The History of Gambling & The Treatment of Problem Gamblers

gamblingSince time immemorial, human beings have been drawn to the lure of predicting the unpredictable and placing money on the outcome. The history of gambling stretches back thousands of years, offering disconcerting parallels between the games of chance played by the ancient Greeks, and the $70 billion daily fantasy sports leagues that tens of millions of people play on their lunch breaks every day. Addressing the question of how to treat problem gambling has shed light on both the science and culture of addiction.

The Gambling Business

Every year, 32 million Americans spend approximately $467 per person on their fantasy sports leagues. Forbes magazine estimates that the fantasy football market in particular nets anywhere between $40 billion and $70 billion, while the National Football League’s annual revenue is a paltry $10 billion.1


The explosive growth of fantasy sports leagues has not been universally welcomed. The Boston Globe writes that even with a federal law that draws a line between fantasy gaming and gambling (2006’s Unlawful Internet Gaming Enforcement Act), a handful of states have banned their residents from participating in the online games to win cash prizes. A growing number of experts are voicing questions as to whether the relentless flow of money behind fantasy sports leagues constitutes a new form of gambling.2

“Are daily fantasy sports even legal?” asks the Washington Post, pointing out that most state governments have banned sports betting, and that legal perception and enforcement of online gambling and fantasy leagues differ across state and federal legislatures – especially since the 2006 federal law did not anticipate the fantasy boom (what a Forbes magazine article called “the Hyper Growth of Daily Fantasy Sports”).3,4

Are daily fantasy sports even legal? The reality, the editor of tells the Post, is that no one knows.

A New Spin on an Old Tradition

bigstock-Football-Player-79716439Fantasy football leagues have long been a tradition of football season, so why has the boom of online avenues been met with such extremes skepticism and popularity? The difference, Forbes explains, is that while the standard form of fantasy gaming entailed drafting a team prior to the start of a sports season (and then following it through to the end), the system offered by online sports companies allows daily drafts and immediate cash prizes that are paid out the same day.

The former format is considered to be relatively harmless, a way for sports fan to partake in armchair management. The latter format, with its incessant cash prizes and relentless advertising (DraftKings, a leading online fantasy sports company, spent more money on television commercials than any other company during, not coincidentally, the opening week of the 2015 NFL season), veers dangerously close to gambling – something the DraftKings CEO acknowledged to the Nevada attorney general’s office in 2012, three years before regulators in that state ordered DraftKings to either cease business operations in the state or apply for a gambling license.5,6

A Brief History of Gambling

“Gambling” has, for a very long time, been a dirty word. Even a civilization as ancient and revered as the Greek allocated special areas where citizens could play games of luck with dice, coins, and other tools. But much like it does today, gambling carried a stigma; the fear of losing a fortune cast a cloud of shame over the people who frequented such establishments, with Greek authors and philosophers of antiquity comparing gambling to a plague. It appears their reservations toward the practice were also motivated by the propensity that some players would cheat at the games, bringing an aura of dishonesty to the entire enterprise.7

Gambling’s origins in antiquity speak to primal human needs to take risks, to escape, to increase social standing, and to win. Speaking to LiveScience, an evolutionary psychologist explains that the desire to take risks in the pursuit of success is in our genes. While we are not all drawn to gambling, there are other areas of life where the propensity for taking risks is irresistibly high: other financial ventures (speculating on the stock market, for example), recreational, ethical, social, and with regards our health.8

Is the temptation to take risks really undeniable? LiveScience writes of how even after airbags started to be installed in cars, the rate of automobile deaths didn’t decline as much as was expected, because people simply drove faster. Drivers believed that the installation of airbags inoculated them against the dangers of speeding.

Gambling: Believing You Have Nothing to Lose


Gambling, therefore, is simply an extension of the belief that even though we can lose, we won’t – that we know the system, that we know how to play, and that we can figure out how to win. When someone is optimistic about the outcome of their behavior – a gambler who fervently believes that this next round will be their moment of glory – they stop seeing gambling in terms of risks. The need to take risks is what drives them to the edge, but deluded by the potential of winning big, they think they have it in the bag. They may think they’re smarter than the other players, that they’ve got the game figured out; and in that context, they may honestly believe they’re not taking a risk, because they feel they have nothing to lose.

Even when they do lose, they tell themselves that they’ve learned how not to make the same mistake again, thereby increasing their chances of winning; and thus, the cycle continues.

In this way, gambling resembles a substance abuse problem, mimicking the way people with addictions will helplessly consume more and more of a drug in order to make the painful and distressing feelings of a comedown or withdrawal go away.

Gambling as an Escape

Not all gambling comes from a genetic impulse to risk it all to try and have it all. Some people are captivated by the James Bond-esque setting of glitzy casinos in exotic and fancy locales, providing an alternative to a mundane, frustrating, or stressful day-to-day life.

For others, the escapism that comes from gambling has more tragic origins. BBC News writes of a woman, who, after the death of her 13-month old son, found refuge and solace in the nonstop atmosphere of a casino (compared to her home, overwhelmingly silent in the absence of her baby).

To “numb the pain” of her unimaginable loss, she started to spend her free time at the casino, playing on slot machines for up to five hours at a time. Within days, she took out a loan of thousands of pounds, desperate to lose herself and get away from coping with the death of her child.

The woman’s previous experience as a casino dealer may have contributed to her gambling addiction. In explaining “Healthy Ways to Navigate Grief,” a Psych Central blogger writes that people who are mourning the loss of a loved one are confused, disoriented, and deeply and emotionally pained. They may find solace in the comfortable and the familiar. In and of itself, that is not a bad thing; but their sorrow deprives them of perspective and boundaries, and a person who feels at home in a casino may find that being in a casino is infinitely preferable to being surrounded by memories of a deceased 13-month-old baby.13

Gambling to Get Away from It All notes that it is usually men, not women, who tend to escape by immersing themselves in a facet of life to an inappropriate degree. Women generally withdraw into themselves, showing a lack of interest in hobbies and activities that they once enjoyed. Men, on the other hand, may appear aggressive or angry and not recognize these emotions as symptoms of depression. They may also attempt to cope by immersing themselves in drugs, alcohol, or gambling.14

In the BBC News story, the woman’s prior experiences with a casino environment might explain why she did not conform to the pattern.

The exuberant atmosphere of a casino makes it very difficult to entertain feelings of depression (especially when contrasted to a home situation of grief and stress). In that way, the allure to stay there, night and day, playing cards or slot machines, when the alternative is going back to an empty house, is powerful and insidiously logical.

But like any addiction, the illusion comes to an end. The woman in the BBC News article explains that at its worst, she felt suicidal, wondering if the only way to be free of her compulsion to gamble would be to kill herself.

She eventually got help for her problem, but tells the BBC that the fight to resist the temptation to gamble will last her the rest of her life.15

Like most temptations, gambling has a dark and seedy side to it, but many people are blinded by the extravagance and presentation of casinos and card parlors. talks of how generations of spy movies and action thrillers have created the idea – not entirely inaccurate – of elegant European clubs or hotels in Las Vegas, where sharp dressed men and femme fatales bet millions of dollars without blinking an eye. Numerous television shows have used casinos as their setting, while the crime movie genre owes a debt of gratitude to the Italian mafia running the gambling industry during the 1970s and 1980s.16


While never shying away from depicting the unethical, ruthless, and violent nature of gambling – even dramatizing it, in fact – the fictional depictions of gambling nonetheless make the practice look exciting, sexy, and outrageous. Financial gains are often conflated with sex and drug escapades, as was shown in 1991’s Bugsy (which was nominated for 10 Academy Awards) and 1995’s Casino (which Varietydescribed as an epic about money, sex, and criminals achieving “the pinnacle of wealth and power”), movies based on real-life stories of organized crime rising and falling on the fortunes of their casino empires, often ending with bloodshed.17

But movies have also shown gambling in much lighter and attractive contexts, with the Ocean’s Eleven film series (starting with 1960’s Ocean’s Eleven) forgoing violence in favor of comedy and the adventure of a multimillion dollar heist. In writing of how “every gambling story ends the same way,” The New York Times hits the nail on the head of how America’s voyeuristic (and vicarious) fascination with excess is mirrored by how movie directors choose the gambling stories to tell: “either a catastrophic vice, or a charming hustle.” California Split (1974) ends with a gambling character snarling that “none of it meant anything,” while Rounders (1998) climaxes with a gambler setting his sights on the $1 million prize at the World Series of Poker, a real-life series of poker tournaments held every year in Las Vegas.18

Gambling and the Law

Gambling may be connected with organized crime, professional cheating, and addiction problems, but it is far too powerful an entity to be outright criminalized. In 2012, casinos pulled $37.3 billion in gross gaming revenue, almost 5 percent more than the preceding year.

states_casino_earningsWith that much money to be made, gambling is federally legal, but each state is allowed to legislate and regulate gambling as it sees fit. Most states choose to restrict the style of gambling seen in casinos to small geographic areas (such as the resort city of Atlantic City in New Jersey) or Native American reservations, which, as domestic independent nations, receive a degree of leeway by the federal government.

Nevada is infamous for its casinos, earning $10.86 billion in gross gaming revenue in 2012, and more states are starting to dance to that tune. TIME magazine reports that Kansas – a state not frequently thought of as a gaming hub – saw its gross casino gaming revenue increase by 603.7 percent in 2012, an increase of $293 million from 2011, and only five years after the state legalized casinos.19

States that have a stake in casino ownership benefit greatly from the business. Aside from Nevada, 10 other states earned in excess of $1 billion from their casinos in 2012:

  • Michigan ($1.42 billion)
  • Iowa ($1.47 billion)
  • Illinois ($1.64 billion)
  • Missouri ($1.77 billion)
  • New York ($1.8 billion)
  • Mississippi ($2.25 billion)
  • Louisiana ($2.40 billion)
  • Indiana ($2.61 billion)
  • New Jersey ($3.05 billion)
  • Pennsylvania ($3.16 billion).20


Gambling vs. ‘Entertainment’

However, the face of gambling is constantly changing. With the advent of online casinos and fantasy sports leagues making serious money, the question of how to regulate a new extension of the industry is a controversial one.

One of the questions being asked is whether such practices even constitute gambling. The chief financial officer of FanDuel, the largest daily fantasy sports company, adamantly told USA Today that his product was not sports betting or gambling, but “entertainment.” He pointed at his company’s strategic partnerships with the 14 teams in the National Basketball Association and 16 teams in the National Football League, as proof that his company did not engage in gambling (since American professional sports leagues have traditionally distanced themselves from sports betting).

However, given the sheer amount of money to be made from online fantasy leagues (FanDuel says it pays out prize money of more than $10 million every week), professional sports leagues have looked to buy in, eyeing the increased television viewership and revenue that would come from partnerships. USA Today suggests that if sports fans invest money in daily fantasy sports, those fans are more likely to tune in to professional sports games, than if the financial (and/or emotional) investment was not there.21

‘An Accepted Form of Entertainment’

To that effect, the NBA Commissioner has called for sports betting to be legalized and regulated. Writing in The New York Times, Adam Silver argues that bringing the practice into the mainstream will end illegal betting to the tune of $400 million every year.

But more ominously, Silver says that with most states offering lotteries, legal casinos, and approving online gambling, gambling itself “has increasingly become a popular and accepted form of entertainment in the United States,” and sports fans have an “obvious appetite” for putting money on their teams’ performances.22

A Gambling Addiction or a Gambling Impulse Control Disorder?

Regardless of the ethics of legalizing sports betting, it is hard to argue with Silver’s opinion on the rise of gambling as a form of recreation. For people struggling with compulsive gambling, seeing a source of temptation and fear be so enthusiastically promoted in media and popular culture brings to mind the debate over whether such a condition as a “gambling addiction” even existed.

Historically, pathological gambling was thought to be an impulse control disorder, a psychiatric disorder characterized by the uncontrollable desire to harm oneself or others (such as borderline personality disorder, antisocial personality disorder, or even attention deficit hyperactivity disorder).23 The Fix explains the difference between an impulse control disorder and an addiction. People who are addicted to a substance (or behavior) are psychologically dependent on the action, for some of the reasons explained above: a need to take risks, a need to escape from stress or depression, etc.24

On the other hand, people with impulse control disorders aren’t psychologically dependent on the action, but cannot control themselves once they start. In the context of drinking, this might mean people do not abuse alcohol to get away from their problems; they may not even be frequent or regular drinkers. But when they do drink, they drink to dangerous levels of excess, putting themselves or others in harm’s way.

Controversy and Reclassification

Although the distinction may seem negligible (Scientific American calls impulse control disorders “a fuzzy label”), it has pushed hundreds of people away from getting help. Speaking to The Guardian, a doctor who established a problem gambling clinic as part of the United Kingdom’s National Health Service explained that society is still coming to terms with gambling being an actual addiction and not just a matter of willpower. The severity of the condition is often drowned out by the advertising and promotion given to the positive experiences of the few winners; for the many others, losing their homes, their jobs, their families, or their freedom suggests that the need to gamble goes much deeper than expected.25

As Scientific American puts it, the idea of gambling becoming a destructive habit like a drug or alcohol problem was “controversial.”

In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association reclassified pathological gambling under disorders related to substance abuse and addiction, reasoning that the mechanics of a gambling problem more closely resemble those of an addiction, not an impulse control disorder.26


For a person to be diagnosed with a gambling addiction, they must show at least four of nine symptoms within 12 months:

  • Increased tolerance (needs to wager more money to feel excited about gambling)
  • Becomes agitated or withdrawn when not gambling
  • Attempts to cut down or stop gambling have proved futile
  • When not gambling, thinks about gambling constantly
  • Gambles as a way of coping with stress, frustration, depression, etc.
  • Suffers losses of personal relationships, professional accomplishments, or academic standards as a result of their focus on gambling
  • Returns to gambling even after personal and professional losses are evident
  • Borrows money to cover gambling expenses or losses

The similarity with the signs of a substance abuse problem is stark, and they have led to the same kind of treatment models being applied to people who struggle with gambling.

Treatment and Therapy for Problem Gambling

One such treatment model is Cognitive Behavioral Therapy, which is frequently used to help clients overcome a number of other forms of addictions. With gambling, a therapist could coach a client to recognize harmful thought patterns that would normally precede a gambling episode (depression, frustration, boredom, etc.), and channel those thoughts into different, healthier pursuits (creative expression, exercise, etc.).27

A huge dynamic of helping someone with a gambling problem is to keep them connected with people who can guide them in overcoming their urges. To that effect, 12-Step groups like Gamblers Anonymous provide a network of likeminded people with similar experiences, who can share stories and perspectives on the challenges – and rewards – of abstaining from the behavior.28

‘Negative Flaws’

But the fight continues. When NBC reported that Gamblers Anonymous was considering adding a warning about fantasy sports to a list of activities the organization regards as detrimental to recovery, the Fantasy Sports Trade Association chairman remarked that “fantasy sports don’t have the same negative flaws that traditional gambling products have” – even as professional sports leagues that make millions of dollars a week with fantasy sports companies (where players select sportsmen they think will perform well, with money to be won and lost), officially oppose sports betting.29,30

The Washington Post summarizes the game: Daily fantasy league sports encourage people to gamble on sports, while studiously claiming that what happens is not sports gambling.31


  1.  “The $70 Billion Fantasy Football Market.” (August 2013). Forbes. Accessed February 18, 2016.
  2.  “An Uncertain Line Between Fantasy Sports, Gambling.” (August 2015). Boston Globe. Accessed February 18, 2016.
  3.  “Are Daily Fantasy Sports Even Legal?” (September 2015). Washington Post. Accessed February 18, 2016.
  4.  “The Hyper Growth Of Daily Fantasy Sports Is Going To Change Our Culture And Our Laws.” (September 2015). Forbes. Accessed February 18, 2016.
  5.  “You’re Not Crazy, DraftKings Commercials Really Are on All the Time.” (September 2015). Streetwise Media. Accessed February 18, 2016.
  6.  “Is Fantasy Football Gambling? Yes, Says Nevada.” (October 2015). Christian Science Monitor. Accessed February 18, 2016.
  7.  “Gambling in Ancient Civilizations.” (October 2013). Ancient Origins. Accessed February 18, 2016.
  8.  “Why Do People Take Risks?” (August 2011). LiveScience. Accessed February 19, 2016.
  9.  “Genes Matter in Addiction.” (June 2008). American Psychological Association. Accessed February 20, 2016.
  10.  “Jackpot Fueled Therapist’s Gambling Addiction.” (July 2012). Boston Globe. Accessed February 20, 2016.
  11.  “Gambling and Alcohol Addiction Linked, Report Says.” (February 2013). BBC News. Accessed February 20, 2016.
  12.  “How the Brain Gets Addicted to Gambling.” (November 2013). Scientific American. Accessed February 21, 2016.
  13.  “Healthy Ways to Navigate Grief.” (November 2013). Psych Central. Accessed February 19, 2016.
  14.  “Men and Depression.” (January 2017). National Institute of Mental Health.
  15.  “Gambling Addict Tells of Fight to Save Family Life.” (November 2012). BBC News. Accessed February 19, 2016.
  16.  “Casinos and Popular Culture: Often a Good Bed.” (May 2012). Accessed February 19, 2016.
  17.  “Review: Casino.” (November 1995). Variety. Accessed February 20, 2016.
  18.  “The Perfect Predictability of Gambling Movies.” (October 2015). The New York Times. Accessed February 20, 2016.
  19.  “Casino Revenues Are Up in 2012 – Thanks in Part to Gambling in Kansas.” (May 2013). TIME. Accessed February 20, 2016.
  20.  “These 13 States Raked in $34 Billion in Gaming Revenue.” (April 2014). USA Today. Accessed February 20, 2016.
  21.  “Fantasy Sports Debate: Gambling or Not Gambling?” (January 2015). USA Today. Accessed February 20, 2016.
  22.  “Legalize and Regulate Sports Betting.” (November 2014). New York Times. Accessed February 20, 2016.
  23.  “Should the Scope of Addictive Behaviors Be Broadened to Include Pathological Gambling?” (September 2006). Addiction. Accessed February 21, 2016.
  24.  “The Difference Between Alcoholism and Impulse Control Disorder.” (December 2015). The Fix. Accessed February 21, 2016.
  25.  “Escape from Gambling Hell.” (April 2012). The Guardian. Accessed February 21, 2016.
  26.  “An Examination of a Proposed DSM-IV Pathological Gambling Hierarchy in a Treatment Seeking Population: Similarities with Substance Dependence and Evidence for Three Classification Systems.” (September 2015). Journal of Gambling Studies. Accessed February 21, 2016.
  27.  “Cognitive Behavioral Therapy for Pathological Gambling: Cultural Considerations.” (December 2009). American Journal of Psychiatry. Accessed February 21, 2016.
  28.  “Members of Local Gamblers Anonymous Group Reflect on Addiction.” (June 2015). Daily Tarheel. Accessed February 21, 2016.
  29.  “Gamblers Anonymous Trustees to Vote on Adding Warning Against Fantasy Sports.” (August 2015). NBC Washington. Accessed February 21, 2016.
  30.  “Report: Fantasy Sports Might Be Added to Gamblers Anonymous Warnings.” (August 2015). Legal Sports Report. Accessed February 21, 2016.
  31.  “”Watch Games in Our Daily-Fantasy Gambling Lounges,” Say Leagues That Oppose Sports Gambling.” (August 2015). Washington Post. Accessed February 21, 2016.