Interview with Peter Ferentzy, PhD (Part 4 of 5)

SBO.net interview with Peter Ferentzy, Ph. D, about gambling addiction, changes and trends within the gambling world. (Part 4 of 5)

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TREATMENT OF PATHOLOGICAL GAMBLERS

SBO.net: Well, you said that since the early 1900s there has not been much of an improvement in the treatment of gambling, they think they can fix the problem when somebody doesn’t want help, if you get what I mean, whereas you’re saying that the reason they think they’re having more success is because they have the facilities there when the people want to fix themselves.

Peter Ferentzy: Yes. Also, we are, we’re more client centred than other approaches, and in my view that’s a good thing.  In the old days the attitude was either abstain or get lost, be more research, mess yourself up and then come back when you’re ready, so if somebody wasn’t ready to abstain completely we’d tell them to get lost. Today we are willing to work with people who are not ready to abstain completely and do everything we can to minimize the harm along the way.  The success stories are not so glorious, but we can help more people this way.

SBO.net: And reduce their impact on society and their damage to themselves obviously as well.

Peter Ferentzy: Exactly, exactly. Think of recovery as a process, very natural, very real, imperfect, packed full of shades of grey. What recovery is not is falling on your face, seeing the light and growing angel wings out of your ass and then becoming a totally different person, but for the longest time that is what the treatment system wanted, and they would accept nothing else.

SBO.net: And where do you think these changes are coming about?  Is it coming more from North America and Europe, or is it a world-wide approach?

Peter Ferentzy: Both, both, and the proliferation of harm reduction approach has not even been premised on the fact that moderation works. It’s premised on what we know is that in 95 percent of cases, abstinence oriented therapies fail.

If you send 20 people to alcohol rehab or gambling rehab, you’ll be lucky to have one of those 20 abstinent after two years, so 95 percent failure rate means that something else ought to be tried.

SBO.net: So in terms of gambling then, if they’re not going to abstain from the gambling and they’re still chasing that win, how do they go about getting someone to stop gambling if obviously it’s an issue if they’re gambling money that’s affecting other aspects of their life?

Peter Ferentzy: The answers are as varied as there are gamblers out there. People will find their own reasons to change.  After the fact many people give you reasons. They’ll say ‘I changed because of A, B and C’, but then you might look at that person and say, “A, B and C were just as true ten years ago so why did you change now?’ and that’s why we have to admit that we don’t know.

MEDIA AND MIDDLE CLASS PROBLEM

SBO.net:  There seems to be a perception in the media in terms of substance abusers, gamblers, that they’re failures in society and they create problems – which obviously they do create problems, but do you think that the stigma attached to these addictions through the media is a negative thing or it’s that just the way it is or do you think the media could do more to help people with addictions?

Peter Ferentzy: Well the media already has changed. Problem gambling is far less stigmatized now, and more people are likely to see it as a disease or a medical condition than they were 20, 30 years’ ago, and there’s a simple reason for that: a higher percentage of middle class people started to become problem gamblers.  Economic and social class has a lot to do with why some things become medicalized and some things remain not medicalized. All through the 19th century chronic drunkenness was a vice if you were poor and a disease if you were rich. That’s just how it was, and we’ve grown out of that but our class biases still figure in how we categorize people, so when a higher percentage of middle class people started to become pathological gamblers, next thing you know pathological gambling found its way into the diagnostic and statistical manual, yes, it became a disease. When more people were poor, when more poor people and people on the fringe were pathological gamblers, then it was a vice. It became a disease when nice people started to do it too.

SBO.net: So they still had the treatment before 20, 30 years ago?

Peter Ferentzy: They had treatment but it wasn’t very extensive and there wasn’t much around. You had, Gamblers Anonymous was around since the mid-20th century. You could find a GA meeting, but there wasn’t too much forward treatment for gambling. That started to happen, you know, in the wake of the proliferation of legal gambling venues. That’s how I started my career, by the way. I was just finishing my PhD and I couldn’t find work in my field, but the governments that were making so much money off gambling were all about to do something about problem gambling, so there were opportunities in pathological gambling and I found a job.

It’s hard for a budding PhD, you know, not everybody wants to hire you, but I found an opportunity and pounced on it.

GOVERNMENT PROFITING FROM GAMBLING

SBO.net: So do you believe that the improvement in services or the change in how people classify problem gambling is due to the fact that it’s become more of a middle class problem?

Peter Ferentzy: Absolutely.

SBO.net: Would this be linked to the fact that the casinos themselves have tried to change the perception, or is it just solely because it’s middle class?

Peter Ferentzy: Well, there is that too.  Because these are legal venues, because governments are making a ton of money off of it, they are all about to do something about the trouble. Their public relations is bound to do something about the trouble.

SBO.net: So if they’re making money from it they have to present it without a problem.

Peter Ferentzy: Yes, yes.

All of the, the money that pays for gambling research and most of gambling treatment comes from a little bit, a small percentage that the government shaves off of casino winnings and lottery winnings.  They’re making a killing off of gambling, so they-.

SBO.net: And, lotteries are obviously just the same as any other gambling.

Peter Ferentzy: Oh, yes. Oh, yes, they are just the same. Some people will spend everything they have on lottery tickets.  Some people will buy hundreds of lottery tickets a week.

SBO.net: So the government makes a ton of money off gambling that pays towards gambling problems and treatments et cetera.

So how does that compare to, say, drug abuse and the way that they approach it?

Peter Ferentzy: Well, it depends on the substance. When it comes to alcohol, alcohol is taxed, so some of those taxes go toward alcohol rehab and prevention measures, campaigns against drunken driving. Cocaine, marijuana and heroin are not legal, so the government, so all of the profits from those industries go straight to gangsters. I don’t see that as an improvement. We do a better job – it’s not perfect – when things are legal, and we try to face up to the damage.

SBO.net: So considering that in North America there used to be prohibition and gambling was completely illegal, then, in one way they’re making considerable advancements to how they used to deal with it.

Peter Ferentzy: Yeah. Almost all covert forms of gambling were illegal for the longest time. You did have illegal horse racing all over North America. That was one type of gambling that, I don’t know, escaped the prohibition, but it was always illegal and gangsters controlled it.

Some people don’t know this, but organized crime makes more money off of gambling than it does off of drugs, but people don’t care as much about gambling, so drugs get more press, but gambling is big money and gambling is all about money, money, money, and it takes time to develop a tolerance for a certain amount of degradation, a certain amount of drinking, a certain amount of drug using.  You develop your tolerance over time.  A gambler can double his tolerance just by saying ‘double or nothing’, so it can progress very quickly, and there’s a lot of money in it.

SBO.net: Would you consider it to be more addictive than other addictions?

Peter Ferentzy: No. I wouldn’t consider it more addictive, but potentially more devastating.

Suicide rates among problem gamblers are very high.

SBO.net: Compared to substance abuse?

Peter Ferentzy: I think it’s higher among gamblers, because of the desperation they feel when they corner themselves into such high debts. They typically have very high suicide rates.

STATISTICS FOR LEGAL DRUGS/PROBLEMS

SBO.net: Well, that’s very interesting. What is the percentage of pathological gamblers?

Peter Ferentzy: Okay, that will hinge upon how narrowly or how broadly you define pathological gambling.  Approximately one percent, something around one percent, of people in the west, in North America and in Western Europe, would be called problem gamblers, one percent.

But if you want to broaden your definition to a group sub-clinical but still problematic gambling, then you could push that percentage up to three percent, say.

SBO.net: And that three percent, are regular gamblers or just people that gamble?

Peter Ferentzy: Those are three percent who may not be absolutely compulsive, who may not be out of control, but they still spend a lot more money than they should and they still get themselves into a little bit of trouble, you know, spending their rent money, their grocery money, things like that, when they shouldn’t do.

SBO.net: But is the three percent based on the general population?

Peter Ferentzy: Yes, yes, yes.

You got a pretty high percentage of people who have broader, loosely defined gambling problems.  If you’re looking for hard core pathological gamblers, you’re looking at maybe one percent of the population.

SBO.net: That’s a considerable amount!

Peter Ferentzy: Yes, yes, it’s pretty high.

SBO.net: And how does that compare to substance abuse?  Do you know?

Peter Ferentzy: It depends on, it depends.

Tobacco addiction stands at something like 20 percent in North America, 18 percent, you know, it used to be much higher. Alcoholism, depending on how you, remember too, this is always going to hinge upon how narrowly you define the problem. If you want to give a very strict definition of alcoholism, full-blown, then maybe one percent of the population is alcoholic. If you want to broaden it to include people with minor problems and this and that, a little bit of compulsion, you can push that number up to ten percent. It hinges upon the definitions you use.

SBO.net: So we’re talking one to three, say, for gambling.

Peter Ferentzy: Yeah.

SBO.net: 20 percent for tobacco, one to ten for alcohol. They’re all the ones, then, that government gets tax off effectively. How does that compare to the drugs that they don’t tax or the substances that they don’t or vices?

Peter Ferentzy: Well, cocaine has a high addictive potential. People who use it are more likely to become addicted than people who just drink, but even with something like crack, supposedly an instantaneous high, most people who use it don’t become addicted, but the numbers for illegal drugs are harder because the populations are hard to find. You have to do ethnographic research, you have to dig through so-called hard to reach populations. You have to interview people who might not want to tell you about their drug use.

SBO.net: By having things turned illegal then, you’re doing a disservice to everyone, really, because you don’t know what’s going on.

Peter Ferentzy: That’s my opinion, yeah. I think that when you make something legal you’re simply taking the profits away from gangsters and, maybe, you know, you can put some controls on it, try to help people a little bit. Prohibition didn’t do us very much good here in North America, you know, all it did was control a system of organized crime that we’re still struggling with.  It emerged during prohibition. We’re still stuck with it.

SBO.net: With prohibition there would there have been a link between gambling and alcohol?  Would the two have went hand in hand?

Peter Ferentzy: Oh, there’s a lot of gambling going on in speakeasies, of course.  But there were always people who were pretty specific.  There were many drunks who looked down at gamblers and many gamblers who looked down at drunks.  In fact, there’s a whole thing among the addict world, everybody wants to look down at the other person’s vice in order to vindicate his own, so drunks look down at needle freaks, needle freaks look down at violent drunks, and so on.  Gamblers often look down at substance users, et cetera.  It’s kind of funny actually.

It’s, you know, you’ve got somebody who’s drunk every day, he’s drunk all day and night, and he’ll say, “Yeah, but I don’t use drugs,” “Good for you,” right, you know?  A cocaine addict’ll say, “I might be paranoid and I may swat flies, but I’m not violent and I don’t bump into things like that stupid drunk over there, see, so I’m better than somebody at least,” you know?  I don’t know, it’s just something.

SBO.net: I guess everyone likes to feel better than someone! 

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