Eric Webber, director of the gambling addiction program at Wernersville, Pa.-based Caron Treatment Centers, went from being the informal “gambling guy” to helping launch a formal track Feb. 13 as demand for treatment continued to rise.
An estimated 2.5 million U.S. adults experience severe gambling addiction, and nearly 20 million people report at least one problematic gambling behavior several times in the past year, according to the National Council on Problem Gambling.
Mr. Webber, a therapist, first trained in treating gambling addiction in 2013. At the time, he was Caron’s internal and external referral source.
“If somebody had a problem, they called me,” he said.
The treatment landscape shifted after federal deregulation of gambling in 2018. In the years that followed, Mr. Webber began seeing more patients — particularly young adults, college students and first responders — seeking help for gambling. Like other addictions, he said, gambling can become a way to cope or disengage.
Referrals saw an increase, counselors reached out for resources and media outlets sought interviews. Mr. Webber said he brought the growing demand to Caron’s vice president of clinical services, and within weeks the organization established a dedicated gambling track. The organization currently runs two groups a week.
The program was built with an emphasis on identifying gambling behaviors during intake. Mr. Webber said the organization implemented the South Oaks Gambling screening tool as part of its assessment process, along with “live bet” screening that asks two questions: Have you ever lied about your gambling? Have you ever bet more than you wanted or planned to?
He said the screening process takes about six seconds and consists of yes-or-no questions, making it easier for providers.
“If healthcare — any level of healthcare, in any discipline — is interested in screening for it, it is not a big lift,” Mr. Webber said.
Monitoring relapse presents distinct challenges. Unlike substance use, gambling relapse is cognitive and behavioral rather than ingestive, making it more difficult to detect. An individual can gamble internally, he said, even on something as simple as whether a football team’s next play will be a run or a pass.
“I can drug test. I can Breathalyze. But how do you test if somebody’s gambling?” he said. “For gambling issues, how do we monitor whether somebody is in relapse mode, whether somebody is adhering to the rules? That challenge is still working out. I don’t have a lot of answers to that and I’ve got a lot of questions.”
Technology access — including to phones and televisions — adds another layer of complexity in treatment settings.
“How do we manage [the gambling problem] from a clinical standpoint? In the patient milieu, not everybody has a gambling problem,” he said. “Not everybody in my unit has an alcohol problem. That doesn’t mean I’m going to have a crack of beer in the lounge.”
Launching the track required coordination across staff, identifying who wanted to participate, outlining training requirements and accounting for associated costs.
The varied legalization of gambling between states also complicates the landscape. Unlike other substance use conditions, the same attention is not directed toward gambling addiction.
“I don’t know that we’re paying attention to the problem like we are paying attention to the opioid epidemic that we’re paying attention to alcoholism and other substance use. I don’t know that society is seeing as much of a problem as it sees other things.”
