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Brandon and Amanda Clevenger, both 34, St. Marys, have experience with drug addiction and are counselors at Foundations Behavioral Health Services in Celina.
By ERIN GARDNER and
LESLIE GARTRELL
newsroom@dailystandard.com
Although many people look forward to the rollout of sports betting in Ohio, local and state addiction specialists say it could open the door to a severely underreported illness - gambling addiction.
It's estimated up to 10 million people in the U.S. have an addiction problem because of gambling, according to the North American Foundation for Gambling Addiction Help (NAFGAH). More than 90,000 Ohioans may be problem gamblers, according to Ohio for Responsible Gambling.
Overall, compulsive betting behavior costs about $6 billion per year for U.S. economics, according to NAFGAH.
And while sports betting advertisements have been increasingly prominent, the Ohio Casino Commission last week admonished sports gaming stakeholders for failing to follow industry standards when advertising, including advertising to people under the legal betting age of 21 and lacking responsible gaming messaging.
While there are no drugs involved, those with a gambling addiction get "high" from gambling, said Foundations Behavioral Health Services Substance Abuse Coordinator Matt Ronan.
Gambling addicts experience a high from betting, a sensation which may start with something small like lottery tickets, he said. As the high wears off, gamblers increase the risk with more money.
"Nobody starts gambling or using drugs to get addicted," Ronan said. "It's a brain disease (where) what clicks in some people doesn't necessarily click in other people."
People who gamble might rationalize their addiction because they're not putting anything harmful in their bodies, Ronan said.
For some people, gambling can be easier to justify because "it's not meth, it's not heroin," said Amanda Clevenger, a peer recovery coach at Foundations.
Amanda and her husband Brandon Clevenger, both 34 and of St. Marys, have experience with drug addiction. Brandon Clevenger also works at Foundations as a counselor.
Like drugs, gambling can affect the brain's reward circuit by flooding it with the chemical messenger dopamine, according to the National Institute on Drug Abuse. Surges of dopamine in the reward circuit cause the reinforcement of pleasurable but unhealthy activities, leading people to repeat the behavior again and again.
Over time, the brain adjusts to the excess dopamine, which reduces the high that the person feels compared to when they first started taking the drug - an effect known as tolerance. In response, an individual might use more of what is causing the addiction, trying to achieve the same high.
Like other addictions, there are risk factors and warning signs. For example, men are more likely to have gambling problems than women, according to Yale Medicine.
Men appear more drawn to so-called strategic forms of gambling as card games or sports betting, while women tend to prefer non-strategic forms such as bingo or slot machines, according to Yale Medicine.
Genetics, parental history, mental illnesses such as bipolar disorder or attention deficit hyperactivity disorder and other factors make certain people more susceptible to addiction.
Brandon Clevenger said a gambling addiction can be harder to treat because it is more socially acceptable.
Scott Anderson, problem gambling coordinator with the Ohio Department of Mental Health and Addiction Services, identified three major diagnostic criteria for diagnosing a gambling addiction - tolerance, withdrawal and preoccupation - similar to alcohol problems.
However, gambling in general - and sports betting in particular - have specific elements that make them harder to identify. The lack of visibility makes the task of identifying a gambling disorder especially difficult.
"I could tell if your words are slurring or not right now, and I could wonder where you went for lunch," Anderson said. "But you could've gone on Draft Kings and dropped ten grand before you got on the phone with me, I would have no way of knowing that. So it's really a hidden thing, and not a lot of people come forward, a lot of times, until they're in really, really dire straits."
Another difference between gambling and substance use is the perceived benefit. Anderson said gamblers sometimes feel a sense of investment because they've racked up so many perks - free plays, discounts at casino bars, etc. - and don't want to throw them away.
And, of course, they could always win.
"The house always wins, so I think it's setting people up to fail and lose more money than they realize," Brandon Clevenger said.
Sports betting also offers nearly limitless opportunities to play. Anderson said that in the lottery, people are more likely to develop a gambling problem playing Keno, which draws every four minutes, rather than Powerball, which draws twice a week.
With in-game betting apps, people can bet almost constantly, a dramatic increase in what Anderson termed "velocity of play" that he said might lead to a rise in gambling problems.
"You're going to be able to bet 140 times in an NFL game," he said. "You're going to be able to bet on punt, pass, kick, penalty, score at the first quarter, score at the first half, color of Gatorade dumped on the coach, length of the national anthem. You're going to be able to just hit your thumb on the button and bet on everything that happens."
With the rollout of sports gambling on Sunday morning people will be able to bet anywhere, making it easier to bet and harder to spot someone who might have a gambling problem.
"The staff in the casinos and racinos (racing casinos) are trained to look and listen," Anderson said. "If I'm in there in the same clothes three days, or I'm in there for 18 hours straight, or I'm not taking breaks to go to the bathroom or eat, or I'm banging on the machine, somebody's going to intervene. If I'm on my couch in the dark with my blinds shut, there's nobody who's going to tap me on the shoulder and say, 'Hey, Scott, why don't you take a break, man?'"
In recent years, Anderson and others pushed to create a national problem gambling helpline number, 1-800-GAMBLER, which uses a caller's location to connect them to the helpline in their state.
Other states have seen a surge in helpline calls with sports betting, including in Michigan, which went from around 1,500 calls in 2020 to almost 4,500 in 2021 after the legalization of sports betting.
At the same time, the increase doesn't necessarily correspond to new gambling problems. The legalization of sports betting has made helplines more visible to those with an existing problem, Anderson said, and the Ohio helpline often gets callers looking for customer service at the casinos. Still, the Ohio helpline, which also saw an uptick during the pandemic, is preparing its staff to handle a potential influx.
Recovery is not linear nor is it a universal experience, mental health officials agree.
"I think we all are in the denial phase for a while," Brandon Clevenger said of recovery. "It takes negative consequences to come face to face with your own behavior."
"That rock bottom that you hit, it's just like a slap in the face," Amanda Clevenger added.
Because gambling and sports betting is legal, people with gambling addictions usually think they're not harming anyone because the addiction is "legal," and they often don't seek treatment unless there's a personal connection.
"It has to be like an out of sight, out of mind (mentality)," Ronan said. "We know there's not going to be physical withdrawal from not gambling, there's going to be a mental withdrawal. A gambling addiction can be very complex."
"The breaking point was, in my opinion, another person in the family coming forward and saying, 'You need to do something about this,'" he continued. "If it hurts you enough emotionally, that's when people usually change. Remember everybody has a different bottom. It's really hard to determine at times what is the breaking point."
Generally, Ronan said, the breaking point is when a close family member or friend expresses concern because "you're specifically telling me what I'm going to lose," he said of the gambling mindset.
Ronan said he tells his clients in recovery to change their people, places and things. For example, he said that could mean changing where someone gets gas because they buy lottery tickets there.
Amanda Clevenger said when she got sober, she knew she had to change her phone number and cut off friends and family who also used drugs.
"Every one of them laughed at me and I was like, 'I'm going to prove them wrong,'" she said. "That was my motivation. I've changed my people, places and things. I just didn't go back. I knew I needed a different environment."
Brandon Clevenger agreed everything had to change for him, including the people around him. He said he tells his clients to write down all their friends and what they do with those friends.
"My mom used to say, 'Show me your friends and I'll tell you what you're into.' I hated to hear it as a kid, but it is the truth," he said.
Once a person has identified that they might have an addiction, Foundations or a counselor can complete a mental health assessment, which opens up doors to understanding how their behaviors are impacting their life, according to Matt Kinkley, an outpatient therapist at Foundations.
"Gambling deals with the dopamine/pleasure sensor in the brain. So how do we work to encourage abstinence while still allowing pleasure to be stimulated so people can still have pleasure?" Kinkley said of treatment.
Treatment is based on the individual, he said. Options can include cognitive behavioral therapy and group therapy. Understanding the motivations behind gambling, practicing abstinence and finding other ways to enjoy life are often steps people take toward sobriety, he said.
While change can seem daunting, Brandon Clevenger said it is possible with determination and a good support system.
"You're not alone and there are people out there who are willing to help you, but it starts with accepting that you might have a problem," he said.
- Tom Haines, William Kincaid and Bob Tomaszewski contributed to this report.
