Compulsive gamblers are often able to fool those around them about their problem — at first. But, the person they most often fool is themself.

Twenty-five years ago, gambling was restricted to Nevada and Atlantic City. Gamblers could take a weekend trip once or twice a year, come home and forget about it for a while. But, now that all 50 states have some form of legal gambling, it is as close as the lottery tickets on sale at the corner convenience store.


As the problem of compulsive gambling grew, the American Psychiatric Association recognized it for what it is, an emotional illness, another form of addiction. The APA states it is an impulse-control disorder causing negative consequences, similar to drug and alcohol addiction.


Now, states are setting up TOGEL centers where certified compulsive-gambling counselors are trained to help gamblers deal with the addiction and keep it from taking over their lives and ruining the lives of their family members.


Provident Counseling in St. Louis is one of the recognized compulsive-gambling treatment centers in Missouri. In a workshop recently, counselors and Missouri professionals who deal with compulsive gambling explained how widespread the problem is and what resources are available to help gamblers kick the habit.


There were 23 million visits to Missouri riverboat casinos last year. Some people only went one time, others visited everyday or more frequently. It is estimated that about 1 percent of the persons who gamble will have a compulsive gambling problem.


A toll-free telephone number is available to anyone in the metropolitan area, including the Metro East, where seekers may find counseling and treatment. They may also be referred to their local chapter of Gamblers Anonymous or for families of gamblers, Gam-Anon. The services are provided free of charge to the compulsive gambler who needs help. The number is 1-888-BETSOFF.


Scott, who gave only his first name, is a person who availed himself of the toll-free number. He was on the Alton Belle in June 2001 when he called.


“I asked for a location where a Gamblers Anonymous meeting was being held that night,” Scott said. “Fortunately, I was given the number of Provident Counseling on Watson Road.” There was a meeting that night which Scott attended. He was assigned a counselor who helped him break his habit.


“I have relapsed,” Scott admitted. “I was clean for 14 months, but gave in. I’ve been clean for three months now. Three months is easy because of the shame. It’s like a puppy that pees on the carpet and you smack it with a newspaper. After a while, the puppy forgets about the newspaper and does it again.”


Ironically, the funding for the programs to help compulsive gamblers control their addiction is provided by the riverboat casinos.


The industry believes its interests are best served when gambling is viewed as recreation and not as the path to destruction.


A problem gambler may be charming and loving, intellectually astute, articulate, sociable, philanthropic, energized and enduring, achievement oriented, and clever — clever enough to make people think that everything is fine.


Sooner or later, though, the truth about the gambler’s insecurity and low self-esteem and the fact that he is unrealistic about goals comes to the fore.


John Crum, director of counseling for Provident Counseling, described the stages of problem gambling that experts believe most problem gamblers go through as they move toward becoming compulsive gamblers.


The lure is the winning stage when the person discovers that gambling is an exciting social activity and perhaps a way to escape the stress of work, family or loneliness. Not all gamblers go through these stages, nor do they occur in any particular order or rate.


The gambler may share his largesse by showering family and friends with gifts, taking them on expensive vacations, and just plain living “high on the hog.”


There is the losing stage when the gambler becomes preoccupied with gambling. Bets become larger and more frequent. Then the gambler starts to “chase” his losses — to try to recoup the money and get ahead of the game. The gambler may start to max out his credit cards, pawn or sell personal property, dip into investment accounts, and borrow heavily. The problem becomes visible to those around the gambler. Bill collectors may come knocking at the door.


In the desperation stage, the gambler may experience health problems, relationships my falter or fall apart, and the gambler may turn to crime after financial resources are exhausted.


According to Crum, some experts believe there is a fourth stage called hopelessness, when the gambler believes there is no hope or help. Depression is common and suicide is a real risk. Suicide risk among problem gamblers is twice that of society at large and more likely than with any other addiction.


Compulsive gambling can affect men and women of any age, race or religion, without regard to social status. Young people are getting involved in gambling as early as elementary school.


“This is the first generation of kids who have grown up with the proliferation of legal gambling,” said Shelley Perez, Responsible Gaming Program coordinator for the Missouri Lottery. “We didn’t have this when we were growing up. Now there’s the lottery and the riverboat casinos.”


Perez and Melissa Stephens, Problem Gaming Program administrator for the Missouri Gaming Commission, developed an assembly program for middle schools called “Beat the Addiction: Choose the Right Path,” which they presented in 19 schools last year, reaching 7,400 students.


“Schools denied they had a gambling problem because they aren’t located near a riverboat casino,” Perez said. “So we geared it toward all addictions and made it an assembly program to reach more children.”


The program is available free of charge to all public and private schools in Missouri, funded by the Missouri Alliance to Curb Problem Gambling.


Both Missouri and Illinois have set up a voluntary ban program for compulsive gamblers. By signing up, gamblers accept a voluntary ban from casinos, in Missouri for a lifetime, in Illinois for a lifetime with an escape clause.


After five years, a gambler in Illinois can petition to get off the list and go back to gambling on the boats with an affidavit from a licensed mental health professional that says the patient is no longer a compulsive gambler.


But, the counselors on the panel at Provident scoffed at this. “That’s a malpractice suit waiting to happen,” said one. Under Missouri’s program, compulsive gambling is a lifetime problem for which there is no cure, only treatment.


The program has consequences for violators. If they go on a riverboat casino they are subject to an arrest for trespassing and to a fine. Stephens said 6,000 people have voluntarily put themselves on the lifetime ban list in Missouri.


“We have 8 to 12 arrests per month on average,” she said.