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Orville Dash sits in a recliner with a clipboard. Tall and broad-shouldered, with wispy white hair where a pompadour once rose, the former statistical engineer for Caterpillar removes a sheet of paper, clicks on the flashlight he uses for reading and goes over his numbers.

One spin every six seconds. Ten spins a minute. Six hundred spins an hour.

The 81-year-old widower estimates that, at his worst, in 2015 and 2016, he spent about $2,400 a week on video slot machines, which he played at a hotel and a handful of restaurants and bars around his hometown of Maroa, a farming community of close to 1,700 people north of Decatur in central Illinois.

Looking over his handwritten calculations, Dash figures he lost more than $25,000 in that time.

“It hurts to lose that money,” he said. “I’m addicted to these machines, and I’ve been working hard to understand why for a long time.”

In the 6 ½ years since video gambling went live in September 2012, some 30,000 video slot and poker machines have been installed at 6,800 locations around Illinois, more than in any other state. Gamblers here have lost over $5 billion playing the algorithm-driven machines, which have been described as “electronic morphine” and “the crack cocaine of gambling.”

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Yet the state has failed to address the issue of gambling addiction in any meaningful way. Lawmakers introduced and passed the 2009 Video Gaming Act in less than 48 hours, without holding a single hearing or conducting even a cursory study of the potential impact of the massive gambling expansion. Despite promises to increase funding for gambling addiction, Illinois spends less today than it did before legalizing the machines, a ProPublica Illinois/WBEZ investigation has found.

Over the past decade, the number of people receiving state-funded treatment has declined. The state has allocated inadequate amounts for marketing campaigns to encourage people with gambling problems to seek help. It has spent no money to conduct research to measure the prevalence of addiction or to gauge which treatments are most effective.

What’s more, the state has failed to adopt basic prevention measures, such as a self-exclusion list that would allow individuals to bar themselves from playing the machines or safeguards to ensure underage people don’t gamble on the devices.

Instead, Illinois lawmakers have fixated on how much money video gambling has brought into state coffers, though a ProPublica Illinois/WBEZ investigation in January found that the revenue has fallen far short of the legislature’s projections, even as video gambling saddled the state with unfunded social and regulatory costs.

Now, some lawmakers and the gambling industry are pushing another expansion that would include sports betting, new casinos and even more video slot and poker machines. In May, the U.S. Supreme Court paved the way for legalized sports gambling, and other states have begun to explore gambling expansions in hopes of tapping potential revenue streams.

Of the eight states that have legalized video gambling outside of casinos, Illinois is one of two — the other is West Virginia — that have chosen not to track the rate of gambling addiction, a decision a leading gambling researcher calls “mind-boggling,” considering the number of video gambling machines in the state and the amount of money being wagered.

A conservative estimate, using what most researchers set as a national average for gambling addiction — 2.2 percent of people 18 or older — would suggest about 217,000 Illinois residents are addicted to gambling. (Like substance abuse, gambling addiction is generally defined as behavior that jeopardizes someone’s financial security, relationships and emotional well-being.)

The number of people afflicted is likely higher, however, because studies show the rate of gambling addiction tends to increase with the number of gambling options, and Illinois has more locations to place a bet than Nevada.

Yet even as video gambling expanded, state spending on addiction fell nearly 20 percent between 2012 and 2017, according to the most recent figures available. The number of people assessed or treated for gambling addiction by state-funded providers declined nearly 37 percent during that time.

While Illinois’ highways are dotted with billboards advertising video gambling, little money has been spent to raise public awareness of gambling addiction or market what few resources are available to combat it. The most prominent, the state’s 1-800-GAMBLER hotline, received 2,324 calls in 2018, according to state records. Of those, 837 callers were seeking help; the rest were wrong numbers or people calling for other reasons.

Video gambling revenue reached $1.2 billion in 2017, yet the industry is required to contribute little to the state’s efforts on gambling addiction. That’s because, unlike at least three other states with legalized gambling, Illinois does not set aside tax money from video gambling to fund addiction services.

“With gambling, the social impact is just not visible until it affects you or your family,” said Anita Pindiur, executive director of the Maywood-based treatment center Way Back Inn, which treats about 80 people with gambling problems a year. “Our state is so driven by the money video gambling brings in, we don’t see the people it impacts.”

Go to a pizza joint in Springfield or a gambling parlor in Elmwood Park, a motel in the central Illinois town of Clinton or a string of bars in Berwyn, and there’s ample evidence of the problem. Whether it’s mid-afternoon or after midnight, you’ll see people robotically feeding bill after bill into flashing, ringing games.

“To me, it must have been the urge for some big win. Something for nothing, perhaps,” Dash said. “For other folks, they’re trying to get the money to pay the rent. Because they spent that money yesterday. And the food money goes. And the hand-wringing. And the crying. I’ve seen it all.”

In May 2013, less than a year after video gambling went live in Illinois, the American Psychiatric Association reclassified “gambling disorder” from a compulsion to an addiction in its Diagnostic and Statistical Manual of Mental Disorders, which clinicians use to diagnose and classify mental illnesses.

“Many clinicians have long believed that problem gamblers closely resemble alcoholics and drug addicts, not only from the external consequences of problem finances and destruction of relationships, but increasingly on the inside as well,” said Dr. Charles O’Brien, a prominent psychiatrist and addiction researcher at the Perelman School of Medicine at the University of Pennsylvania who helped write the classification change.

O’Brien and other researchers say brain imaging studies show that, much like drugs or alcohol, gambling triggers spikes in the chemical dopamine, which activates the brain’s reward system and influences human behavior. Researchers have found that gambling addiction is often accompanied by other forms of addiction.

Those who are susceptible wager beyond their means or spend inordinate amounts of time gambling. Unable to see, or indifferent to, far-reaching consequences, they may find themselves lying to loved ones, turning to crime to cover their losses or becoming suicidal.

“To me, it was a vicious circle, going back to the bars because of the high when you won,” said a 51-year-old mother of two from Springfield. She said she lost her business and still struggles to keep away from the machines. “You walk out and think you’re never going to do it again. But before you know it, you lose.”

The gambling industry and some researchers say there is no evidence video gambling is more addictive than other forms of gambling, though few studies focus on this question. They argue that some people are at risk of becoming addicts regardless of the type of gambling they choose.

Christine Reilly, senior research director at the National Center for Responsible Gaming, a nonprofit largely funded by the gambling industry, pointed to NCRG-funded research that found 70 percent of gambling addicts already suffered from depression, anxiety or other mental health issues. That, she said, makes them susceptible to developing a gambling addiction.

“There are lots of people who took cocaine and never got addicted,” Reilly said. “It’s the relationship between the person and their vulnerabilities. Things are not inherently addictive.”

Yet other studies have shown that people may develop a gambling addiction first, and that can lead to other conditions, such as depression, substance abuse or other mental health issues.

“There is research that shows it’s really a two-way street,” said Rachel Volberg, an associate professor at University of Massachusetts Amherst and a leading gambling researcher.

The state’s trade group for video gambling, the Illinois Gaming Machine Operators Association, said in a written statement that “there has been no concrete evidence of widespread gaming problems related to video gaming” and that the group has “committed significant resources and effort to fighting problem gaming.”

Researchers and clinicians generally agree greater access to gambling can increase addiction rates. They say the wide proliferation of video gambling in Illinois has likely fueled a rise in addiction here. It’s a phenomenon clinicians say they see every day.

But Illinois doesn’t know the extent of its gambling addiction problem or how it has changed as the number of gambling locations has grown. The legislature never commissioned a prevalence study to measure the rate of gambling addiction, which researchers and clinicians say is a crucial first step to combat the disease.

“If you have that many machines that widely distributed and you have no idea what the impacts are, how do you even know where to start?” asked Volberg.

On a Thursday afternoon, you can walk into a gambling parlor on North Harlem Avenue in Elmwood Park and find players who have wandered across the street from the Chicago side, where video gambling remains illegal. The attendant may ask if you’d like a drink, or you can take a butterscotch candy from the crystal bowl at the counter before you sit down to play.

Pick a game like Wolf Run, with a theme featuring dream catchers and the silhouette of a wolf howling at a full moon. The game allows players to bet as much as $2 a turn, distributing their money among as many as 200 lines that zig-zag across the screen like a digital spider’s web. Each line combination could be a winner.

Deposit a $5 bill into the machine and bet the minimum: 40 lines for 40 cents. Hit the spin button, and flutes, electronic horns and whistles blare while the virtual reels spin. As each reel comes to a stop, it sounds as if gears are locking into place. Suddenly, a wolf howls, more bells and whistles go off and lights flash. The screen shows you’ve “won” 10 cents.

But because the bet was 40 cents, you’ve actually lost 30 cents, or 75 percent of your wager, a sleight of hand known as a “false win” that, experts say, keeps people gambling. The $5 is gone in minutes.

Some researchers describe video gambling as “electronic morphine” and “the crack cocaine of gambling.” Every detail of the video gambling experience, from the lights and the shape of the buttons to the sound effects, has been meticulously designed to make people play longer and faster — to spend more money.

In her book, “Addiction by Design: Machine Gambling in Las Vegas,” New York University cultural anthropologist Natasha Schüll spent years examining how players in Las Vegas became hooked on video gambling and how the design of video gambling machines and software played into their addictions.

“I don’t think slot machine designers have as their main goal to create an addict, but what they do have as their main goal is to monetize our attention,” Schüll said.

Each individual machine contains an array of games, which are targeted at different kinds of players. Some feature themes centered around shopping, jewelry and makeup; others depict busty, scantily clad women.

The games create the impression that gamblers can control the outcome by touching the screen or hitting the spin button to stop the virtual wheels. But the outcome is determined the moment a player pushes the button.

Many players believe machines run hot or cold, as if the devices get on streaks, or that the more spins a player makes, the greater the chances of a payout. In fact, video gambling machines take a fixed percentage of the amount wagered over a set number of spins or amount of time, known as the “hold” or the “house edge.” Data from the Illinois Gaming Board, which regulates the industry, shows that, on average, the machines take more than 25 percent of the money put into them.

Video gambling chairs, which can cost hundreds of dollars, are built to be occupied for long periods, with padding and ergonomic designs. Some look like recliners, with buttons embedded in the armrests, so people can play without moving their arms.

Anatomy of a Video Gambling Experience

Gone are the days when playing the slots meant pulling a lever on a clanky machine. Today’s video gambling machines are like computer games, with sophisticated algorithms designed to make people bet more and play longer. Here’s what one video gambling experience might look like, though set-ups vary greatly.

In her book, Schüll describes interviews with gambling addicts who talk about a trance-like state they call “the zone.” Absorbed in the sights and sounds emanating from the slot machines, they lose track of time as they settle into a rhythm the machines are programmed to accommodate. Often, that rhythm is quick-paced, with small doses of wins or “false wins” egging on the brain’s reward system to keep playing.“The solitude factor goes hand-in-hand with the speed factor as you can play up to 1,200 spins an hour,” Schüll said. “That’s why slot machine designers talk about a reward schedule.”

A Lack of Funding — and Concern

In May 2009, when the Video Gaming Act came up for a final vote, not a single member of the state Senate spoke about the social costs of gambling. In the House, according to transcripts, only one lawmaker, Rosemary Mulligan, a Republican from Park Ridge, questioned what Illinois would do to combat gambling addiction.

“Video gaming is one of the most addictive forms of gaming,” said Mulligan, who died in 2014. “So, I would like to see [the law] fund something that has long been underfunded in Illinois.”

That didn’t happen. In 2016, Illinois ranked 28th out of 40 states nationally in per capita funding for addiction services, according to the most recent survey from the National Council on Problem Gambling, a nonprofit that advocates for problem gamblers but says it takes no position on legalized gambling.

That’s because legislators structured the Video Gaming Act and the finances behind it with little concern for the potential consequences. The law called for the state’s share of video gambling revenues to cover borrowing costs for building projects. Licensing and administrative fees would pay for regulating the industry and confronting social costs, such as addiction.

In 2017, for instance, video gambling players lost $1.2 billion, according to state reports. The state’s take was about $300 million. Cities and towns that are home to video gambling received about $60 million. Terminal operators and establishments took in $840 million.

The sponsors of the Video Gaming Act estimated licensing and administrative fees would reach $6 million a year and promised 25 percent, or $1.5 million of that, would be set aside for addiction services. Yet those licensing and administrative fees have never amounted to more than $4.2 million. As a result, the legislature has never appropriated more than $1.03 million.

At the same time, the agency tasked with issuing grants for treatment, outreach and training for clinicians, the Illinois Department of Human Services, has struggled to spend the money that is appropriated each year. In 2012, for instance, DHS spent 83 percent of the funds appropriated for gambling addiction, according to DHS financial reports and figures from the comptroller’s office. By 2017, the percentage had dropped to 63 percent.

DHS officials say providers have had trouble getting gambling addicts to seek treatment and that there are not enough clinicians in the state who specialize in gambling addiction. They point out that providers often don’t spend all the money they’re awarded in contracts. In 2017, for example, DHS awarded $794,000 in contracts but providers spent just $600,000.

“It has been challenging for our gambling disorder providers to bill for the full amounts of their IDHS contracts that support these services,” DHS said in a written statement to ProPublica Illinois. “While there are many people who have serious problems with gambling, only a small percentage actually seek treatment.”

DHS, the statement said, “is committed to supporting community outreach and education to battle the stigma associated with addiction and encourage more people to begin the path to recovery.”

Yet between 2012 and 2017, DHS spending for gambling addiction declined 20 percent, from $807,000 to $646,000, even as the number of video gambling machines grew dramatically around the state and appropriations increased slightly. The number of people receiving services also dropped by 37 percent, from 6,773 to 4,274 during that time.

DHS officials said some of the decline in patient numbers may be attributed to gambling addicts being treated for accompanying alcohol or drug abuse, and included in those numbers instead.

Service providers say few problem gamblers know where to turn because the state doesn’t do enough to build awareness. They say they need more billboards, TV and radio ads and sophisticated social media campaigns to educate the public about how to identify the warning signs of problem gambling.

“That’s why we don’t get people in for treatment until they’ve lost their home or their job or their family — or they’re suicidal,” said Pindiur, of the Way Back Inn.

DHS officials said the stigma around gambling addiction is greater than substance abuse, since there are fewer outward signs of trouble and many people still doubt that gambling addiction is a real disease. That’s one reason the agency has begun to focus more on outreach and awareness, the officials said.

In 2017, DHS used more than 40 percent of the money it spent, or about $300,000, on outreach and awareness, compared with 25 percent in 2009. DHS officials said they are planning a push in March to coincide with Problem Gambling Awareness Month, which will include a new website, as well as mailers, flyers and posters distributed around the state.

A lack of clinicians certified to treat gambling addiction has also made it hard to tackle the problem, according to DHS. While private therapists can help addicts, some experts say many private therapists aren’t trained to properly assess and treat people with gambling issues.

With few options, gamblers seeking help often attend one of the state’s more than 60 Gamblers Anonymous meetings each week. Researchers say studies haven’t been done to evaluate the 12-step program’s effectiveness, and Gamblers Anonymous officials said they haven’t studied the issue either. Although many people who attend the meetings say they believe the program helps them, a majority of those meetings are held in and around Chicago, leaving gambling addicts outside the metropolitan area with fewer options.

“Patients have nowhere to go. They don’t know who to call,” said Dr. Donald Black, of the Carver College of Medicine at the University of Iowa and a prominent gambling researcher who has studied addiction in Illinois. “The central theme around video gambling is no one cares.”

A Possible Measure For Prevention

One measure has proved somewhat effective at helping problem gamblers: a registry, called a self-exclusion list, that allows people to bar themselves from gambling. Illinois has had one in place since 2002 for the state’s 10 casinos. But the state has yet to implement one for video gambling.

Illinois Gaming Board officials acknowledge the technology to create a self-exclusion list exists but said that implementing it across the state’s 6,800 video gambling locations poses a huge hurdle and would likely lead to steep revenue declines.

A 2015 gaming board memo that examines self-exclusion programs around the world suggests the impact on revenue is among the biggest obstacles. “One might argue,” the memo says, “that the most binary of approaches has emerged: a forced choice between profit and social responsibility.”

A 2016 gaming board memo acknowledges video gambling “will result in numerous additional problem and compulsive gamblers.” The challenges of implementing a self-exclusion list for video gambling, the memo says, include “a lack of political fortitude on the part of elected officials facing growing budget deficits.”

Any effort by the gaming board to implement a self-exclusion list would require approval from the General Assembly’s Joint Committee on Administrative Rules, or JCAR. For years, gambling interests have lobbied successfully to thwart the board’s proposed rules on a range of issues. Because any self-exclusion list would probably cut into revenue, the industry would likely oppose it.

Board chairman Donald Tracy, a Springfield attorney, said he doesn’t believe the threat to revenue alone has scuttled the program. “It’s an indirect factor only in the sense that we’re realists,” he said. “We have experienced pushback from the legislature and JCAR and the industry when we try to do something that people are opposed to.”

As of November, more than 13,000 people, including some 9,000 Illinois residents, had put themselves on the state’s self-exclusion list for casinos. Of those, nearly 38 percent, or about 5,700, say video gambling was why they applied to be placed on the list, according to gaming board statistics.

Self-exclusion lists are easier to enforce at casinos because there are only 10, gaming board officials said. If people on the list are caught gambling, they must forfeit winnings, which are donated to nonprofits that tackle gambling addiction. They can also be charged with trespassing.

Other countries have established self-exclusion lists for video gambling. Sweden, for instance, requires anyone who wants to play video slot and poker machines outside of casinos to register and receive a player card or government-issued ID, which must be swiped at each device before a bet can be placed.

It’s not clear how the registration has affected addiction rates in Sweden, but it has led to a 30 percent drop in revenue there, according to research cited in the 2015 gaming board memo.

The gaming board has taken what Tracy called a “baby step” toward addressing video gambling addiction. In February 2018, the board created a registry that sends “regular e-mails providing information on problem gambling and containing links to problem gambling prevention and treatment resources” in the state.

As of this month, 40 people had signed up for the registry, according to the gaming board.

“This is probably one of those initiatives that hasn’t been given the priority that perhaps it needs,” Tracy said. “We need to get back on track and become more focused on this issue.”

Illinois legislators could require the board to implement a self-exclusion list — and provide funding to study the issue — but have made no move to do so. Gamblers on the casino self-exclusion lists and clinicians said the lack of one for video gambling has added obstacles to their recovery.

“The people we work with who have developed problems with video gambling have asked for a self-exclusion program for video gambling and expressed confusion why there isn’t one,” said Elizabeth Thielen, senior director of NICASA Behavioral Health Services, a nonprofit that treats about 40 gambling addicts a year at its northern Illinois locations.

Another option to combat problem gambling is to add technology to the machines to control play. Some provinces in Canada have installed tracking devices on video slot and poker games to limit the time and money spent on each machine. In Illinois, gaming board officials said they believe these measures are ineffective, since players can simply move to other machines or locations.

Teenagers are among a growing population of problem gamblers, according to treatment providers. Some video gambling machines are located in places where no one checks that players are at least 21, the legal age for gambling in Illinois. The legislature has failed to enact basic measures other states follow to help prevent underage gamblers from using the machines, such as requiring a manager on duty to check identification or keeping machines out of view of those under 21.

The gaming board only began enforcing the ban on underage video gambling in September 2015, three years after the games went live, according to a review of meeting minutes. Tracy said the board takes the issue of underage gambling seriously, levying fines of up to $5,000 on locations caught in the board’s underage sting operations.

“[Underage gambling] is a gigantic problem here because we have 6,800 locations,” said Tracy, who took over the board in February 2015. “If we were dealing with like 30 or 40 of them, it sure would be a lot easier to devise a solution. We need to do more, and I think that is one area that has suffered from a lack of resources.”

A 42-year-old Gamblers Anonymous member named Leon, who asked to be identified only by his first name, said he realized he was a problem gambler when he lost money he had set aside to pay his mortgage and had to tell his husband. He said he is on the state’s casino self-exclusion list but wishes he could place himself on a list for video gambling.

“Those little gambling establishments are [on] every corner now, in every restaurant, every gas station,” he said after attending a Gamblers Anonymous meeting in Downers Grove.

When he called a video gambling company to ask about a self-exclusion list, he was told he should just keep away from establishments with the machines, he said.

“I’m like, ‘Lady, tell a heroin addict not to put needles in his arm,’” he said. “They don’t get it.”

His Most Difficult Addiction

Sitting in his recliner on a brisk, sunny autumn afternoon, his pudgy dog Nikki snoring on the carpet beside him, Orville Dash said he had managed to stay away from the machines for three or four months.

It wasn’t because he’d kicked his addiction. He suffers from macular degeneration, lung cancer and Parkinson’s disease, he said; he’d become wobbly on his feet and recently had fallen, cracking two ribs. Only his ailments were keeping him home.

A recovering alcoholic and former longtime smoker, Dash said he entered a treatment program for alcohol abuse while at Caterpillar in the 1970s. There, he learned about the 12-step program, which he has used in his efforts to quit gambling.

In 2016, as he began to confront his addiction, Dash wrote himself a letter as part of his recovery effort.

“I have a history of addictive behaviors, including alcohol, smoking and most recently playing slot machines,” he wrote. “I have been sober for 30 years, smoke-free for 14, and am just entering the effort to overcome a gambling addiction. I have some confidence I can overcome this addiction. But it is beyond a doubt the most difficult of the issues I’ve faced.”

Two years later, as he reviewed the calculations showing how much he had lost, his confidence had waned. He struggled to understand why he kept returning to video slots. Despite his statistical training, he couldn’t contain the irrational hope that he would beat the odds and come out ahead.

“I knew better than that, but I did it anyway.”

Source : https://www.alternet.org/2019/02/how-illinois-is-failing-people-addicted-to-the-crack-cocaine-of-gambling/

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