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Just Once More: The Face of Addiction

Gambling and other addictions strike too close to home, according to our exclusive survey of Hispanics 40+. Just ask our writer, whose mom is addicted to the slots.

“It’s not accepted to share your secrets outside the family,” says Mikell, an addiction counselor for over 33 years who advocates more culturally sensitive approaches to treatment. “Once you start to explore your feelings and concerns with people who are not family members, you have created a sense of shame about the family.”

For this reason, group approaches such as Gamblers Anonymous—through which participants work to overcome their addictions by practicing the 12 steps adopted from Alcoholics Anonymous and by sharing details of their gambling activity—may not be as appealing to Latinos, says Mikell. Because shame within the family represents a greater barrier to treatment among Latinos than in the general population, says Mikell, involving family members in treatment is especially important. She recommends asking about the availability of family therapy and outpatient treatment (rather than inpatient treatment that separates patients from their families) in choosing a treatment provider.

Adds Pike: “The gambler starts having these thoughts—‘This is my lucky day, this is my lucky number,’” Pike says. “The gambler’s fallacy is that ‘If I continue to gamble, I will win it back.’ Because there has been a big win in every gambler’s past, and that has a tremendous effect on the brain.”

Negative emotions such as helplessness, guilt, shame, and anger can trigger the gambling urge, experts say. Problem gamblers cope with these emotions by attempting to replace them with the positive feelings that gambling generates in the brain. In the case of “escape” gamblers like my mom—those who favor slot machines and more solitary forms of gambling—the brain enters a trancelike state that allows the problems of everyday life to recede. “Action” gamblers prefer games such a poker or sports gambling, craving the adrenaline rush that comes from competition.

There Is Hope

The good news is that it’s possible to successfully treat gambling addiction with a combination of psychotherapy and medications or through 12-step programs based on Alcoholics Anonymous.

In therapy, psychologists work to “retrain” the brain by substituting other thoughts or activities when the urge to gamble arises. The UCLA Gambling Studies Program has published a self-help workbook for problem gamblers, asking its users to identify the positive and negative effects of gambling along with other pleasurable activities to replace the destructive activity. These activities can include listening to music, exercising, and engaging in other diversions that allow a person to ignore the gambling craving. Over time, the craving fades as the brain learns to find pleasure in other ways.

Medications aimed at easing depression, anxiety, and obsessive -compulsive behavior, in conjunction with psychotherapy, can also help control the urges, says Dennis McNeilly, associate professor of psychiatry at the University of Nebraska Medical Center and a specialist in the field.

Before pursuing any kind of medication and psychological therapy, McNeilly warns, older adults should undergo a comprehensive geriatric assessment to make sure that the gambling problem is not caused by dementia or an early form of Alzheimer’s disease.

One of the most widely available sources of help for problem gambling is Gamblers Anonymous, a fellowship with meetings (including some in Spanish) in all 50 U.S. states and 49 countries. Because of its pledge of anonymity, Gamblers Anonymous doesn’t track participation or success rates, but more than 1,000 meetings are held weekly worldwide and that number, says Karen H., GA’s international executive secretary, is “definitely growing.”

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