Column: WARNING ... Gambling May Be Dangerous to Your Health

American politics is dedicated to a central principle: the non-decision is sacrosanct, baring compelling evidence otherwise, the status quo shall be preserved. Thus, as in the"Ideal Type" legal rational bureaucracy described a hundred years ago by Sociologist Max Weber, precedence has priority. Whether good or bad regarding particular matters, there is an overall aura of functionality in this principle. It allows all of us to go about our lives and our routines and plan for our mundane futures with some assurance that the rules of the game will not be changed on us mid-stream. We can accept a continuation of what we don't like with a resignation and a rationalization that"the devil we know" may be much better than the"devil we do not know." Hence, if the Food and Drug Administration has decreed that a substance is forbidden, i. e. the chemicals in Marijuana, it remains forbidden. If they have approved another substance that may be harmful (at least if given in massive doses to Canadian mice), that substance, nonetheless, may remain on the open market. Accordingly, sugar and fatty foods remain on very open market shelves even though they are known to be very harmful for sizeable portions of the population. It might be interesting to ask just"what if" they were not"grandfathered-in," what kind of restrictions might be put on their use.

So too, another product seems to be allowed on the open market shelf with but few restrictions. That product just may have a chemical substance attached to its use. Here, I pose the question: what if the FDA were given"gambling" and asked to approve its use for a consuming society.

On December 10, 1984 Thomas R. O 'Brien, Director of the New Jersey Division of Gaming Enforcement spoke to a meeting of the Sixth National Conference on Gambling and Risk Taking at Bally's Casino Hotel in Atlantic City. He commented:

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11It seems to some of us, such a long time ago, that New Jersey undertook to establish this new industry as a"unique tool of 11urban redevelopment," the success of which is based upon how successfully that industry marketed its only 11product. That product is not entertainment or recreation or 11leisure--it's 11really Adrenalin--a biological substance 11capable of producing excitement--highs and generated usually 11by anticipation or expectation of a future event especially 11when the outcome of that event is in doubt.

11I think most of us here today who have had experience with gambling will agree that no form of risk taking or risk acceptance generates the intensity or can produce the amount of Adrenalin in the shortest period of time than a roll of the dice, spin of the wheel or turning of a card, and 11interestingly enough, the level of excitement is not in11proportion to the amount of money riding on the event but depends to a large extent upon the subjective psychological 11approach to the game by the player.

The product of gambling, according to a top regulator was a chemical substance that while internally generated, still existed as a real substance in the body, and the substance moved to the brain and could affect mental activity, i. e. produce excitement and other feelings.

Let us ask if we would really legalize gambling if government officials accepted that gambling was in essence a mind altering drug--as Thomas O'Brien clearly suggested it was. Consider that legislators might have a hard time making such a decision. After all, how many legislators are biochemists? How many are pharmacologists? How many are medical researchers? None--or at least very few. As collective bodies legislatures lack the required expertise to make good decisions in the area of legalizing drugs. Rather than flying blind, Congress has another procedure. Congress delegates authority to the Food and Drug Administration.

So if FDA was given the mind altering"gambling drug" to analyze, would they legalize it? The answer is not easy. But the process they would follow in making a decision is clear. First, they would authorize extensive tests--initially on animals (perhaps those Canadian mice), but then on selected human beings. What would the tests tell them: Look at numbers of l000 who were asked if they had serious problem gambling symptoms (the DSM-IV Criteria established by the American Psychiatric Association) in a random population survey which I helped conduct a few years ago in Wisconsin. Of the 1000 surveyed, 12.9% had at least one symptom; of those indicating that they gambled, 19.8% had one symptom. Conclusion: perhaps the gambling drug is completely safe for 80.2% of those taking it. But 19.8% show one or more side effects that might be troublesome for them. Almost one percent of the population, and 1.4% of the users (in the Wisconsin study) exhibited several serious side effects. Using the Psychiatric criteria we could suggest that these were serious problem gamblers--others might use the term"pathological" gamblers. These side effects could be potentially life threatening, as this drug leads to widespread urges to commit suicide. It also leads to socially unacceptable activities--stealing, writing bad checks, cheating on insurance matters, missing work regularly, family break-ups. From several surveys we discerned that between 20% and 30% of persons who are diagnosed (admittedly a process that has subjective attributes) as pathological gamblers actually admit that they have attempted suicide. No other group of addicted persons experiences such desperation with anything near as high a frequency. The pathological gambler imposes hurt not only onto himself or herself, but also onto family members, friends, co-workers, those with whom he or she has business relationships, and onto the general public as well. It has been estimated that between 10 and 15 persons are directly and adversely affected by this person. The gambler will borrow from close associates, the gambler very likely will also steal. And when the associates can't pick up the pieces, the entire society may have to pay for welfare, for treatment costs, for police service, for jails and prisons. Conservative research suggests that the pathological gambler burdens society (other people not in the family) with costs close to $10,000 a year.

But then this begs the question, after all, the drug does not seem to harm 80.2% of the users. In fact many of these might claim that the act of gambling--the"drug"--helps them relax, allows them to get away from daily work or home problems, gives them a measure of excitement lacking in other phases of their lives. They believe the drug improves their lives. Moreover, there may be economic advantages for promoting the commerce entailed in merchandizing the drug. Drug manufacturers (lotteries, casinos) provide jobs to society and the sales people pay good taxes. There is also evidence that some people will use the drug even if it is not legalized, and if they do, the government will not receive any taxes, nor will the government have the opportunity to control facets of how the drug is used.

So should such a drug be legalized? Perhaps. But before certifying any drug as safe enough to be legalized, the FDA would insist that certain controls be imposed. First, the FDA might recognize the gambling drug as an adult drug. They might stipulate that the drug could not be taken by children. The drug might be conditionally approved to be sold only in select locations and the dosages would be regulated. The buyers, moreover, might have to receive the prior approval of an outside expert (a doctor, perhaps, or in this case, a financial advisor, or a family counselor) before they could make a purchase. And experts (again, doctors, or financial advisors) might have to monitor the drug use and certify that the individual taking the drug was not having serious side effects. When the side effects became noticeable, the person would be weaned off the drug, or in serious cases taken off the drug immediately and completely, lest the drug become addictive.

The FDA has established elaborate controls for the dispensing of drugs. Government policy makers might be wise to follow FDA-type procedures as they establish additional controls over gambling in order to assure that serious problem gamblers do not succumb to the bad side effects of what might otherwise be a good drug for many people. Certainly policy makers should consider the FDA analogy before they legalize more of the drug.