VA Doubles Down On Treatment For Vets With Gambling Addiction
The Department of Veterans Affairs has known for decades that veterans are at higher risk for gambling addiction, but expanding treatment has been slow.
Ronnie Reyes is just now coming to terms with a military sexual trauma from his time in the army from 1989 to 1991. He said he believes it is one reason behind his gambling addiction.
“I think it has a numbing effect,” Reyes said. “When I’m in the heat of the moment, at the tables or a slot machine, I just get tunnel vision. And nothing else seems to matter.”
Originally from California, Reyes spent the last 26 years in Las Vegas. He continued to gamble, even when he was a blackjack dealer. Now he's in treatment at the VA. It was hard for him to admit he had a problem until he was thousands of dollars in debt.
“There is not a substance attached to it,” Reyes said. “There is no drug, there is no bottle. It’s a behavior that can be easily hid.”
Open in November, Las Vegas is only the second inpatient treatment program in the VA system. Vets spend up to 45 days in therapy and group activities like yoga.
Vets with PTSD have a 60% higher rate of gambling addiction than the general population. Gambling also contributes to the higher suicide rate among veterans. Even so, gambling hasn’t attracted nearly as much funding as drug and alcohol addiction, said Bo Bernhard, executive director of the International Gaming Institute at University of Nevada Las Vegas.
“Drugs and alcohol have public voices, public faces,” he said. “And a much longer history of those voices advocating in this field. Gambling addiction is really a newer field.”
The history of seeing gambling as an addiction actually starts with one pioneering VA doctor — Robert Custer in Ohio.
Custer opened the first inpatient treatment center for problem gambling in 1974 after he saw symptoms among his drug and alcohol patients.
“Many of them were 'swapping seats on the Titanic,' as he used to put it,” Bernhard said. “We’re switching from a drug and alcohol addiction to what he thought of, first, as a gambling addiction.”
Custer left the VA shortly after creating the first treatment program. In 1980, the American Psychiatric Association would formally recognize gambling as an addiction, largely because of Custer's work.
There are outpatient programs throughout the VA system. In San Diego vets are sent to treatment programs in the community. But for decades, Custer's Cleveland-area VA remained the only inpatient treatment program in the VA system. With its high concentration of gambling and a growing veteran population, Las Vegas seemed the obvious choice for a second.
One thing that makes gambling addiction different from drugs or alcohol is "the chase." The feeling that no matter how deep the hole, you can somehow win everything back.
Roxanne Untal, who runs the 20-bed clinic in Las Vegas, said she has patients with more than $100,000 in debt. Researchers believe it’s one reason veterans with gambling addiction have a higher suicide rate.
“You can treat the gambling, and once you treat the gambling, you’re still facing that debt,” Untal said. “And how do you go about living a life that is meaningful with that. I think it’s just very different consequences and very different pathways.”
Treatment has to include classes in financial management.
“Paychecks come in one day, gone. I get paid one day. The next day I’m broke,” said Jim Romero, who was a mechanic in the Air Force in the early 2000s.
Romero was homeless by the time he entered the program at the VA Southern Nevada Health Care in Las Vegas. He’s been battling one addiction or another for 20 years.
“I got away from what I wanted to do,” he said. “I thought I had it under control, but I’ll never have this disease under control. It’s something I’ll have to fight every single day.”
VA research indicates that among those who have tried gambling, about 5% of the population is addicted to gambling, but 8% of the veteran population. Advocates say those numbers are probably low. At the moment, the VA doesn’t screen for gambling addiction the way it does for drugs and alcohol, Untal said.