Opportunities to gamble have increased substantially in the United States over the past two decades. Gambling is now legal
in 48 states (Utah and Hawaii being the exceptions), with state lotteries in 37, racetracks in 40, and casinos in 38.1 In addition, numerous casinos have been opened on Indian reservations throughout the US. Although gambling is illegal for
anyone under 18 to 21 years of age, depending on individual state law, it is a significant and growing problem among minors
across the country.
Gambling has been defined as "placing value upon a game/event or a bet of any type that has an unpredictable outcome, and
in which the result to some magnitude is determined by chance."2 It has many forms, including lottery, scratch cards, casino games, sports betting, Internet gambling, horse and racetrack
wagering, video-game betting, placing bets with bookmakers, and playing cards, dice, and charitable games such as bingo. In
a national survey, 80% of children 12 to 17 years old (and 82% of US adults3) reported they had gambled in the past year.4 (Gambling was defined as an affirmative response to any of 15 questions that asked about participation in certain activities,
including bingo, cards, dice, sports betting, casino games, tracks, lottery, and Internet gambling.) Over the past 10 years,
the percentage of children gambling in the preceding year has increased from 65% to 80%.5
In North America, it is estimated that more than 15 million youth are gambling without adult supervision or knowledge, and
that at least 2 million of them are experiencing problems related to the gambling.5 The rate of gambling by 12th graders is estimated to range from 75% to 91%, and between 10% and 14% of adolescents have,
or are at risk of developing, a problem gambling habit.6
Given these statistics, it is essential that pediatricians develop a better understanding of the problem of gambling, including
an appreciation of the cognitive framework of children as it relates to this activity.
When is gambling a problem?Several terms are used to describe gambling behavior, including "pathological gambling," "problem gambling," and "compulsive
gambling." Most clinicians and health-care professionals distinguish between "pathological gambling" and "problem gambling."
In 1980, pathological gambling was officially recognized by the American Psychiatric Association as a disorder of impulse
control, with specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III).7 In the most recent version, DSM-IV-TR (fourth edition, text revision), pathological gambling is defined as "persistent and recurrent maladaptive behavior that
is not better accounted for by a manic episode."8 The rate of pathological gambling among youth exceeds that of pathological gambling among adults.3
Problem gambling refers to "all individuals with gambling-related problems, including mildly affected individuals who do not
meet clinical diagnostic criteria as defined by the DSM-IV."9
The term "compulsive gambling" is used by lay persons and some organizations (e.g., Gamblers Anonymous).7 Compulsive gambling is often likened to pathological gambling in terms of severity.
Several phases of problem gambling have been described based on clinical experience.10,11 In the winning phase, a gambler is empowered by his winnings and success. Next comes the losing phase, during which the gambler tries to win back his losses. This is followed by the desperation phase, during which the gambler may resort to illegal activity, including stealing, to continue gambling. Some gamblers experience
a fourth phase, the giving up phase, where they become ambivalent about winning but nonetheless desperately try to stay afloat in a game.12
Although these phases are useful descriptively, they are not supported by empiric data. What is certain is that some gamblers resort to borrowing, lying, or even stealing to continue their habit. Among young people who
gamble, the need for funds to sustain the behavior can foster a variety of illegal behaviors. One study showed an association
between slot machine use and juvenile crime.13
Table 2 At the intersection of adolescent risk-taking and gambling: The significant associations*
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A study of Vermont children in the eighth to 12th grades found a variety of risk-taking behaviors significantly associated
with problem gambling (Table 2). There was a stepwise increase in risk-taking behaviors as one went from children who did
not gamble, to children who gambled, to children with problem gambling.14 No surprise, then, that more than half of adolescents undergoing outpatient treatment of substance abuse were found to be
pathological gamblers.15 Gambling may thus contribute to significant family, school, and social problems in youths and progress to detrimental sequelae
in adulthood. Alarmingly, adult pathological gamblers have a 17% to 24% rate of suicide attempts, according to one study.16Links to other diagnoses Depression has been linked to pathological gambling in as many as 76% of adult gamblers.17 (Few studies have been done of children who gamble, but studies of adult gamblers offer some insight into associated disorders.)
Pathological gamblers may also suffer from other mood or anxiety disorders, such as panic disorder, phobias, obsessive-compulsive
disorder, generalized anxiety, or post-traumatic stress disorder. Between 15% and 40% of pathological gamblers may have comorbid
antisocial personality disorder.12
As many as 20% of pathological gamblers have comorbid attention-deficit/hyperactivity disorder (ADHD).18 Having ADHD may be a risk factor for problem or pathological gambling, but this hypothesis has not been examined in longitudinal
studies. The most prevalent comorbid condition is a past or present substance-use disorder, which affects as many as 30% to
50% of pathological gamblers.12
Why children are rolling the dice Television, the Internet, radio, newspapers, and billboard advertisements portray gambling as an exciting way to win large
amounts of money.19 Depictions of gambling as a "quick win" or a glamorous and easy way to get cash are generally not accompanied by warnings
about age restrictions for gambling or by discussion of the true odds of winning. Children reading or listening to these advertisements
may glean a false sense of the reality of gambling. Buchta found that 41% of adolescents believe that gambling is appropriate
behavior for teenagers.20 Thus, many children do not view gambling as potentially problematic. Adding to concern is the observation that, just as the
availability of alcohol is linked to alcohol dependency, the increasing availability of gambling could lead to more problematic
gambling in children and adults.3
One survey of college students found that those who gamble do so for fun or excitement, to socialize, to win money, or to
"just have something to do"21—reasons similar to those for adults who gamble. Some investigators theorize that children begin gambling because it is fun
and exciting and a way to obtain money, but others hypothesize that gambling fulfills a desire to lose or resolves parental
conflict.22 Adolescents who gamble may cycle through rebellion or depression, of which gambling is a part. Gambling may be a means of
"escape" from parents (conflict) and a way to avoid dealing with impending issues. Adolescents with gambling problems often
need to dissociate or escape from daily life stressors. Examining the theories why children gamble may lead to better prevention
and treatment strategies.
Where and how children gamble Lotteries, card playing, and sports betting are the most common gambling activities among children overall.5 (The figure below shows the level of participation of a sample of children in the US in different types of gambling.) The
popularity of a particular form of gambling among the pediatric population varies by access and location. In areas dense with
casinos, such as Atlantic City, N.J., Las Vegas, and Indian reservations, children have easier access to slot machines and
table games and, therefore, become more engaged in these activities.
Similarly, where there is increased access to casinos or gambling sites, there is increased utilization of these venues by
adolescents and children.1 In Atlantic City, for example, as many as 87% of junior and senior high school students surveyed reported gambling activities.23 The free distribution of alcoholic beverages in casinos presents the dual risk of drinking and gambling.
The World Wide Web now provides immediate, 24-hour access to gambling in many homes across America. With a click of a mouse
and a valid credit card, any child can find a site to spin the roulette wheel or "double-down" in blackjack without necessarily
being identified. Many of the companies that run these virtual casinos post their charges under disguised names, keeping the
parents from easily spotting the fact that their child is spending money on gambling. This also makes it difficult to estimate
with accuracy the number of children who gamble online.
One study of Internet usage by the Federal Trade Commission found that minors had easy access to gambling sites, with 20%
of sites lacking any warning about age restrictions. In addition, advertisements for online gambling pop up on non-gambling
Web sites.24 It is estimated that, each week, 2 million players log on to more than 1,800 virtual casinos, accounting for an annual loss
among participants of $3.5 billion dollars.25
Which children become pathological gamblers? Predicting which children who gamble will develop a gambling problem is difficult. But conclusions can be inferred from studies
showing that certain childhood behaviors mirror future adult behavior problems, including gambling. Adult pathological gamblers
are more likely to be male, single, non-Caucasian, and less educated.26 Recent estimates suggest that the gender disparity may be disappearing, however. Women start gambling later than men, but
they progress more rapidly to pathological gambling, a concept known as "telescoping."12
Many adult problem gamblers began gambling at an early age. In one study that evaluated adult pathological gamblers undergoing
treatment in Iowa and Massachusetts, 25% and 36%, respectively, reported that they started gambling before age 15.26
Risk factors for problem gambling in an adolescent include male gender, starting gambling at an early age (as young as 8 years),
poor grades at school, and the presence of other addictive behaviors (smoking, drinking, illegal drug use). Table 4, containing
information that is part of a broad conceptual framework underscoring the relationship of childhood gambling to adolescent
behaviors, categorizes risk factors and protective factors.
Table 4 Gambling among youth: Risk factors, protective factors
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Genetics and exposure to gambling in childhood are influences. In a survey of adolescents, those who gamble were almost twice
as likely to have at least one parent who gambled compared to nongambling adolescents.20 More than half of pathological gamblers report at least one first-degree relative with symptoms consistent with gambling
problems,27 and some preliminary data suggest that gambling is familial.28 Other studies support the familial association of the dopamine D4 receptor gene (DRD4) with pathological gambling.28,29 Studies of twins suggest that the familial role is both genetic and environmental.30In short, early gambling behavior and a family history of pathological gambling are risk factors for pathological gambling.
Screening patients for a gambling problem Increased awareness of the problem of childhood gambling by health-care professionals, parents, and teachers is imperative.
Anticipatory guidance and screening for problem behavior constitute a significant part of the well-child and adolescent visits.
Because pediatricians are pressed for time, a practical approach to preventing and treating pathological gambling is essential.
Screening of patients for a gambling problem should probably start by junior high school. (According to one article, one third
of eighth-graders in Delaware reported gambling in 2002.31) Incorporating gambling into the HEADS adolescent screening (recently expanded to HEEADSSS) and modifying it to HEADGeS (or
HEEADGeSSS; Home, Education/employment, Eating, peer-group Activities, Drugs, Gambling, Sexuality, Suicide/depression, Safety) is one reminder strategy for clinicians.20 [Editor's note: For more on the HEEADSSS interview, see "Getting into adolescent heads: An essential update," in our January
2004 issue, www.contemporarypediatrics.com/contpeds/article/articleDetail.jsp?id=108002.]
Screening youth for pathological gambling can be as simple as adding a few questions to your basic risk assessment:
- Do you gamble or bet on games?
- Have you ever felt that your gambling or betting was out of control?
- Have you ever gotten into a fight with your family or friends because of gambling or betting?
- Have you ever felt like you lost too much money in gambling or betting?
Table 5 Lie/Bet (two-question) screening tool
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Although no single question can reveal pathological gambling, the Lie/Bet questionnaire,32 validated for adults, gives providers two simple questions to help identify gambling issues (Table 5): 1) Have you ever felt the need to bet more
and more money? And 2) Have you ever had to lie to people important to you about how much you gamble? A "yes" answer to either
question may indicate a problem. Warning signs of problem gambling in children include a sudden drop in school performance, going out at night and not being
forthcoming about where, personality changes (moodiness, defensiveness, depression), money missing from the home, and the
sale of expensive items with no accounting for the money.
Parents should be asked about their gambling behavior, too, as children raised with people who gamble are at risk for problematic
gambling. As always, we should emphasize to parents the need to be role models for our children.
Screening for problem or pathological gambling behaviors can segue into a discussion of other risk-taking behaviors. In addition,
identification of other risk-taking behaviors may be a red flag to screen for gambling behaviors because they tend to be interconnected.14
When concerns about gambling are raised on initial screening, several options are available for more detailed surveillance.
One is to use the criteria for pathological gambling from the Diagnostic and Statistical Manual of Mental Disorders, Multiple Response, Revised for Juveniles, Fourth Edition, (DSM-IV-MR-J, 2000).33DSM-IV-MR-J is more germane to adolescents than DSM-IV, and its responses are in a simplified format. Other screening options include the South Oaks Gambling Screen Revised for
Adolescents (SOGS-RA). SOGS is the tool most utilized in research settings to identify adult pathological gamblers.34 Questions from the SOGS-RA are listed in the box at right.
Several other gambling screening instruments are available, including The Canadian Problem Gambling Index,35 The Massachusetts Gambling Screen,36 and Gamblers Anonymous (GA) 20 Questions.32 Many of these more comprehensive instruments are used by gambling treatment experts and in research protocols. Regrettably,
many of these tools have not been comparatively validated.7 One comparison of the SOGS-RA, DSM-IV-J (1992), and GA-20 found that the GA-20 identified the most problem/pathological gamblers and the DSM-IV-J identified the least.37
Treatment options No standard or proven treatment exists for pathological gambling, but several useful models are available, including inpatient
treatment centers, self-help groups, cognitive-behavioral psychotherapy, and addiction-based psychotherapy.38 Psychotherapy, particularly cognitive-behavioral therapy, is often recommended for both pediatric and adult pathological
gamblers. Children with pathological gambling behaviors should be referred to a therapist with experience in this area. Experiences
at a youth gambling and research clinic suggest that adolescents with gambling problems tend to be referred by parents, health-care
providers, teachers, and friends, not self-referred.
Ideally, treatment should be offered at no or little cost (via insurance support), as gamblers often lack the ability to pay
because of their addiction. Several states in the US and provinces of Canada have treatment programs for problem and pathological
gamblers that are funded by the state or province,38 and many of the programs are free. Unfortunately, there are few treatment resources available for pediatric gamblers. The
resources geared toward adults (e.g., Gamblers Anonymous) may not be developmentally appropriate for younger persons. Clearly,
there is a need for age-appropriate treatments for young gamblers, and recent data showing the high frequency of pathological
gambling in youth may help facilitate their development. Anonymity and access to public transportation are essential when
considering the location of a treatment center.4
The components of psychotherapy for youth in a treatment center are aimed at "understanding the motivations for gambling,
establishing a baseline of gambling behavior and encouraging a decrease from baseline, addressing cognitive distortions of
gambling, establishing the underlying causes of stress and distress, addressing underlying depression, evaluating and improving
coping abilities, restructuring free time, and outcome and relapse prevention."4
As for pharmacotherapy, the medical treatment of pathological gambling has been studied infrequently in adults. Naltrexone
monotherapy and naltrexone and serotonin reuptake inhibitors (SSRI) combination therapy have been shown to be efficacious
in remittance of some gambling symptoms in adults.39 Regrettably, no studies of medical treatment in children with pathological gambling have been conducted. Although SSRI and
naltrexone therapy show promise, no medication can be recommended at this time.
Preventing gambling Prevention of problematic youth gambling is paramount because the link to adult pathological gambling is increasingly clear.
Parents and their young children should be educated about the risks of gambling. Parents should also be encouraged to monitor
their child's spending and Internet usage. The discovery of lottery tickets or casino cards, and excessive reactions to outcomes
of sporting events by their children, should raise a red flag for the parent.
Preventive education in both video and didactic formats has been shown to be effective for grade school and high school students.19,40 Communicating the facts about the chances of winning versus losing in gambling, as well as pointing out the devastating outcome
of problem gambling, may help modify the attitude of children toward gambling. Resources for parents and pediatricians are
listed below.
The American Academy of Pediatrics recognizes gambling as a problem among children and has produced a pamphlet available to
health-care providers: "Gambling: Not a safe thrill."41 Consider keeping copies of this pamphlet in your waiting room.
Implications for the future Gambling is a widespread, potentially serious, and underrecognized problem in children. Children should be screened for gambling
problems, probably by the time they start junior high school. Problematic gambling is often linked to other risk-taking behaviors,
and such behaviors should alert teachers, parents, pediatricians, and other health-care professionals to the possibility of
a gambling problem. Identifying problem gamblers at younger ages may help prevent progression to pathological gambling.
Because accessibility to gambling activities is associated with an increase in the rate of pathological gambling, state and
national regulation of gambling among minors is a critical step in combating this problem.42 Research is needed to investigate what motivates and sustains gambling habits in children so that prevention and treatment
can be more clearly targeted in this age group.
AcknowledgmentDR. TURCHI is co-director, Center for Children with Special Health Care Needs, St. Christopher’s Hospital for Children, Philadelphia,
and assistant professor of pediatrics, Drexel University School of Medicine, Philadelphia.
DR. BLACK is professor, department of psychiatry, University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City.
DR. BUCHTA is director, division of pediatrics/adolescent medicine, Scripps Clinic, La Jolla, Calif.
The authors have nothing to disclose in regard to affiliations with, or financial interests in, any organization that may
have an interest in any part of this article.
Henry R. Lesieur, PsyD, PhD, of the Rhode Island Hospital Gambling Treatment Program, Providence, R.I., and Jeffrey Derevensky,
PhD, co-director, International Centre for Youth Gambling Problems and High-Risk Behaviors, McGill University, Montreal, Canada,
provided thoughtful comments on the manuscript of this article.
REFERENCES 1. National Gambling Impact Study Commission Final Report, June 1999. http://govinfo.library.unt.edu/ngisc/reports/fullrpt.html. Accessed 8/11/03
2. Bolen DW, Boyd WH: Gambling and the gambler: A review and preliminary findings. Arch Gen Psychiatry 1968;18:617
3. Welte JW, Barnes GM, Wieczorek WF, et al: Gambling participation in the US—Results from a national survey. J Gambl Stud 2002;18:313
4. Gupta R, Derevensky JL: Adolescents with gambling problems: From research to treatment. J Gambl Stud 2000;16:315
5. Derevensky JL, Gupta R: Adolescent gambling behavior: A prevalence study and examination of the correlates associated with
problem gambling. J Gambl Stud 1998;14:319
6. Shaffer H, Hall M: Estimating the prevalence of adolescent gambling disorders: A quantitative synthesis and guide toward
standard gambling nomenclature. J Gambl Stud 1996;12:193
7. Raylu N, Oei TP: Pathological gambling. A comprehensive review. Clin Psychol Rev 2002;22:1009
8. American Psychiatric Association (APA): 2000 Diagnostic and Statistical Manual of Mental Disorders (Text Revision), Washington, D.C., American Psychiatric Press
9. Hollander E, Buchalter AJ, DeCaria CM: Pathological gambling. Psychiatr Clin North Am 2000;23:629
10. Custer RL: Profile of the pathological gambler. J Clin Psychiatry 1984;45:35
11. Lesieur HR, Rosenthal RJ: Pathological gambling: A review of the literature. J Gambl Stud 1991;7:5
12. Argo TR, Black DW: The characteristics of pathological gambling. Understanding and Treating Pathological Gambling. American Psychiatric Publishing, Inc., in press
13. Yeoman T, Griffiths M: Adolescent machine gambling and crime. J Adolesc 1996;19:183
14. Proimos J, DuRant RH, Pierce JD, et al: Gambling and other risk behaviors among 8th to 12th grade students. Pediatrics 1998;102:e23
15. Kaminer Y, Burleson JA, Jadamec A: Gambling behavior in adolescent substance abuse. Subst Abus 2002;23(3):191
16. Ciarrochi J, Richardson: Profile of compulsive gamblers in treatment: Update and comparisons. J Gambl Behav 1989;5:53
17. McCormick RA, Russo AM, Ramirez LF, et al: Affective disorders among pathological gamblers seeking treatment. Am J Psychiatry 1984;141:215
18. Specker SM, Carlson GA, Christensen GA: Impulse control disorders and attention deficit disorder in pathological gamblers.
Ann Clin Psychiatry 1995;7:175
19. Ferland F, Ladouceur R, Vitaro F: Prevention of problem gambling: Modifying misconceptions and increasing knowledge. J Gambl Stud 2002;18:19
20. Buchta R: Gambling among adolescents. Clin Pediatrics 1995;34:346
21. Neighbors C, Lostutter TW, Cronce JM, et al: Exploring college student gambling motivation. J Gambl Stud 2002;18:361
22. Jessor R: New Perspectives on Adolescent Risk Behavior, 1998, Cambridge, United Kingdom, Cambridge University Press
23. Lesieur HR, Klein R: Pathological gambling among high school students. Addict Behav 1987;12:129
24. Federal Trade Commission: FTC Warns Consumers about Online Gambling and Children. Report released June 28, 2002. http://www.ftc.gov/opa/2002/06/onlinegambling.htm. Accessed 4/17/03
25. Horn J: Point and Bet. Newsweek October 29, 2002, pp 50-52
26. Volberg RA: The prevalence and demographics of pathological gamblers: Implications for public health. Am J Public Health 1994;84(2):237
27. Grant JE, Won Kim S: Demographic and clinical features. 131 adult pathological gamblers. J Clin Psychiatry 2001;62:960
28. Black DW, Moyer T, Schlosser S: Quality of life and family history in pathological gambling. J Nerv Ment Dis 2003;191(2):124
29. Comings DE, Gonzalez N, Wu S, et al: Studies of the 48 bp repeat polymorphism of the DRD4 gene in impulsive, compulsive,
addictive behaviors: Tourette syndrome, ADHD, pathological gambling, and substance abuse. Am J Med Genet 1999;88:358
30. Walters G: Behavior genetic research on gambling and problem gambling: A preliminary meta-analysis of available data.
J Gambl Stud 2002;17:255
31. Crary D: Youth gambling is increasing, worrying addiction specialists. Boston Globe July 14, 2003, Section A6, The Nation
32. Johnson EE, Hamer R, Nora RM, et al: The Lie/Bet Questionnaire for screening pathological gamblers. Psychol Rep 1997;80:83
33. Fisher S: Developing the DSM-IV-MR-J criteria to identify adolescent problem gambling in non-clinical populations. J Gambl Stud 2000;16(2-3):253
34. Lesieur HR, Blume SB: The South Oaks Gambling Screen (SOGS). A new instrument for the identification of pathological gamblers.
Am J Psychiatry 1987;144:1184
35. Ferris J, Wynne H, Single E: Measuring problem gambling In Canada: Final report-Phase 1. International Provincial Taskforce on Problem Gambling, Canada. Canadian Centre of Substance Abuse
36. Shaffer H, LaBrie R, Scanlan KM, et al: Pathological gambling among adolescents: Massachusetts Gambling Screen (MAGS). J Gambl Stud 1994;10:339
37. Derevensky J, Gupta R: Prevalence estimates of adolescent gambling: A comparison of the SOGS-RA, DSM-IV-J, and the GA
20 questions. J Gambl Stud 2000;16(2-3):227
38. Westphal JR, Johnson LJ, Stodghill S, et al: Gambling in the south: Implications for physicians. Southern Med J 2000;93:850
39. Grant JE, Kim SW: Effectiveness of pharmacotherapy for pathological gambling: A chart review. J Adolesc 2002;14(3):155
40. Sylvain C, Ladouceur R, Boisvert JM: Cognitive and behavioral treatment of pathological gambling: A controlled study.
J Consult Clin Psychol 1997;65:727
41. American Academy of Pediatrics: "Gambling: Not A Safe Thrill," 1999, HE0287, American Academy of Pediatrics, Division
of Publications
42. Jacques C, Ladouceir R, Ferland F: Impact of availability on gambling: A longitudinal study. Can J Psychiatry 2000;45(9):810
DR. TURCHI is co-director, Center for Children with Special Health Care Needs, St. Christopher's Hospital for Children, Philadelphia,
and assistant professor of pediatrics, Drexel University School of Medicine, Philadelphia.
DR. BLACK is professor, department of psychiatry, University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa
City.
DR. BUCHTA is director, division of pediatrics/adolescent medicine, Scripps Clinic, La Jolla, Calif.
The authors have nothing to disclose in regard to affiliations with, or financial interests in, any organization that may
have an interest in any part of this article.
Questions from the South Oaks Gambling Screen, Revised for AdolescentsIn the past 12 months ...
How often have you gone back another day to win back the money you lost?
When you were betting, have you told others you were winning money when you really weren't winning?
Has your betting money caused any problems for you, such as arguments with family and friends, or problems at school or work?
Have you gambled more than you planned to?
Has anyone criticized your betting or told you that you had a gambling problem, regardless of whether you thought it was true
or not?
Have you felt bad about the amount you bet, or about what happens when you bet money?
Have you felt that you would like to stop betting money but didn't think you could?
Have you hidden from family or friends any betting slips, IOUs, lottery tickets, money that you've won, or other signs of
gambling?
Have you had money arguments with family or friends that centered on gambling?
Have you borrowed money to bet and not paid it back?
Have you skipped or been absent from school or work due to betting activities?
Have you borrowed money or stolen something in order to bet or to cover gambling debts?
Source: Poulin C: An assessment of the validity and reliability of the SOGS-RA. J Gambl Stud 2002;18(1):67-93; Winters KC, Stinchfield RD, Fulkerson J: Toward the development of an adolescent gambling problem severity
scale. J Gambl Stud 1993;9(1):63-84. Used with permission.
Resources for pediatricians and families
Gam-Anon International Service Office
P.O. Box 157
Whitestone, NY 11357
718-352-1671
www.gam-anon.org
Gamblers Anonymous International Service Office
P. O. Box 17173
Los Angeles, CA 90017
Telephone: 213-386-8789
isomain@gamblersanonymous.org
www.gamblersanonymous.org
National Council on Problem Gambling, Inc.
208 G Northeast, Second Floor
Washington, DC 20002
Telephone: 202-547-9204
Helpline: 800-522-4700; offers
24-hour confidential assistance
ncpg@ncpgambling.org
www.ncpgambling.org
The national council has 35 state affiliates that offer a variety of services for problem gamblers and their loved ones.
Wanna Bet? magazine
www.wannabet.org
An online magazine for kids concerned about gambling
YMCA of Greater Toronto, YMCA Youth Gambling Project, Ontario, Canada
www.ymcatoronto.org/gambling
Prevention and education program designed to reduce the harm associated with youth gambling. Free services, including presentations
to schools and community groups, education workshops, and referrals for those living in the province of Ontario.
YouthBet Youth Gambling Project
www.youthbet.org
Part of a University of Toronto research project to assess teen use of the Internet to help with gambling issues
We subscribe to the HONcode principles of the Health On the Net Foundation