.
So what's the issue? Simply put, it's whether it is by conscious choice that some people hurt themselves by gambling and losing amounts of money they just cannot afford.
Gov. Robert L. Ehrlich Jr. has argued that gambling is an "adult decision" involving the willingness to resist temptation.
That is precisely correct.
Richard E. Vatz is a professor at Towson University and is associate psychology editor of USA Today Magazine.