Gambling, addiction, and responsibility

Last post I described common denominators between drug addiction and compulsive gambling. Today I want to ask: how do we assign responsibility for promoting products that benefit some while seriously harming others — because they are too attractive?

I got back from my trip to Australia about three days ago and I can finally see straight this morning. I came home travel weary but armed with some great new insights and perspectives. Most of what I learned was by way of the “Many Ways to Help” conference organized by the Victorian Responsible Gambling Foundation. In particular, the counsellors, case workers, policy makers, and researchers in the audience and at the podium repeatedly raised the question of responsibility — and how responsibility is related to technology, access, and profit.

Let me unpack that. Gamblers in the Melbourne area come in droves to the Crown Casino, a multi-level pleasure palace packed with every conceivable form of entertainment and an enormous number of high-tech slot machines distributed among the bars, bandstands, restaurants, craps and roulette tables…along every feedingmachinecorridor, in every nook and cranny. These machines have been designed to appeal to a great variety of individual tastes. In some, the spinning character set settles into a poker hand — usually a losing hand. Others rely on matches among fruits, goblins, jewels, and shining, flickering, mesmerizing tokens lifted from fairy tales and Kung Fu movies. Some mix cards, dice, and fairy-tale images on their glittering screens. The variety and artistry are incredible.

slotrowWhat offers all this excitement, this sense of fun, and what keeps gamblers playing and losing and playing and losing, derives from innovations in design, programmernerdprogramming, psychological modeling,  video game development, and the technological know-how to package all these in a single product. And of course the paycheques of the designers, programmers, artists, and so forth come from a casino industry that rakes in enormous profits.

The attendees at the conference were pretty pissed off. Because, despite the various placards encouraging gamblers to take it easy, and despite various government regulations that force casinos to notify gamblers when they’ve reached the danger playingcurveszone, there’s a confluence of factors that attract people to play as much as possible. Especially at the slot machines, where play becomes almost mindless (see bankruptguyprevious post). The conference attendees spend their lives trying to help people who continue to lose — not only their money but their homes, marriages, interpersonal relationships of all sorts, and even their lives — sometimes directly via suicide, sometimes slowly through the alcoholism and other forms of escape that ride on gambling addiction. It just doesn’t seem fair. The casinos know what they’re doing, and they’ve got the resources to do it very effectively.

But there’s another side to this argument. The casinos (and other gambling outlets — I’ve chosen slot machines at casinos as an overt example) are just businesses. They exist to make money, pay their employees, and increase their profits, just like any other business. Does it make sense to blame them for being good at what they do? Is it their responsibility to protect the fewer than 1% of adults in the Melbourne area who are “problem gamblers” (and the 2.4% who are “moderate-risk gamblers”)? See recent research findings here. Or should the government come down hard on an industry that brings pleasant entertainment to many but serious harm to a few? These are some of the questions at the forefront of the discussion about problem gambling in Australia. And the same questions are debated just as hotly in the US and the UK.

candycrushIf the answer is “maybe,” then let’s take the argument further: Should the manufacturers of fast cars be held responsible for accidents that result from speeding? Should the makers of video kidsvidsgames like The Sims and Candy Crush be penalized for making the most attractive (and addictive) games ever known? Should Facebook be banned? Nir Eyal has a fascinating blog that explores the issues and ethics at the core of addictive technology, and the answers to these questions aren’t simple.

Aren’t adult humans supposed to be responsible for controlling their own impulses? After all, the world is full of temptations, some of them natural, some manufactured. It’s hardly conceivable to block temptations at the source, especially when most people can steer around them quite successfully. And would we want a world that minimizes tempting attractions, even if we could achieve it?

godfatherWhere this conundrum interests me most is where it intersects with the problem of drug addiction. And alcoholism. The parallels are mind-blowing. First, stigmatization, family disintegration, avenues of treatment, and support groups continue to blossom in both realms. Second is the question of making profits off people’s suffering. Third, how do we balance the suffering of the few against possible benefits to the many? The sale of addictive drugs like heroin, methamphetamine, and crack line the pockets poorfarmersof drug lords and gangsters, but they also pay simple farmers all over South America and Asia. And the legal addictive drugs like oxycodone and Vicodan (most famously) certainly profit Big Pharma, but they pillbottlesalso provide badly needed relief for the millions suffering pain. Next, should we restrain what might be called the technology of attraction at all? The substances I just listed, as well as modern slot machines and internet gambling, evolved from links between profit and technology. Technology needs money (e.g., profit) to grease its wheels. Even scotch whiskey — at least the good scotch that I like — is the product of an industry that harms a portion of its users while feeding some of its profits into technological advancement. Alcoholism kills 88,000 Americans per year. Yet almost nobody recommends a return to Prohibition.

glenkinchieSo maybe it’s the same problem in general — the same problem for gambling industries, video game makers, social media designers, drug manufacturers, and distilleries with exotic names like Glenkinchie and Laphroaig. Many of the products that make modern life fun, pleasant, interesting — or even just bearable — for many of us also make life hell for those who lose control. Should we assign blame for making, selling, or buying something that’s too desirable? Do we just turn responsibility over to the user, or is there a sensible way to restrain the dealer? Is there any concept of regulation, packaged warnings, education, or harm reduction that could help across the board?

I’d love to hear your thoughts.

 

 

36 thoughts on “Gambling, addiction, and responsibility

  1. Matty H. November 1, 2016 at 10:13 am #

    In Opium and the People, Virginia Berridge describes the situation in the UK where in the 19th century, opium in oral form was widely and legally available, but led to very few problems and addiction rates. I would start by looking at this model and then asking important questions about the people, the society and culture at the time. What is different now and would it be possible to introduce cultural elements that would lead to a similar outcome now? And then how to use those cultural elements for other addictions as well?

    “In a particular historical period and in the social context of a particular country, and with opium as a drug available only in oral form, we can begin to see the outline nature of the equilibrium reached between society and the drug – a plateau at a high general level of usage and with regional variation, no persuasive evidence of large-scale social incapacity, but with associated mortality levels which, though not too disastrous when matched against certain modern drug experiences, were nonetheless cause for concern.”

    • Marc November 6, 2016 at 1:34 am #

      This is a thoughtful perspective. Those cultural elements might include globalization — see Bruce Alexander’s book, the Globalization of Addiction. Nobody actually belongs to the artificial culture that’s sprung up in the middle of real, actual cultures. So a lot of people feel this disenfranchisement or alienation.Trump supporters? If they feel they’re boxed in and their lives are meaningless, they’re more likely to get more than a little smashed when strong psychotropic drugs are available, to gamble compulsively, eat to excess, in short to do whatever gives them the sense that they can change reality from the inside. That’s when the usual human constraints start to fail, and then people start to split into two groups: addicts and those who loathe and fear addiction.

  2. Beth@WeightMaven November 1, 2016 at 3:09 pm #

    I don’t have any great thoughts on solutions, but wanted to point out that this is a huge issue when it comes to food and the food industry. Whether or not you believe in food addiction (I do), there are very compelling arguments that the food industry is doing the same kind of innovating in design, modeling etc to help sell their products, more often than not at the expense of our health (ref Michael Moss or David Kessler for lots on this).

    • Marc November 6, 2016 at 1:38 am #

      I totally agree. Walking down the desserts and snacks isles at the supermarket is mind-blowing. Reminds me of my early days in Berkeley, where there were different pills (different colours, different highs) available on every corner of Telegraph Avenue.

      • matt November 7, 2016 at 6:46 am #

        How old are you? I remember seconal, nembutal, amytal, tuinal…reds, yellows, blues and rainbows… all barbiturate sleeping aids supposedly replaced by the “harmless” benzodiazepines (like the harmless substitution of heroin for opium and morphine addiction in the early 20th century). “Whites” (and blacks) were typically reserved for the amphetamines. Then came LSD and the color coding went off the rails…

        • Marc November 10, 2016 at 5:26 am #

          Orange Wedge sticks in my mind…probably in more ways than one. Yes, I remember all those drugs….and then some. What were “black beauties” anyway? I never figured those out, but I do remember liking them.

          • matt November 10, 2016 at 8:56 am #

            Amphetamine + dextroamphetamine. Then came Eskatrol, a buffered form of dextroamphetamine in time release spansules. Another “mother’s little helper” diet pill from the 70’s. Packed a wallop punctuated by a horrible depressive episode.

  3. Rita November 2, 2016 at 4:23 am #

    Sleep debt from artificial light, sedentary life; inflammatory pollution make for addictive brains. Big cities suffer most from these risk factors, so drugs and gambling can be prohibited in the cities and allowed in rural areas.Each municipality can decide for itself, based on the addiction rates in its population.

  4. Mark November 2, 2016 at 5:44 am #

    I suspect that the best any of us can do is whatever we can to “put a little dent in the suffering in the world.” Beginning with our own. It’s one of the things I think neuroscience has great potential to do. Neuroscience and the mystical poets: a dynamic duo! 😉

    • Marc November 6, 2016 at 1:46 am #

      That rings true, Mark. There is so much suffering — a new brand of loneliness partly because the old supports of family and religion are fraying and disappearing. No, neuroscience can’t help much….though I’m reminded of the study by Coan and colleagues (http://pss.sagepub.com/content/17/12/1032.abstract) showing reduced activation in stress-related brain regions when participants held the hand of their loved one. So brain research shows us how much we need closeness with others to feel safe — as if that weren’t already obvious.

    • Marc November 6, 2016 at 4:24 am #

      Mark, I just came across some words of Alan Watts that somehow seemed to fit what we are talking about:

      “you will cease to feel isolated when you recognize, for example, that you do not have a sensation of the sky: you are that sensation. For all purposes of feeling, your sensation of the sky is the sky, and there is no “you” apart from what you sense, feel, and know.”

      –this came from Maria Popova’s wonderful weekly blog: https://www.brainpickings.org/

      • Mark November 6, 2016 at 5:31 pm #

        Thanks, Marc. I’ve been following Maria beginning the first year she started posting. Seems like it must be ten years now.

        Wouldn’t it be interesting to see a side by side comparison of Alan Watts brain, say, with mine. I suspect they would look as different in mass, connectivity and integration as these two … http://www.committedparent.com/Gauss.html

  5. Sherilene November 2, 2016 at 7:25 am #

    That’s a very interesting parallel you make with fast cars and alcohol. The thing is though, we have laws that restrict the speed you can drive and the amount of alcohol you can drink (at least whilst driving anyway). There are also pretty strong social norms around acceptable alcohol consumption. To my knowledge, there are no laws, or even government endorsed guidelines, for how much money you can safely gamble. People are free to literally gamble their lives away. Maybe it’s time to start thinking about the health risks of gambling in the same way we think of other harmful products, like alcohol, tobacco, and fast cars!

    • Matty H. November 2, 2016 at 1:10 pm #

      Interesting sidenote: There aren’t any speed limits on the majority of German highways. 🙂

      • Sherilene November 2, 2016 at 4:53 pm #

        No doubt there are countries that don’t have blood alcohol limits for driving too! At least in Australia we do … and we’re all safer for it. 😊

      • Karen November 3, 2016 at 2:30 pm #

        Germans can’t get a drivers’ license without doing courses with a registered professional driving instructor, and the standards for passing are considerably higher than in NZ and Australia. There is a Fahrschule (driving school) on every corner. This has been so since the 1960’s I believe. The population in Germany is twenty times as dense as ours, and if they drove like us NZers and Australians do, it would be a blood bath. I think Germans are much more law-abiding and considerate, less aggressive and competitive, on the road than we are – quite a different attitude. Parallels with alcohol and addiction? I believe alcohol is consumed more as part of a meal or social eating in Germany, so non-addictive consumption of alcohol is modelled frequently for children.

        • Karen November 3, 2016 at 4:00 pm #

          And I don’t think it’s the majority of German highways where there’s no speed limit either – only a subset of them, the Autobahns, which are engineered to the highest of standards, and have awesome high tech surfaces.

        • Marc November 6, 2016 at 1:52 am #

          Okay, but a lot of that comes down to social norms — people’s sense of what’s decent and proper. I live in Europe and I love the way people drive here…compared to N.America. The word respect comes to mind.

          And those same social norms apply to excess in gambling and intoxication.

          • Karen November 14, 2016 at 1:56 am #

            Which comes first, social norms or laws and regulations? Chicken and egg?

    • Marc November 6, 2016 at 1:57 am #

      Sherilene, I think you’re wrong about that. At this gambling conference I attended, a lot of the discussion was about stigmatization. Problem gamblers are not well regarded by friends and family. So social norms are present and they are overt, and people who cross those lines pay for it with a major loss in esteem!

      Hari’s book, Chasing the Scream, points to milder forms of stigmatization that help young people avoid nasty drugs in a country where they are available and more or less legal.

  6. Donna Jaroslawski November 2, 2016 at 8:08 am #

    I think a good solution is to rethink our tolerance for the ways of our capitalist economy. Most of the organizations profiting from it have not taken any real responsibility. They benefit tremendously and are not required to use those benefits to help those in need. We really need to rethink about how our capitalist economy is benefiting the few at the expense of the “little guy” (whether that is financial or personal power) What kind of world is this that we allow this kind of wide-spread abuse to exist with no responsibility and call it free market economy. To claim this is inaccurate is to choose to put our heads in the sand and fear any change of the status quo. I believe the answer is to require the profits (beyond a sustainable level for industry trail blazers who work hard to create new and interesting products and services) need to be used for education. Real education. Not some stupid placard that puts the onus back on the individual but as Marc and Johann Hari have taught us … these problems are societal and require a societal solution. A new infrastructure that does not tolerate taking advantage of those who struggle. That is, they need to be extremely honest about the problems and solutions to those problems that their products create and not make a person feel they are personally weak and suffer. No, they suffer because it is inherent in that product to cause them a loss of personal power. With this way of taking responsibility, those who can enjoy without personal harm get to do so and at the same time we are being totally honest and transparent to help those who fall prey. How do we accomplish this? Marks post (above) says it best: “I suspect that the best any of us can do is whatever we can to ‘put a little dent in the suffering in the world.’ Beginning with our own.” Or the old Margaret Mead-ism: “Never believe that a few caring people can’t change the world. For, indeed, that’s all who ever have.”

    • Marc November 6, 2016 at 2:15 am #

      I don’t deny anything you’re saying, Donna. But just the concept of responsibility in the way you mean it is completely novel on the human landscape. If the other guy suffers because you’re making a profit, tough shit for him. That’s the way it’s always worked. Even in my (beloved?) Canada, there are no restraints on developers and retailers who have the ethical proclivities of reptiles — Shoppers Drug Mart comes to mind, as does the condo and billboard infestation of my home town, Toronto.

      I’d love the world to be different, but I don’t know how to make it so.

  7. Matt November 2, 2016 at 9:46 am #

    When you codify,institutionalize, and commercialize the activity of winning and losing, you codify institutionalized and commercialize the role of winners and losers

  8. Terry Klingberg November 2, 2016 at 10:01 am #

    When social and personal responsibility is not taught or fostered in the home, church, synogogue, mosque, school, etc, it cannot be assumed that people will behave within these parameters, especially in a capitalistic free-market system which our country’s economy is based upon. People can act morally reprehensible and be rewarded for this callousness…i.e. Trump … remember Atlantic City. Get involved in local politics and listen to what the candidates are promising, and then do your due diligence by discovering what big corp lobbyist is funding which candidate. Only invest in stocks that reflect socially responsible business practices, etc, etc…I believe it must begin with the individual.

    • Marc November 6, 2016 at 2:09 am #

      Investing in companies with ethical practices is a great way to help…a little. Despite what you say, humans and other animals have some kind of intrinsic pull toward altruism….though, agreed, it sure is hard to see it much of the time.

  9. Karen November 2, 2016 at 3:40 pm #

    What about teaching emotional intelligence in schools? Teaching people to, in Marc’s words, control their own impulses, to successfully steer around the many temptations in the world, natural and manufactured. These are skills and attitudes that are learned, mostly in childhood – or not, if you happen to be born into a dysfunctional family or society. Use some of the money which the “free market” system allows casinos, alcohol retailers, and drug pushers to amass in such large amounts, to set up attitudinal healing / spiritual / emotional intelligence programs in schools.

    • Marc November 6, 2016 at 2:02 am #

      Hi Karen. There is movement in exactly this direction. Some call it teaching emotional intelligence, a la Goleman..others call it teaching social regard or empathy, not exactly the same thing but certainly related. The Dalai Lama’s idea (which the Mind and Life Institute is trying to implement) is to teach compassion for self and other at the earliest phase of public education (i.e., kindergarten or so).

  10. Lisa Martinovic November 2, 2016 at 9:09 pm #

    The problem needs to be addressed on both individual and societal levels. Those of us who have sufficient intellectual and psychological resources must be responsible for our own behavior, and beyond that it’s incumbent upon us to make whatever positive impact we can on the larger world. This while recognizing that we need a socioeconomic reprioritization to undo the devastation wreaked by free-market capitalism run amok.

    What Donna describes above speaks to what economists call “externalities.” If a factory employs people and produces useful goods everyone thinks that’s a market success. Meanwhile the factory is dumping carcinogenic effluent into the river that won’t start killing people until years after the factory has shut down and left town. The factory and its wealthy owners never have to pay the full price of doing business, which would by rights would include victim compensation and environmental restoration — all those costs are externalities to be borne by individuals or, if they’re lucky, the government.

    Similarly, the junk food, alcohol, tobacco, and gambling industries provide pleasure that most people can handle in moderation but many cannot. The damages suffered by individuals, families and communities are externalities that industry has no responsibility to ameliorate. I like Donna’s idea of using profits for education. But, boy howdy, that’s a hard sell — try convincing a libertarian! They don’t even want to be taxed or regulated at all. Of course, the ever lowering corporate and superrich tax rates is one of the reasons why we have such a crappy educational system for all but the wealthy.

    And given the abysmal state of public education in the US, many students emerge functionally illiterate. Combine that with the emotional and psychological deficits that result from poverty and dysfunctional social settings and you have a recipe for intergenerational disaster. How can these people be expected to evaluate the risks of worldly temptations, much less know how to resist them? I’m with Donna and Karen on this — use some of the profits generated by capitalizing on addiction to educate people about how to take control of their own lives. For so many people this does not come naturally.

    A separate issue is this: I wonder if there is a way we could legislate against intentionally making products more addictive. Tobacco in its natural state is plenty addictive, but Phillip Morris, et al, juice up their product with even more nicotine. Why is this allowed?

    In the junk food world, scientists are employed to make their products as addictive as possible with just the right balance of fat, sugar, salt, and flavorings. Does the world really need a more compelling Dorito? Ah, but this is the logic of capitalism. If you can make a buck it doesn’t matter that you’re contributing to the obesity epidemic. This also raises the question of conscience. How do scientists justify their role in the relentless assault on public health?

    • Marc November 3, 2016 at 4:56 am #

      A very thoughtful comment, Lisa. What you say about “externalities” makes excellent sense, as these are measurable costs — although only measurable by projection, math modelling, etc., but then we’re very good at such things when we send rockets into space and and buy stocks and bonds (I think). Sure, these are real costs, and conceivably industries could be made to pay them.

      But when you speculate on whether or not manufacturers can or should be made to stop short of making their products maximally attractive, and when you reflect on the ethics of company scientists, I think you’re entering a dream state. The world doesn’t seem to work that way.

      As far as education….a much bigger issue. Carl Hart has become somewhat famous for advocating decriminalization of drugs in general — including nasty drugs like meth — and putting our energies into education instead. Kids need to be taught, not restrained. This has a solid ring to it. Yet, if meth, for example were available at the corner smart shop (here in Holland) the externalities would ALWAYS be many times the price tag, so it seems.

      • Lisa Martinovic November 3, 2016 at 4:48 pm #

        I’m painfully aware that my suggestions are based on an idealized world that does not currently exist. But a gal can dream, can’t she? I’m also a big believer in asking for what I want — for myself and for society at large. I think it’s important that we articulate a more humane and sustainable vision of what’s possible as as a first step in the manifestation process.

        200 years ago an America without slavery was inconceivable. 100 years ago advocating for women’s suffrage was heresy. So I don’t think it’s unreasonable to envision and work towards a world where human and environmental rights take priority over profits — in fact, it’s essential. And, yeah, I get that it’s an uphill battle.

        Regarding availability, I believe in the decriminalization of all drugs. But I don’t think they should be available at the corner store. The middle ground is the medicalization/harm reduction model. If you’re strung out on meth, there should be facilities available where you can get and use clean product in a supervised setting that also provides counseling, detox and rehab. So much of drug addiction is wrapped up in the thrill of outlaw life (it certainly was for me!) By making drugs available in a clinical setting, we take the sexy out of using.

        And it’s true that some percentage of the population will not avail themselves of help and will simply drug themselves to death. They will be society’s collective externalities. But the system as it exists now creates far far more externalities in terms of human and social suffering caused by the criminalization of drug use. People will always kill themselves using drugs, but with sane policies we can minimize how deeply their toxicity penetrates the rest of the culture.

        • Marc November 6, 2016 at 2:06 am #

          I think you’re dead right about decriminalization…and making drugs available for addicts in supervised settings. Hari writes about success stories in Portugal and Switzerland, and Switzerland is particularly interesting because the addiction rate keeps dropping even though heroin is available and accessible legally. The thrill is gone, baby….so might as well get on with life.

  11. Joanna Nicci Tina Free November 7, 2016 at 12:19 am #

    A young man in India is a friend of mine. He studied here in the States for a year and worked with me on a video and other projects. During his time here he visited an amusement park. The thing he found most amusing about the park was the litany of words used to protect the owners and operators of the rides from litigation. He said, “When you go on a ride or some other amusement in my country, you know that you are taking your life into your own hands.” Then he laughed his gentle laugh and said, “That’s part of the excitement!” He said people can get maimed or killed on the rides there, and no one has a leg to stand on if it happens (pun intended). We have such a drive now to sanitize and protect and behave and be appropriate… things are packaged up so neatly so that no one gets hurt and, if they do, it’s the fault of the one bringing the service, the amusement… we don’t want to take responsibility for sh*t.

    In my work, I talk with people about how to kick tobacco, but I am NOT anti-tobacco. I’m pro-freedom. I’m also pro-pleasure. I smoked tobacco for decades. I was 12 years old when I started in 1969 and hell, I knew the risks then… how did anyone NOT know the risks? You’re inhaling smoke. That’s how people are most likely to die in a burning building, not by the fire… goodness, we know this, right? I chose to do it anyway for a long list of reasons. The bottom line is: it made sense at the time. That’s it. And then I was IN… until I found the way OUT..

    I am in favor of a world in which we offer options AND the ways – effective, free and low-cost ways – to delight in or shun those options. Offering ways to resource everyone, across socioeconomic status, returns to them the power of choice. You and Hari and Maté and Brady and more are giving us the leg to stand on in asserting the need for this kind of collective reform. I am most grateful! YES – as you said, let’s teach (AND nurture), not restrain. Best to you – Joanna Free

  12. Omar Manejwala, M.D. November 14, 2016 at 4:52 pm #

    I think you make some great points here. At the end of the day, we won’t be able to restrict our way out of these problems and access to prevention, treatment and recovery seems to be whats needed most.

    An interesting approach is to tax the negative externalities (i.e. the so-called “pigouvian” taxes.) I think that makes sense and aligns the costs with the risks.

    I take a more simplistic public health approach–interventions that improve lives with minimal costs monetarily or to basic rights are the low hanging fruit.

    Great article.

  13. Carmelia November 23, 2016 at 11:27 pm #

    Gambling in casino is fun and risky as it is associated with lots of money. If one is gambling once in a while for fun it won’t of a great deal but if one becomes addicted to gambling then it’s the end of his life. Whatever he earns he will spend it in casino, I have seen many people who even lost their house and job.

    I personally am against gambling because of my father. He started gambling for entertainment but carried away and lost everything. He left us and we faced many difficulties in growing up. Once in a while father comes and get money for gambling from mom. She is weak and cannot fight against dad. So I’m thinking of taking him to an addiction rehab centre in Toronto but not sure if he is ready to stop gambling.

  14. Dave Jansa November 29, 2016 at 12:22 pm #

    Marc, your question: Do we just turn responsibility over to the user, or is there a sensible way to restrain the dealer? Is there any concept of regulation, packaged warnings, education, or harm reduction that could help across the board?

    Yes. Consider the journey the US and other nations have taken in their efforts to deal with tobacco/nicotine. Apply that general template to many/most addictive substances or behaviors and you have the best possible balance among competing interests. Growers and suppliers, public health, public safety, prevention and personal wellness choices are either protected or made available.

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