← Thriving with Addiction with Dr. Jonathan Avery
Thriving with Addiction with Dr. Jonathan Avery
The Rapid Rise of Gambling Addiction with Tim Fong
00:38:29
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A
Welcome to the Thriving with Addiction podcast where we explore how recovery is not just about surviving, but about truly living. Each week we'll dive into the science stories and strategies that help people and families heal from addiction and build healthier, more resilient lives. I'm your host, Dr. John Avery. Let's get started,
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John.
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A
I'm John Avery and welcome back to Thriving with Addiction. Today I'm joined by Tim Fong. Dr. Fong is a clinical professor of psychiatry at the Jane and Terry Semmel Institute for Neuroscience and Human Behavior at ucla. He completed his undergraduate and medical school at Northwestern University in Chicago. He then came to UCLA and finished his residency and Addiction psychiatry fellowship. He now serves as the co director of the UCLA Gambling Studies Program. The purpose of this program is to examine the underlying causes and clinical characteristics of gambling disorder in order to develop effective evidence based treatment strategies. He also now runs the UCLA Addiction Psychiatry Fellowship and is part of the faculty leadership of the UCLA Cannabis Research Initiative. Tim, thanks for joining me.
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B
Thanks for having me. It's great to be here.
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A
I'll add that you're also the president of the American Academy of Addiction Psychiatry, in charge of all the addiction psychiatrists in the country. What are you doing with that power?
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B
Well, I don't know about in charge of all, but it's an amazing institution and organization. American of Addiction Psychiatry. Founded in the mid-80s. We have 1500 members. It is the home of addiction psychiatrists and also anyone who does addiction care. So you've been to those annual meetings. You know what we stand for, we talk about it and it's just a, a privilege and an honor to be the president for 2026 and 2027.
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A
Well, I know you'll lead us boldly into the future. And you've always been ahead of your time. You were one of the first experts in gambling. And tell us how you ended up as an addiction psychiatrist and getting into this field of gambling.
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B
Yeah, you know, it's a fascinating story, at least I think so. I grew up in the suburbs of Chicago in the 80s hard Gen X, enjoying culture and stuff in the 80s and music and movies. And I went to medical school or college at Northwestern and I got a degree in English and bio. And at the time I actually wanted to be a science fiction writer. I think Michael Crichton had just come out with er, you know, Jurassic park and I thought that would be incredible to write science fiction. But that's very, very difficult. I'm like, well, fine, I'll go to medical school. And In Medical School 1994, it was July 1995. I went to the Betty Ford center, the summer institute for medical student. I did it to beef up my resume to get a free trip out to Palm Springs. And that changed my life because that's when they talked about addiction as a brain disease. It talked about the psychosocial components of addiction. But furthermore, for spending a whole week with men and women with addictive disorders, just entranced by their stories and by just how they fell into it, how they, you know, the pain and the suffering and the hope and the recovery, they got me interested in addiction. Some of my early mentors were Sheldon Miller and John Franklin, who were pioneers in the field of addiction psychiatry. Lawrence Westright there of New York. In 1997, I went to my first addiction AAAP meetings. That's how I got started. I came to LA match 1998, 2002, and one of the first things I saw landing in LA was a casino. I said I didn't realize that they had casinos in California. And that led me to just always be curious about the gambling culture in America. And obviously in the last 25, 26 years, we've seen huge changes in American culture around gambling, from tribal gaming to destination resorts, online poker, now online sports betting, prediction markets, and literally, can I get away? Massive Powerball numbers. And so that's kind of how I got into it all. But addiction psychiatry, for folks who are just hearing about it for the first time, it's a distinct medical field. We are psychiatrists that provide mental health care with addictive disorders and co occurring mental health illnesses. I fold it under the rubric of addiction care. We have our friends and colleagues in addiction medicine, internal medicine, family medicine, anesthesiologists. So all of us provide addiction care, but we can't neglect our friends in psychology and social work and marriage and family therapists. You put it all together, we are all addiction specialists. And that's my little song and dance about how I got here.
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A
Well, we're very lucky you're one of our addiction specialists and that you decided to, to specialize in gambling. So let's jump right into gambling. It's changed a lot over time. I think when you and I were growing up, you know, I was into sports too. I mean, we would, you know, we would bet a little bit on March Madness or on the super bowl, play poker with friends, and it wasn't as it is now. How have things developed over time?
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B
So if you trace the story the last 20 years, gambling in a lot of different arenas, brick and Mortar, casino gambling, the lottery, online opportunities, spend money on gains of chance, have all expanded in the last seven years with the rapid expansion of sports betting. We've seen what we now have in American culture, which is a normalization of gambling. Gambling is no longer seen as a vice, it's no longer seen as a sin. It's no longer seen as a morally questionable activity. So when you normalize an activity because you have businesses that have sprouted up, governments that have legalized it, advertisements that have promoted it, then of course you're going to get a normalization of gambling everywhere. Combine this with our phones and we sometimes forget you can gamble not just on sports, but you can gamble on poker, and you can even have video games of which you can spend money on that are essentially forms of gambling. So we've taken a human element, something that we all do every day in our lives, which is take risks, which is gamble with our time, our money, our careers, our relationships. And we've now basically made it into a 24, 7 activity we can do on our phones or over the Internet. And again, American culture has said we are okay, we are completely okay with gambling. We don't mind gambling as an activity. We're not going to forbid it. Imagine again, growing up in the 80s, you could only bet on sports in person in two states, Nevada and Atlantic City. Now, every single state in America has unregulated gambling on sports. And now nearly 40 states have state sanctioned and approved forms of sports betting. No other form of entertainment, I think, has changed so dramatically, so quickly in the span of just literally 25 years.
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A
I have no doubt in my mind that if I was growing up now, with my love of sports, with the way I was sort of back then, with the guys growing up, I would have been online betting on sports in high school. And I'm sure many of my friends would, and some of them would have ended up in trouble, whereas we sort of escaped it from not having this access and availability. The access and availability is just so tremendous, as you're highlighting.
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B
And that creates risk anytime we know in addiction. Access, availability, anonymity, all that leads to potential risky behaviors that can lead to addiction. I did a presentation a couple weeks ago to a lacrosse high school team. So, like 35 young men, all under 18 years of age. So how many of you guys have a gambling app on your phone? 80%. How many of you are betting real world money on those apps? Every single one of them. I said, you realize every single one of you, that's illegal, that's not allowable. And they were like, no, it is. It's completely. Why? Because everybody's doing it. I said. So I said, guys, how are you getting access? My dad has an account. He gave me the password. My brother, who's in college, we share an account. I pretended I was 21 and I used a VPN and here I am. So if I said, hey, if that entire lacrosse came with drinking alcohol or using drugs, you know, it'd be a scandal. So that's a perfect example. Now, do I think that's a bad thing? I think it's a risky thing. I think for at least a few of those team members, they're going to run into trouble, they're going to run into some harm. And that could create problems for them, not only right now, but four or five years from now.
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And just to sort of put some numbers behind all that, how many people are gambling betting these days? How has that changed over time?
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B
So again, we go back to how do we define gambling? I define gambling as putting something of value, usually money, but it could be your time on event of uncertain outcome in the hopes of winning a larger reward, but knowing you could also lose your initial investment. So gambling traditionally is thought of games of chance, randomness, slot machines, roulette, blackjack. Then you get into other forms of gambling that people are saying are skill based gambling, like poker or sports betting, like older school sports betting. But you know, things like gambling in the lottery, people will say, oh, there's no skill there. That's clearly chance and randomness. I think that's where things have changed a lot, where sports betting. Sometimes people say, well, I don't gamble, I bet on sports. Because they don't view it as randomness. They think they have a skill to it. Pile it all together. We know that through some surveys, national and local stuff, with that, about 65, 70% of Americans in general will have gambled on one of those formats in the last year. We know that in the last couple years that in the college age groups that velocity of who's gambling, who's gambling with frequency has gone up dramatically, where now it's almost 60, 70% of college students report gambling actively. But what I'm more interested in was the number of gambling addiction. So the prevalence of people having gambling disorder in various states has ranged anywhere between 1% up to 6% of a state just walking around claiming that they have some problems related to gambling addiction. That's a big number. So like Oklahoma, Illinois, Massachusetts, 4, 6%, you know, almost, you know, one out of 21 in, you know, 15 people, that's a pretty big number. So I think that's a concern where we see rise of gambling addiction incidents and prevalence. But then on the flip side, we know just by nature, gambling is a risky activity. You are going to spend money, you are going to lose money, you're going to spend time. The sheer nature of it as a form of entertainment can lead to harm, just like alcohol and tobacco. So we have a lot of folks who, you know, don't have alcohol use disorder, but they get a DUI or, you know, they get assaulted. They're not people with addiction. That's just a public health consequence of drinking. Public health consequences such as gambling include gambling disorder, but also include those other things, other unintended consequences like debt or spending more than you wanted to, or not spending time on doing something else, or cannibalizing your entertainment dollar. So instead of going to the opera or building your backyard, it just goes to a casino.
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And how do we know when we've reached that point of the gambling addiction? What does that mean exactly?
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B
So it's interesting, right? When we went to medical school, you and I, and residency gambling was called pathological gambling and or at least gambling addiction was called that. And it was considered a impulse control disorder, meaning it wasn't considered an addiction. It was considered in the same category as pyromania, kleptomania, trichotillomania, impulse control disorders, kind of that catch all basket that in med school we kind of read. But we knew it wasn't going to be on the test, right? So then you Fast forward to 2013. DSM 5 comes out. Can you believe it's been 13 years? But DSM 5 comes out and because through the power of science and research, they then place gambling, pathological gambling, into the same chapter of other substance use disorder. The chapter, of course is called substance related and addictive disorders. 10 classes of substances, alcohol, tobacco, cannabis, opioids, set of hypnotics, stimulants, blah blah, blah blah blah. Gambling disorder is inside that chapter. Now. It's called gambling disorder. The criteria are similar to substance use disorder. It's an addictive disorder. So that's how we categorize and think about it. Now we use the term a person with gambling disorder. I don't like hearing, oh, he's a gambling addict, he's a degenerate gambler, he's a compulsive gambler. Those are old terms and similar to a lot of the work you've been doing, you know, through the years. Of destigmatizing. We want to destigmatize gambling addiction by calling it what it is. Is a person with a gambling disorder.
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That's right. And I guess related to the definitions for other addictions, it's when the gambling starts to impair the function or there's other criteria that need to be hit when it's qualifies for an addiction.
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B
Yeah. And again, people ask that all the time. And I say we don't have a blood test, we don't have a brain scan. Our clinical interview looks for the following things. We look for that basic pattern. Does someone's gambling behavior increase and improve their quality of life or does it create harm? If it creates harm, do they view gambling as a solution to their problems? If they say yes, then that's really leaning toward the lane of gambling disorder. The specific symptoms are going to be things like preoccupation with gambling, lying about your gambling tolerance, and withdrawal to gambling activities, meaning you bet the same amount but you don't get the same sense of thrill or you need to bet more and more and more and more to get a sense of action withdrawal, where you literally cannot gamble and you have like flu like symptoms which are impairing you. You have things like continuing to gamble despite harmful consequences to your work or losing out opportunities. One unique one in the gambling addiction world is chasing where the symptom is you chase your losses by repeatedly going back to get your losses back. Now people will say, well, doesn't everybody do that? And the answer is no. There's lots of people that have a weekend gambling or download an app and they spend a couple hundred dollars and they said that's enough, I don't want to do this again. And they just literally stop and they don't gamble again for a year or, or long longer. Someone who chases their losses, they lose that money and then they immediately have an intense desire to get back that money. They chase their money even though they may not have the financial means to it, or it's just, it's a struggle. And I think that's a perfect example of a gambling disorder symptom.
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And so many of us are going to get exposed to gambling. Now with this availability, are there certain people that are at risk of transitioning on to full gambling disorder?
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B
You know, one of the things we all been working on, right, is what causes addiction. You know, and I'm excited to read about your book because I'm sure there's going to be some things I'm going to learn there, but biological Psychological, social, spiritual causes for addiction when gambling disorder is no different. So it's interesting, we know that there are some biological risk factors. Family history, head injuries, other certain types of neurologic conditions, being exposed to certain medications that alter your dopamine system. All these things could generate biological risk. Sleep deprivation, that's a biological risk. Not exercising, not the biological risk. Psychological risks are personality. Folks who are very impulsive, who are sensation seeking, people who like to take risks, people who also aren't bothered by losing. So the irony is that many people with gambling disorder, the losses hurt, but the loss, the hurt from the losses don't stick. They may have a big loss and then that's why two or three days later they're like I gotta get it back. And they don't remember how bad the pain was. Right. So it's kind of a loss aversion sort of quality. But high levels of impulsivity, high levels of wanting action and other psychological risk factors are clear where it's going to be. Untreated mental health conditions, adhd, depression, bipolar disorder, personality disorder. I had a patient with ADHD who said it so well, I'm bored with everything in my life that's part of my add. I need a high level of stimulating activities that draw my attention. The only activity I can do that draws my attention is betting on sports. So that's kind of like a self medication hypothesis. And then lastly the social risk factors that lead to gambling disorder. Of course, as we mentioned briefly earlier, availability, access, anonymity and social acceptance of gambling. I had a young man who came to my office last week, college sophomore, didn't gamble at all in high school. Zero loved sports, got into a very good school here on the west coast and within a couple of months of coming here I was gambling on the app. Because that's what all the college students and his friends he met were doing. That was the major social point of discussion. What are you betting on today? What games do you like? What numbers are you into? That's what the young men were talking about. Instead of saying what music are you listening to? Or what do you think of that movie? Or what do you think of that Marvel show they were talking about? What Betsy, do you have going on tonight? You fast forward about a year and a half later. Unfortunately he's developed a severe gambling disorder. Lost well over a hundred thousand dollars of his savings. Lost time, lost productivity, grades declined, stopped exercising, isolated, more lonely, more emotional pain. All that could be tied directly from the gambling behavior. A gambling disorder that created misery financially Misery emotionally. So his story is not uncommon. So when people say, well, what does it look like? It looks like that visually when I met him, strapping, healthy young man, fit, looks, looks great. Inside, though, he's really, really hurting. I think that's the sort of thing that makes it so difficult with gambling disorder, as people can say, well, everybody's doing it, it's natural to lose money. So how do you tell the difference? Well, we spent a good part of an hour highlighting how his gambling behavior was not normative, was not part of the typical experience that people have with sports betting, and that all the pain and suffering he had wasn't normal, that that was part of the condition that comes with addiction.
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And a lot of the examples you've given today are males. Does it impact males more than females?
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You know, it does in the sense that we have many, many, many more males coming into treatment. When we do survey data of prevalence rates, it does tend to be more male than female, particularly in the sports betting world. But it's narrowed and a lot. For instance, like if you look at just slot machines, it's about 50, 50 in terms of who comes to treatment for slot machine gambling disorder in terms of gender. The question I can't answer, we've been trying to debate is why aren't there more women coming into treatment with sports betting, gambling disorder? Just don't see any of that. I know that there are a lot of women out there betting on sports, more so now than ever before, but we're not seeing at least them present the treatment. So I think that it's happening. I think it's still very stigmatized in terms for a female with a gambling problem, and particularly betting on sports, which is a predominantly male world, to admit in a, in a public setting that, yeah, I, I have a gambling problem on sports.
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And then when gambling does develop, does it make changes to the brain? Or what have we learned in terms of the neurobiology of all this?
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So the question I would say is, do you think gambling can be neurotoxic? We have no doubt in our minds, of course, through science and methamphetamine, cocaine and, and even cannabis, to a degree, impacts brain structure and functioning. We now are, are, are recognizing that gambling does the same thing too. You know, we know that there's some biological vulnerabilities in folks, but then again, just the sheer act of gambling excessively over months or years is probably not good for brain structure and functioning. All right, well, I have a good
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sense now of how gambling develops, what it Looks like what to do when you're in trouble with gambling. What are some of the treatments that are out there?
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So we're changing our language to say to folks, if you're curious about what gambling is doing to your body, your brain, your mind, your wallet, or your future, that's the time to go in and talk to a person who is very, very familiar with gambling behavior. This is a way kind of destigmatizing it. However, you know, the simple matter is when people know, by the time people call me, they know they have a serious problem. They're suffered a lot of damage. Like this young man I spoke to, he was hurting. He was hurting hard, and his parents had no clue. They just thought he was fine. He looked great. He showed up on time, and they weren't looking at his bank accounts. So he said to his mom and dad, oh, my God, I made this terrible mistake. I spent all this money in gambling. I don't know what to do. But he's not the one that called me. His mom then said, okay, let's get you professional help. So she googled gambling addiction help, finds my number and calls. So I think for anyone watching this who's concerned about your own gambling or someone else's gambling, the first stop is professional help. So, thankfully, we have a lot of helplines. 1, 800, gambler or 1, 800, my reset that gets you linked up to gambling treatment experts right away. But I think people have to recognize, like any other medical or psychiatric condition, the longer you wait, the worse it's likely to become. By definition, addiction can be progressive. Sometimes people figure it out on their own. They're able to modify and cut back on their own. And those are probably going to be the mild or more moderate cases. But I think it just behooved people to realize, well, if gambling is taking on too big of a role in your life, it's okay. And it's probably better for you to go talk to a professional therapist. And even just one time or two times can make a huge difference in the clinical course of gambling disorder.
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And so you call, you look for help, and then you're seeing a therapist, a psychiatrist. What sort of therapies exist for this?
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So the, the good news is that treatment works for gambling disorder. And people say, well, what do you actually do other than tell people to stop gambling? Do a lot, a lot of what we do with the principles of other addictive disorders. We have biological treatments, psychological treatments, social treatments, and spiritual treatments. So the biological treatments we have, certain medications have been Shown to reduce and dent the urges, the craving, the preoccupation, the rewarding experience that gambling has. So that's kind of cool, right?
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And that's naltrexone, the primary.
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Primary, yeah, naltrexone is the main one, but we'll also use lithium. Now emerging are potentially transcranial magnetic stimulation. That's very, very interesting. We've had a lot of antidepressants have been tried with not a lot of success. But a lot of medication strategies are about treating the co occurring disorder that's driving gambling addiction. So again, if ADHD is not treated or depression's not treated, well, we know the gambling disorder will continue to thrive. So you treat those other co occurrence disorder, things get better. I also think that again biological treatments are sleep and exercise and nutrition. So people are like, you gotta be kidding me. You know, I'm like, no. Sleep, nutrition, physical movement allows your brain to heal. So, so those are the things we do in that the psychological treatment. A wide variety of psychotherapies that work from supportive psychotherapy, cognitive behavioral therapy, motivational interviewing, psychodynamic therapy. But the relationship of the therapist that allows you to talk about what gambling did and didn't do to your life I think is profound. I've had so many folks come in and say I don't know what good it's going to be to talk to you about all the money I spent and lost gambling, I can't get that money back. I'll say our goal isn't for you to get that money back. Our goal is to deal with the emotional pain that came with losing that money. And they're like aha, now we get it. And then social treatments. Of course the mainstay is Gamblers Anonymous and providing 12 step fellowship and support for folks experiencing gambling disorder. But there are other now new social treatments such as self exclusion programs where you ban yourself from casinos and apps. We have software blockers. We have now a gambling recovery app. One that I'm working with is a group called Evive E V I V E where it's a very neutral gambling app that gives messages of hope, Built up skill base, kind of like calm and headspace for meditation. But now we have that for gambling behavior as well.
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A
If you're struggling, how do you decide which of these to tackle first? Do you go to Gambling Anonymous? Try the apps, see a psychologist for the therapy. How do you know where to turn?
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So a lot of my patients have said, well I'm just gonna go online and see what I can do. So you can do things immediately right now, 24, 7, you can download the app, you can listen to gambling recovery podcasts where you can hear other people's journey through recovery and try to apply it to your own life. These are things that are completely free and could make a huge impact for you right now. You can call a helpline. And even just calling a helpline and talking about your situation can be helpful. Getting guidance from a helpline counselor. But again, when people want to get down to the much more sophisticated route of a professional that's going to be checking with your insurance or checking with a therapist directory through these gambling helplines to get therapists that are very, very well trained in gambling treatment.
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Okay, and is gambling Anonymous Similar to AA or other 12 step work, or are there differences there?
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The principles are similar. The idea of fellowship, the idea of safety, the idea of a room or zoom or an online meeting full of other people who aren't going to judge you, who aren't going to criticize you, who aren't going to blame you for what you've done or what you think you might do, and instead provide messages of hope and support. They have online meetings, they have in person meetings. They have some things that ga, gambled Anonymous do a little bit differently. They have like pressure relief meetings where they will talk a lot more about managing debt and finances. They obviously don't give out chips, you know, to mark recovery, abstinence. They give out, you know, pins or other things there. But the data, and it's kind of not nearly as well studied as we'd like, but whatever data does exist, shows that if you have a sponsor and a commitment to a meeting, you do tend to have better recovery rates and higher abstinence rates from gambling.
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And I find it very hard some of the behavioral stuff for people to do, like exclude yourself from all these different apps and opportunities, but also how to involve family in managing your money or keeping an eyeball on your money and managing finances in general. What do you recommend around those sort of things? And how to involve family in helping with the checks and balances.
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B
So for years I would just see gamblers in isolation, just the patient. Then I realized, would we ever treat cancer, just the patient? No. And that all medical conditions are always better outcomes and better treatment when you involve family members and other folks to create a village around that person. So that's really kind of where that's broadened out. Where I've been spending a lot more time with bringing family members in earlier to talk about things like money Management, who's going to pay the bills, consequences if gambling continues to go unchecked. Reducing enabling. I get a lot of cases where folks are enabled very, very much so by their family or by their friends, and they just keep getting money sent to them. And that's a form of enabling. So that's something how we involve the family. We like to do that super early on. I think for folks that, again, are having so much shame about what they've done is we work a lot in the beginning to reduce that shame and say, you know, you do deserve to come here. There is a way out. There is a way to improve your life. I think that a lot of times people don't think that, or there is, and there's still a lot of puzzling. A lot of people are wondering, what do you actually do inside that hour with patients? Like, how do you actually help them? And I think that's what I've learned through the years by helping them, by just actually letting them hear their story, letting them find their voice and highlighting things for them that they may have neglected or just not taken seriously. I mean, so many of my patients just don't take exercise or physical sleep as a serious part of recovery, right? They just say, oh, well, no. But I tell them exercise has been shown to be as powerful as any pill we can prescribe. And I think those are the sort of things that we really focus on.
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At what point do you start to consider more intensive treatments like outpatient rehab or inpatient rehab? Does that play a role in this addiction as well?
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B
You know, it does. And some people are surprised to find out that there are brick and mortar residential treatment programs for gambling disorder. There's one here in Los Angeles called Right Action Through a place called Batshuva Algamus, you know, is out there in Arizona. There's Prescott House, there's Core in Louisiana. So there are a number of dedicated programs where it's gambling only. But clearly residential treatment is required, just like it is for other addictive disorders when there's a threat of significant loss of life, an overdose, if there's morbidity, if there's a clear need for containment, where if someone isn't contained, their mental health is going to get worse and worse, or they may do something regrettable or, you know, that would set them back. I think also when people have declared that, hey, I want a lot of treatment quickly, that's where a residential treatment setting makes sense. I want a lot of groups. I want to be removed from this world. I want to be Able to really work on my gambling and mental health problems much faster. When people see me, we're talking about once every two weeks, maybe once a month. There's a lot of questions that people have instead, and that's where a residential program might do it. But it tends to be again, folks who are in crisis and need that containment. For instance, folks dealing with the criminal justice system where if they don't go to treatment, they're likely potentially to be incarcerated or know, in jail or something worse. So those are some scenarios, but, but again, co occurring things like acts of suicidality, active substance use, that's really, really dangerous. Unable to function in your daily life. Concerns that if you don't get treatment, your behavior could lead to other really darker chapters, including things like intimate partner violence, white collar crime, blue collar crime, you know, whatnot. Those are the levels of containment.
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Okay, well, I have a good sense of what each individual should do. I feel like you've highlighted a lot of things we need to think about as a society too. I mean, it's, you know, we've talked about big tobacco and big marijuana, but there seems like there's almost this big gambling lobby or forces that have really caused gambling to be everywhere and accessible to everyone. And do we have to think about it like we're thinking about it with social media and getting it off the phones and not exposing kids to it or what's sort of the bigger societal strategy to tackle this, do you think?
- [32:57]
B
Well, you know, that's the ticket, right? It starts with the adults in the room who make laws around gambling or regulate gambling. We made a clear decision that we thought as a society that we should regulate gambling from the government level. We regulate a lot of things from the government. Food quality, air safety, air quality, radio, television, you know, communication, tobacco, alcohol. So it makes sense that we're gambling or regulating gambling because of the risk involved. And we want a fair game. You want a product that is not rigged. Right. So that's why we regulate these sorts of things. On the flip side though, states earn a lot of revenue from gambling. So you know, it's kind of a strange position to be in. On one hand you're saying, hey, it's so dangerous and risky, we got to regulate it. But on the other hand, you're saying, hey, we want as many people to do it because the more people that do this activity, the better it is for our state. And we don't have to raise taxes, which is highly unpopular. So that's one thing. From a societal standpoint, I think Any of our state laws have to be enforced better, firmer and with more clarity. As an example, regulations around gambling advertising don't happen nearly as well as I'd like to see. Trying to go after unregulated forms of online gambling and shutting those nefarious websites down. That needs to happen. Monitoring gambling apps from a regulatory standpoint and saying which apps and which features of the app are the most addictive and the one that we should ban. Right. We ban certain types of alcohol. Right. And when it's above certain proof, right. You know, with cannabis, you know, there's certain dose limits and concentration limits that you can't sell legally. So why aren't we putting these kind of practices in place for gambling? You know, to say if there's a type of bet or wager that's very, very addictive, it's not likely to generate any positive return for folks and maybe we should get rid of it. So. But it all starts also with the consumer. You know, why are people so into these things? Well, they're interesting. The promise of fast money, peer pressure, it's frictionless. That's the term we use, right? It doesn't take much to get a bet down. And once the bet's down, that's when the dopamine starts flowing about. Maybe I'll win, maybe I'll get some money, maybe something good will happen, might come my way. So I think that part has to be very, very, very much a task to say to folks in educating people of all age groups, from teenager, young adult adults, middle aged, older adults, to say, if you start to spend money on your phone on a gambling related platform, whether it's sports betting or prediction markets, or I casino or poker, you really have to be well informed about what these products are and aren't. And you really have to recognize that you need to be educated to do this thing well. You know, it's funny, we don't teach our young kids how to drink, how to smoke, how to use cannabis. Right. We teach our young kids how to drive a car. And we say in order for you to drive a car, you have to meet these basic standards of safety. I've always wondered that. Was there a society at one point where there was no driver? Said, yeah, you know, when it first came out, right. And at some point someone made a decision to say, no, we want to protect the young people. Same thing goes with gambling. Are we going to reach a point where we say in order to protect new people coming into gambling, that maybe you gotta have a gambling license? Card before you can actually place bets, meaning you've taken, you know, four or five hour course. I don't know. But I think about that. Those are some solutions where society could come from. And the last big one, of course is holding credit card companies and banking companies accountable for money. That's way too easy. When I was 19, when you were 19, if I said go get $500, there's no way either one of us could do it. You know, you can't get a loan, you can't get an advancement from a friend that fast. But nowadays 19 year olds can. Payday loans, reaching out to PayPal, putting up a GoFundMe, taking out things on credit and using that to do other things. So all that I think has to be looked at about how do we limit credit in a way that doesn't diminish people's ability to spend money quickly? But also is there really a need to have $30,000 of credit available to you every single day on your credit cards and those sorts of things?
- [37:37]
A
Well, Tim, I really appreciate you joining us today. This is why you're the president. You've got such great information and really can educate us on this really under recognized issue. So thank you very much for shedding light on all this.
- [37:51]
B
Thank you for having me. And the only reason you're not president, you didn' Always great to spend time with you, Dr. Avery, and all that great stuff and look forward to seeing you in person hopefully this year.
- [38:02]
A
Thanks for listening to the Thriving with Addiction podcast. If you found today's episode helpful, please follow and subscribe wherever you listen to your podcasts and share it with someone who might benefit. You can also connect with me on Instagram, LinkedIn and YouTube or visit thrivingwithaddiction.com to learn more. Stay tuned for next week's episode and remember, thriving is as possible.