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This November, Rhode Island voters will decide if Twin River in Lincoln and Newport Grand in Newport should be allowed to become full-scale casinos.
The state constitution requires that any expansion of gambling be approved not only by voters statewide but also by a majority of the voters in the city or town where the gambling facilities are located.
On Sept. 13, 2012, Alliance for a Livable Newport held a forum to hear from supporters and opponents of the casino measure.
Among the speakers was the Rev. Eugene J. McKenna, president of Concerned Citizens Against Casino Gambling, who talked about the social costs of gambling.
He told the audience that according to Dr. Robert Breen, a psychiatrist who heads Rhode Island Hospital’s gambling treatment program, thousands of Rhode Islanders could be harmed by expanded gambling.
"He said there’s at least 7,500 addicted gamblers in Rhode Island, at least," McKenna said, citing Breen. "He said it could be as high as 22,000."
We wondered whether Father McKenna quoted the numbers accurately -- and where they came from -- so we called Breen, who heads the hospital’s gambling treatment program.
In our phone interview, Breen confirmed the figures, saying they were derived from estimates of the rate of gambling addiction nationwide. If you apply those rates to Rhode Island’s population of about 1 million, he said, you come up with roughly 7,500 to 22,500. (For his calculation, he used addiction rates of .75 to 2.5 percent.)
They were the same numbers Breen used in a commentary piece he wrote, published June 17, 2012, in The Providence Journal.
When trying to estimate the number of gambling addicts in the United States, the first step is to define the term. Most academic analyses of the issue use the criteria set by the American Psychiatric Association.
The criteria includes things such as needing to gamble larger and larger amounts to get the same excitement, returning the day after a big loss to try to win it back, lying to family members, therapists and others to conceal the extent of their gambling, and committing illegal acts to finance gambling.
Studies spanning 35 years put the percentage of problem gamblers roughly in the range Breen and Father McKenna cited. However, not all problem gamblers are addicts. Most studies show there is a scale of severity, with only a third of problem gamblers reaching the most severe level, which the studies describe with different terms.
For example, a 1976 University of Michigan study estimated the rate of lifetime "compulsive" gamblers to be .77 percent and the rate of potential compulsive gamblers to be 2.33 percent.
In 1997, Howard J. Shaffer, an associate professor of psychiatry at Harvard University Medical School and director of the school’s Division on Addiction, analyzed data from 119 studies on problem gambling in the United States and Canada. His report said 1.6 percent of the population meets the pathological gambler standard and 3.85 percent show signs of it.
In a 2009 report,The National Center for Responsible Gaming, a research organization financed by the gambling industry, said Shaffer’s findings were still the norm. In that study, Christine Reilly, at the time executive director of the Institute for Research on Gambling Disorders, reviewed studies from 1976 to 2005 and said they all reflected the same range.
"Prevalence estimates of disordered gambling within the general adult population have remained relatively stable from study to study, time to time and place to place," she wrote.
Breen said he used prevalence rates developed by Rachel Volberg, president of Gemini Research in Northampton, Mass., which studies gambling and gambling-related issues.
Shaffer said Breen’s overall number was right, but he made more of a distinction between compulsive and problem gamblers.
"The most recent estimates of pathological gambling in the United States are about 0.6 or 0.7 percent of the population," Shaffer said. "Another 2-3 percent of the population experience subclinical [showing some signs of pathological gambling, but not all of them] gambling problems."
The Rev. Eugene J. McKenna said that, based on rates found in national and international studies, there are between 7,500 and 22,500 adult gambling addicts in Rhode Island.
Father McKenna accurately cited estimates by Breen, the Rhode Island Hospital doctor who treats problem gamblers. He, in turn, was citing ranges found in decades of research in North America. However, neither made it clear that those ranges covered a spectrum of problem gamblers, not all of whom are gambling addicts.
Because the statement is accurate, but needs clarification, or additional information, we find it Mostly True.
National Council on Problem Gambling: accessed Sept. 25, 2012;
National Gambling Impact Study Commission, Final Report : Chapter 4, page 5, accessed Sept. 25, 2012
National Center for Responsible Gaming, "Increasing the Odds," 2009 accessed Sept. 26, 2012
Interview, Dr. Robert Breen, director , Rhode Island Hospital gambling treatment program, Sept. 24, 2012
E-mail, , Dr. Howard J. Shaffer, associate professor of psychiatry, Harvard University Medical School, director of the Division on Addiction Sept. 25, 2012
The Providence Journal, "Commentary-R.I.’s skimpy aid to casino addicts", June 17, 2012
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