What is What is gambling, and gambling, and Chinese American - PDF document

NICOS Chin NICO S Chinese H Healt alth Coal Coalition Problem Gambling: A Hidden Mission: ion: To Enhance the Health and Well-Being of San Francisco's Chinese Community. Addiction in the Asian • Founded in 1985 American Community • Located in SF Chinatown • Public-private-community partnership of 30+ groups • North East Medical Services Michael S. Liao, MSW • IPA (Chinese Community Health Case Association) • Chinese Hospital • On-Lok Lifeways • Self-Help for the Elderly Background • Chinese Community Health Study – (NICO (NICOS/ Four Four Winds Winds, 1997 1997) • Telephone Survey of 1,808 What is What is gambling, and gambling, and Chinese American adults in San Francisco how common is it? how common is it? • Purpose: Health profile • 70% identified gambling as a problem 1

Gambling refers to any game of chance Types of Gamblers or skill that involves a financial risk • Socia Social/C /Cas asua ual Source: California Prevalence Study (Volberg et al. 2006) • 社交賭博 • At-R At-Ris isk • 高危賭博 • Prob Problem • 問題賭博 • Gambling Gambling Dis Disord rder Gambling • 賭博性疾患 , , Disorder 16.9% 70% 9,5% 2.2% 1.5% 嗜賭症 , , 賭癮 DSM-5: Gambling Disorder • Substance-Related and Addictive Disorders • Persistent and recurrent problematic American P American Psychiatric ychiatric gambling behavior leading to clinically significant impairment or distress, as Association: DMS-5 Association: DMS-5 indicated by the individual exhibiting four (or more) of the following in a 12 month period: Criteria Criteria 2

Signs of Gambling Disorder Signs of Gambling Disorder 5. Esc 5. Escape pe: Often gambles when 1. 1. Toler Toleranc nce: Gambles with feeling distressed. increasing amounts of money to 6. Chase: 6. Chase: After losing money achieve excitement. gambling, often returns another 2. 2. Withdr Withdrawa awal: Is restless or irritable day to get even. when attempting to cut down or 7. Lies 7. Lies to conceal the extent of stop gambling. involvement with gambling. 3. Inability to 3. ility to Sto Stop: : Repeated 8. Neg 8. Neglect: t: Jeopardized/ lost unsuccessful efforts to control, significant relationships, job, or cut back, or stop gambling. other opportunities because of gambling. 4. 4. Preoc eoccupatio cupation: n: Thinking about 9. 9. Bail O Bail Out: t: Relies on others to gambling all the time. provide money. Seeing Signs? Exhibiting any one of these signs may ONE+ indicate that gambling has become a problem Asian Americans & Asian Americans & FOUR+ Exhibiting four or more signs means that a licensed mental health professional could Problem Gambling oblem Gambling make a diagnosis of gambling disorder 3

Problem Gambling among Asian Challenges Americans Environmental • Highe Higher rates of p rates of probl oblem m gambl gambling ng and addic and addicted Immigration-Related gam gambling f foun und: Prevalence Issues - Chinese community members - 14.5% problem gambling; 21% pathological gambling (Wong and Toy, 1999) - API University Students - 12.8% probable gambling Stigma / Help-seeking disorder (Zhao, Lee, Kuwatani, 2016) Cultural Acceptance Behavior - API high school students – 11% probable pathological gambling (Chiu & Woo, 2012) • Risk sk F Factors: ors: - Being male, younger, earlier onset of gambling, more Target Marketing Lack of culturally & linguistically recent immigrant, experience of trauma appropriate resources Problem Gambler Medical Utilization, Help Seeking Patterns • Evans and Delfabbro (2005) found that PGs did not view treatment services as an option, but rather as a “last resort” Health Impacts Health Impacts of of • Morasco et al. (2006) found that PGs are Problem Gambling oblem Gambling more likely to be treated in the ER in the past year 4

Physical Health Issues Symptoms Potential Causes Tachycardia (Morasco et.al, 2006) Alteration of heart rhythms Hypertension (Lorenz & Yaffee, 1986) Decreased blood flow to the heart Angina (Morasco et.al, 2006) Neurobiological Neur obiological Headaches (Bergh & Kuhlhorn, 1994, Increased body tension Lorenz & Yaffee, 1986) Basis of Gambling Basis of Gambling Insomnia (Lorenz & Yaffee, 1986) Skin Problems Exacerbation of skin conditions Addiction ddiction Gastrointestinal problems such as Irritation and disruption of the nausea, ulcers, and colitis (Bergh & digestive system Kuhlhorn, 1994, Lorenz & Yaffee, 1986) Cirrhosis and other liver diseases Increased prevalence of alcohol abuse (Morasco et.al, 2006) Are brains of problem gamblers different? This Is Your Brain on Gambling Controls Pathological fMRI of subject Gamblers anticipating a monetary win in simulated game fMRI of subject NAc anticipating a small amount of cocaine Breiter et al., 2001 Reuter et al., 2005 5

Are brains of problem gamblers different? • Pathological Gamblers exhibit lower activity in What Can I What Can I do? do? prefrontal cortex compared to Non-PGs • In performing neuro-cognitive tests, PGs showed similar dysfunctions in prefrontal cortex as Methamphetamine addicts Potenza et al., 2003 What Can You Do? What Can You Do? • Asses Assess! Ask the right questions: ( Brief B ief Biosoc osocial ial • Educat Educate! e! Provide information. To avoid Gambli Ga mbling ng Screen BBGS Screen BBGS) gambling excessively, learn the facts: 1) During the past 12 months, have you become restless irritable or anxious when trying to stop/cut down on - Randomness | 隨機性 gambling? 當您嘗試減少或停止賭博時 ﹐ 您是否感到渾身不自 - Independence of Events | 事件的獨立性 在或脾氣暴躁呢 ﹖ - House Advantage | 莊家優勢 2) During the past 12 months, have you tried to keep your • Set a money limit family or friends from knowing how much you gambled? 是 否曾經對家人或朋友隱瞞自己參與賭博的程度 ﹖ • Set a time limit 3) During the past 12 months did you have such financial • Leave credit/debit cards at home trouble as a result of your gambling that you had to get • Avoid borrowing money The HOUSE (gambling operator) ALWAYS help with living expenses from family, friends or welfare? 是 • Have a plan, win or lose wins! 否曾經應因為賭博帶來的經濟 絕 境而需要 倚靠家人，朋友或 (in the long run) 社會福利組織來提供金錢 ﹖ 6

彩票號碼 Lottery Tickets What Can You Do? 2, 10, 18, __, __, __ • Educat Educate! e! Provide information. To avoid gambling excessively, learn the facts: 以下哪三個號嗎最適合用來填滿以上彩票空位來贏得大獎？ Which of the following three numbers would best - Randomness complete the lottery ticket section to provide us with - Independence of Events the greatest chance of winning the jackpot? - House Advantage • Set a money limit A) A) 19 19, 2 , 20, , 21 • Set a time limit B) B) 27, 27, 39, 39, 44 44 • Leave credit/debit cards at home C) C) 23, 33, 23, 33, 43 43 • Avoid borrowing money The HOUSE (gambling operator) ALWAYS D) 20, 20, 30, 30, 40 40 • Have a plan, win or lose wins! (in the long run) E) E) 任何以上的選擇 | Any | Any of of the Abov Above Tips for family members What Can You Do? DON’T DON’ DO DO • Refer! Refer! Provide information about available community resources: – Give gambler – Seek resources for • Helplines money directly financial planning  1-800 1-800-GAMB MBLE LER R and stress – Enable / rescue / fix  Calif lifornia C Counci cil o on Proble lem Ga Gambli ling management  English, Cantonese, Mandarin, Spanish, 24/7, statewide – Create more drama  1-8 1-888- 88-96 968- 8-78 7888 88 – Limit gambler’s – Take on burden by  NI NICOS Chine COS Chinese He Heal alth Coal Coalition - n - Statewid atewide C e Chinese Pro e Problem G m Gambling ng access to $$ Hel Helpline yourself  English, Chinese (Mandarin, Cantonese, other dialects), 24/7, SF Bay Area  Includes referrals to mental health as well as financial and legal counseling – Find support 7