State cuts back money to treat gambling addiction
Three gamblers try their hand at slot machines at Foxwoods Resort Casino in Mashantucket, Conn., in 2007. The National Gambling Impact Study Commission has estimated that the number of problem gamblers roughly doubles within 50 miles of a new casino or slot complex. Another study found the rates double again within 10 miles of a casino.
Jodie spent nearly two years in prison after stealing hundreds of thousands of dollars from her employer to feed a raging addiction to slot machines at Foxwoods.
In recovery, she now works at a Boston-area nonprofit group helping other compulsive gamblers, but she fears the rollout of casino gambling in Massachusetts could open the floodgates to more cases like hers.
"I still don't know what made me jump off the cliff, but I started to go to Foxwoods and started playing the slots," Jodie recalled. "It was pure escapism — it doesn't make any rational sense. I ramped up very quickly to $100 slots and within six months, I had lost $300,000."
As Massachusetts and other states bet on a casino windfall, gambling addiction programs that depend on public fundingare struggling to prepare for an expected increase in problem gambling. Their new challenge comes amid budget cuts and years of being underfunded, treatment advocates contend and a review by the New England Center for Investigative Reporting finds.
Massachusetts is committed on paper to spend millions on problem gambling programs once casinos are up and running in coming years.
However, amid a series of changes in the funding formula, which have gone unreported in news outlets, the amount casinos eventually will have to pay each year toward problem gambling treatment has dropped by more than $20 million since Gov. Deval Patrick first rolled out plans for casinos in 2007.
And even as it pledges future spending, Massachusetts has axed $560,000 from this fiscal year's budget for the Massachusetts Council on Compulsive Gambling, the state's main prevention and treatment program. That, in turn, has put a big dent in plans by the advocacy group to prepare for the rollout of three Las Vegas-size casinos across the state.
The Mashpee Wampanoag Tribe's $500 million Taunton casino is one of three resort-style complexes proposed in the state. As an Indian casino, the tribe's facility would fall under federal regulations and wouldn't be taxed at the same 25 percent rate as the other two commercial casinos.
While there is talk of opening the Southeastern Massachusetts region to commercial bids, the Massachusetts Gaming Commission is still mulling that idea after holding a forum Thursday at Bristol Community College.
Marlene Warner, the council's executive director, said she now spends her time lobbying at the Statehouse instead of planning new treatment programs.
"You have just expanded gambling," Warner said she has been telling state officials. "We would like to have some time to better prepare this fairly inadequate treatment system."
"It's like the state lowering the drinking age to 15 while completely abolishing all drunken-driving prevention and alcohol treatment programs," said Keith Whyte, executive director of the National Council on Problem Gambling, of the trend that is seeing some states slash money for problem gambling treatment.
'It's peanuts'
Advocates say the cutbacks leave Massachusetts and New England woefully unprepared to deal with a potential surge in problem gambling. There are no inpatient, detox-style treatment programs, specialists in the field say, while outpatient counseling, where it exists, is often clustered in a few urban locations, requiring long drives for many patients.
"It's peanuts — it's not even close to addressing the problem," said John Kindt, professor emeritus of business administration at the University of Illinois and a nationally known critic of the gambling industry.
The Patrick administration's decision to cut back the budget of the Massachusetts Council on Compulsive Gambling illustrates the problem, critics say.
After boosting the council's budget from $1 million to slightly more than $1.8 million at the start of the fiscal year in July, to help it prepare for the arrival of casino gambling, the governor cut that increase back by more than $560,000 in December, said Margot Cahoon, a spokeswoman for the council.
That brought the total down to $1,270,000, where it will remain next year as well, according to the governor's new budget.
To be effective, expanded gambling treatment programs need to be in place before casinos open, said Rachel Volberg, president of Northampton-based Gemini Research, which focuses on gambling and problem gambling.
"You don't want to wait until they (compulsive gamblers) are too far down the line and are in bankruptcy, committing crimes and going to jail," Volberg said.
The budget reduction means the council has had to put on hold plans to double the number of locations across Massachusetts offering outpatient counseling for problem gambling, said Warner.
Problem gambling counseling services are offered at 13 sites across the state, an array of community health centers and clinics dedicated mainly to substance abuse issues, not problem gambling, according to a list on the Massachusetts Department of Public Health's website. Five are in Boston or neighboring cities, with the rest are spread across the state's older, industrial cities.
"It was a substantial cut — we have had to cut back on some of our programs," said Cahoon.
Need help? Go to Connecticut
It is a network that is badly needed, said Scott, a building contractor from the Pittsfield area, who burned through all his retirement savings and sold off all his possessions to feed a raging addiction to slot machines at Mohegan Sun.
When he finally hit bottom, the only gambling addiction counselor he could find was an hour away in Amherst — with a month and a half appointment backlog.
"Help wasn't readily available, that's for sure," Scott said. "I was in dire straits."
Meanwhile, a tentative proposal for the state to team up with a private developer on an inpatient treatment center is out the window, Cahoon said.
As it stands right now, Connecticut is the only state in New England with an inpatient treatment center for gamblers. The Midwestern Connecticut Council on Alcoholism runs the region's only inpatient program for gambling addicts, charging out-of-state patients $450 a day for a one- to three-week stay. Connecticut residents have their treatment covered by a state grant, said Jim Crean, director of outreach and community relations for the Connecticut council.
"We have had people (gambling addicts) who are suicidal," said Dot Duda, director of outpatient psychiatry and the Prevention and Recovery Center at Mount Auburn Hospital. "We have no place to send them in Massachusetts."
Years of research into the impact of new casinos on problem gambling points to the potential for a significant increase once slot machines and table games are within a short drive of most Bay State residents.
Overall, 1.5 to 2 percent of people are problem gamblers (on their way toward becoming addicted) without considering proximity to a casino, Kindt said.
A federal panel in the late 1990s produced a landmark study on the relationship between the expansion of casinos and the number of problem gamblers. The National Gambling Impact Study Commission estimated that the number of problem gamblers roughly doubles within 50 miles of a new casino or slot complex.
That finding was further advanced in 2004, when a study by John Welte of the University of Buffalo's Research Institute on Addictions found that problem gambling rates doubled again within 10 miles of a casino.
The twin findings are now routinely used by experts in the field of gambling addiction to gauge the effect new gambling halls will have on addiction, Kindt said.
A tax cut for casinos?
The cutback in funding for gambling addiction programs comes as Massachusetts has also cut back on the amount it will tax casinos in the state to support problem gambling services.
Gov. Patrick laid out a framework for the rollout of casinos in Massachusetts — and how compulsive gambling programs were to be funded — in the fall of 2007. It included an estimated $50 million to be set aside in a public health trust fund for use in treating gambling addiction.
But casino legislation passed in 2011 limited the dollar amount to 5 percent of all casino taxes collected by the state. Based on current legislative revenue estimates, that would produce anywhere from $20 million to $25 million a year, said Jason Lefferts, director of communications for the Executive Office of Housing and Economic Development.
The change in the formula — which effectively cut in half the amount of money to be devoted to problem gambling — also corresponded with a drop in the overall tax rate on casinos from 27 to 25 percent.
Lefferts said he is unable to explain why the formula to pay for problem gambling treatment changed as it did. But he contends the current amount is more than adequate to do the job.
"It is one of the largest financial commitments to address gambling addiction in the country," he said.
If the Mashpee Wampanoag Tribe's project moves forward, its payments would be regulated by a compact negotiated between the tribe and the governor. The compact was finalized last week and still needs approval by the Legislature and the federal Bureau of Indian Affairs. Under that deal, the tribe would pay a sliding scale of its gross gambling revenue based on competition — anywhere from zero if there's another commercial casino in the region to 21 percent if the tribal casino is the only one in the Bay State.
It's more likely the tribe would pay 17 percent, which accounts for the other casinos in separate regions of the state. Out of that money, 5 percent would go to the trust fund set up for problem gambling, the same amount levied from commercial casinos. The compact also calls for the tribe to kick in an additional $1.5 million annually to the trust fund.
Meanwhile, in a separate agreement with the city of Taunton, the tribe has agreed to pay $60,000 for problem gambling in the first year the casino opens and $30,000 per year after that.
State Sen. Stan Rosenberg, D-Amherst, who played a key role in drafting the 2011 casino bill, questioned how much of an increase in gambling addiction Massachusetts will see given the amount of money Bay State residents are already spending on lottery tickets and at casinos in Connecticut and Rhode Island.
But Warner, of the state Council on Compulsive Gambling, said no one should underestimate the impact that having a casino nearby will have on problem gambling.
"Connecticut is truly a drive for most folks," she said. "Having something in Boston is going to make a difference in people's lives — I don't care how much lottery you play."
Future promises not enough
As it waits for money pledged years in the future, the Massachusetts Council on Compulsive Gambling still faces the challenge of preparing for the arrival of casinos on a budget that has long been inadequate, Warner said.
In a 2009 report, the council argued its $1 million annual appropriation, when measured on a per capita basis, placed Massachusetts No. 18 in terms of spending on problem gambling programs.
The council made a case in that report that it needed $23 million each year just to keep up with current addiction problems sparked by the state's multibillion-dollar lottery, as well as slot machines in Connecticut and Rhode Island, let alone casino legalization in Massachusetts.
A separate national study in 2010 came to a similar conclusion. The report, by the Association of Problem Gambling Service Administrators, found Massachusetts spent just 15 cents per resident on problem gambling services, compared with a national average of 34 cents.
Massachusetts spends $83 million annually on substance abuse issues, but almost all of it is spent on treatment for drug and alcohol addiction.
Stephen Crosby, chairman of the Massachusetts Gaming Commission, outlined a two-track approach to dealing with the issue. The commission plans to hire a full-time staff member to coordinate problem gambling prevention and treatment efforts. As the commission awaits the opening of casinos, it can draw upon its budget to fund programs, he said.
But advocates question how much of the up to $25 million that casinos will eventually pay each year toward problem gambling initiatives will actually end up funding those efforts as opposed to other substance abuse or social service programs.
The future revenue, which won't start rolling in until casinos are licensed and open for business in Massachusetts three or four years from now, will be funneled into a public health trust fund controlled by state officials, Warner said.
She is confident that one chunk of the pot — a $5 million problem gambling fee that casinos will have to contribute toward — will be used for treatment and prevention programs. Warner is less sure about the remaining projected $20 million that she believes will be sought by other social service agencies.
"A lot of people are already thinking through how to spend that money," Warner noted. "I am looking at $5 million being spent on the issue."
But Crosby said while he thinks a good portion of the money in the new trust fund will go toward gambling treatment, he said he can't quantify it beyond that.
The commission plans to hire an outside research firm to first look at the current extent of gambling addiction and then track any potential increase as casinos open up in the state. That study, Crosby said, will help guide prevention and treatment efforts.
The New England Center for Investigative Reporting is a nonprofit investigative reporting newsroom based at Boston University. Center intern Bill Frothingham and Times staff also contributed to this report.
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