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Illinois has done little to address addiction 6½ years into legal video gambling

Video gambling became legal in Illinois in 2012, but the state still hasn’t addressed addiction in a meaningful way. Part 2 of 'The Bad Bet,' a ProPublica Illinois-WBEZ Chicago special report.

Video gambling became legal in Illinois in 2012, but the state still hasn’t addressed addiction in a meaningful way. Part 2 of 'The Bad Bet,' a ProPublica Illinois-WBEZ Chicago special report. | David Kasnic / ProPublica Illinois

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

One spin every six seconds. That’s 10 spins a minute. Six hundred 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 restaurants and bars around his hometown of Maroa, a farming community of close to 1,700 people 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 six and a half years since video gambling became legal in Illinois in September 2012, 30,000 video slot and poker machines have been installed at 6,800 locations around Illinois — more than in any other state. Gamblers in Illinois have lost more than $5 billion playing the algorithm-driven machines, which have been described as “electronic morphine” and “the crack cocaine of gambling.”

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. Today, despite promises to increase funding for gambling addiction, Illinois spends less than it did before legalizing the machines, a ProPublica Illinois / WBEZ Chicago investigation has found.

This is a collaboration among <a href="https://www.propublica.org/illinois/" target="_blank" rel="noopener">ProPublica Illinois</a> and <a href="https://www.wbez.org" target="_blank" rel="noopener">WBEZ Chicago,</a> co-published with the Chicago Sun-Times. It's the first story in an occasional series "The Bad Bet," investigating video gambling in Illinois.

This collaboration between ProPublica Illinois and WBEZ Chicago, co-published with the Chicago Sun-Times, is the second story in the occasional series “The Bad Bet,” investigating video gambling in Illinois.

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Over the past decade, the number of people getting state-funded addiction 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.

The state has failed to adopt basic prevention measures, such as a self-exclusion list that would let people bar themselves from playing the machines or safeguards to ensure that anyone who is underage can’t gamble on the devices.

Instead, Illinois lawmakers have fixated on how much money video gambling has brought state government. That’s even though, as a ProPublica Illinois/WBEZ investigation reported in January, that revenue has fallen far short of the Legislature’s projections, even as video gambling has saddled the state with unfunded costs.

Now, some lawmakers and the gambling industry are pushing for another expansion that would include sports betting, new casinos and 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 expansion in hopes of tapping new revenues. Of the eight states that have legalized video gambling outside of casinos, Illinois is one of two — West Virginia is the other — not to track the rate of gambling addiction, a decision that a leading gambling researcher calls “mind-boggling” given the number of video gambling machines the state has and the amount 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 that about 217,000 Illinois residents are addicted to gambling. As with substance abuse, addiction to gambling generally is defined as involving behavior that jeopardizes someone’s financial security, relationships and emotional well-being.

The number of people afflicted is likely higher, though. 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 latest available figures. The number of people assessed or treated for gambling addiction by state-funded providers in Illinois declined by nearly 37 percent in that time.

While Illinois’ highways are dotted with billboards advertising video gambling, little has been spent to raise public awareness of gambling addiction or to market the few resources that are available to combat it. The most prominent — the state’s 1-800-GAMBLER hotline — got 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 to deal with gambling addiction. That’s because, unlike three other states with legalized gambling, Illinois does not set aside tax money from video gambling to pay for 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 treatment center Way Back Inn, which treats about 80 people a year with gambling problems. “Our state is so driven by the money video gambling brings in, we don’t see the people it impacts.”

Go to a gambling parlor in Elmwood Park, a pizza joint in Springfield, a motel in downstate Clinton or a string of bars in Berwyn, whether at mid-afternoon or after midnight, you’ll see people 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.”

David Kasnic / ProPublica Illinois

Like alcohol or a drug

In May 2013, less than a year after Illinois began allowing video gambling, the American Psychiatric Association reclassified “gambling disorder” from compulsion to 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 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 behavior. Researchers have found that gambling addiction often is accompanied by other forms of addiction.

Dr. Charles O’Brien: “Many clinicians have long believed that problem gamblers closely resemble alcoholics and drug addicts.” | University of Pennsylvania

Those who are susceptible might wager beyond their means or spend inordinate amounts of time gambling. Unable to see or indifferent to the consequences, they might find themselves lying to loved ones, turning to crime to cover 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 who said she lost her business and struggles to stay 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 have looked at this. They argue that some people are at risk of becoming addicts regardless of the type of gambling they choose.

Christine Reilly, senior research director for the National Center for Responsible Gaming, a nonprofit largely funded by the gambling industry, pointed to research it’s funded that found that 70 percent of gambling addicts already suffered from depression, anxiety or other mental health issues. Reilly said that 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.”

But other studies have shown that people might 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, a leading gambling researcher and associate professor in the School of Public Health and Health Sciences at the University of Massachusetts Amherst.

Rachel Volberg. | University of Massachusetts Amherst

The state’s trade group for video gambling, the Illinois Gaming Machine Operators Association, says 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 that greater access to gambling can increase addiction rates. They say the proliferation of video gambling in Illinois is likely to have fueled a rise in addiction.

But Illinois doesn’t know the extent of its gambling addiction problem or how it has changed as the number of places to gamble has grown. The Legislature never commissioned a 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?” Volberg said.

‘Electronic morphine’

On a Thursday afternoon, you can walk in to 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 might 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 lets players bet as much as $2 a turn, distributing their money among as many as 200 lines that zigzag across the screen. 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 as 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 the bet was 40 cents. So you’ve actually lost 30 cents — 75 percent of your wager, a sleight of hand known as a “false win” that experts say keeps people gambling.

Some researchers describe video gambling as “electronic morphine” and “the crack cocaine of gambling.” Every detail of the 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.

For 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 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 machine contains an array of games 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 in the armrests, so people can play without moving their arms.

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, it’s 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, help

In May 2009, when the Video Gaming Act came up for a final vote, not a single member of the Illinois Senate spoke about the social costs of gambling. In the House, according to transcripts, only one lawmaker, Rep. Rosemary Mulligan, R-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 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.

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 gamblers lost $1.2 billion, according to state reports. The state’s take was about $300 million. Municipalities that have video gambling got about $60 million. Terminal operators and establishments took in $840 million.

The sponsors of the Video Gaming Act estimated that 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. The Legislature has never appropriated more than $1.03 million.

The Illinois Department of Human Services — which issues grants for treatment, outreach and training for clinicians — has struggled to spend the money that is appropriated each year. In 2012, for instance, the agency spent 83 percent of the money appropriated for gambling addiction, according to its own financial reports and figures from the comptroller’s office. By 2017, the percentage had dropped to 63 percent.

Officials with the human services agency said providers have had trouble getting gambling addicts to seek treatment and that there are not enough clinicians who specialize in gambling addiction. They said providers often don’t spend all the money they’re awarded in contracts. In 2017, for example, the agency 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,” officials said in a written statement. “While there are many people who have serious problems with gambling, only a small percentage actually seek treatment.”

They said the state office “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.”

But, between 2012 and 2017, its spending on gambling addiction fell by 20 percent, from $807,000 to $646,000, even as the number of video gambling machines grew dramatically and appropriations increased slightly. The number of people receiving services dropped by 37 percent, from 6,773 to 4,274.

Officials said some of the decline in patient numbers might be attributed to gambling addicts being treated for accompanying alcohol or drug abuse, 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.

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

In 2017, the human services department used more than 40 percent of the money it spent — about $300,000 — on outreach and awareness, up from 25 percent in 2009. Officials said they are planning a push in March, Problem Gambling Awareness Month, that will include a new website, mailers, flyers and posters.

A lack of clinicians certified to treat gambling addiction has also made it hard to tackle the problem, according to agency officials. 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 sometimes attend one of the more than 60 Gamblers Anonymous meetings that are held in Illinois every week. But 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.

Though many who attend the meetings say they believe the program helps, a majority of those meetings are held around Chicago, leaving gambling addicts outside the 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, a prominent gambling researcher who has studied addiction in Illinois. “The central theme around video gambling is: No one cares.”

A possible preventive step

One measure has proved somewhat effective at helping problem gamblers: a registry, called a self-exclusion list, that lets people 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 said the technology to create a self-exclusion list exists but that implementing it across the state’s 6,800 video gambling locations would pose a huge hurdle and 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 says 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. For years, gambling interests have lobbied successfully to thwart the board’s proposed rules. 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,” Tracy 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 9,000 Illinois residents, had put themselves on the state’s self-exclusion list for casinos. Of those, nearly 38 percent, about 5,700, said video gambling was why they applied to be 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 also can 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 have 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 deal with 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. Illinois Gaming Board officials said they believe these measures are ineffective, as players can 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 hasn’t enacted basic measures other states have to help keep out underage gamblers, such as requiring a manager to check identification or keeping machines out of view of those under 21.

The gaming board began enforcing the ban on underage video gambling in September 2015 — three years after the games became legal, 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.

Tracy, who took over the board in February 2015, said underage gambling “is a gigantic problem here because we have 6,800 locations. 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 spoke on the condition he 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 said he was told he should just stay away from establishments with the machines.

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

Orville Dash, 81, says he spent about $2,400 a week on video gambling machines at the height of his addiction. | Whitney Curtis / ProPublica Illinois

Gambling addiction ‘most difficult of issues’

Sitting in his recliner on a brisk afternoon, his pudgy dog Nikki snoring on the carpet beside him, Orville Dash, the former Caterpillar engineer, 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 said he suffers from macular degeneration, lung cancer and Parkinson’s disease. He’d become wobbly on his feet and recently had fallen, cracking two ribs, and said that it was only his ailments that were keeping him home.

A recovering alcoholic and former longtime smoker, Dash said he entered a treatment program for alcohol abuse while working for Caterpillar in the 1970s. He learned about the 12-step program there and said he has used it 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, he struggled to understand why he kept returning to video slots. Despite his statistical training, he couldn’t contain the irrational hope he would beat the odds and come out ahead.

“I knew better than that,” he said. “But I did it anyway.”

Jason Grotto and Sandhya Kambhampati are ProPublica Illinois reporters. Dan Mihalopoulos is a reporter for WBEZ Chicago.

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Read ‘The Bad Bet,’ Part 1