- November 07, 2025
- Gambling
TRIGGER WARNING: This content discusses suicide, suicide attempts and related topics. Please proceed with caution. If you are struggling, please reach out to the National Suicide Prevention Lifeline at 988.
November is Veterans and Military Family appreciation month, so we’re having an in-depth conversation with Dr. Shane Kraus, associate professor at UNLV, about his research on gambling disorder among military veterans and active-duty service members. Dr. Kraus discusses the high rates of co-occurring mental health issues, including PTSD and suicide, the presence of slot machines on overseas military bases, and the urgent need for early screening and intervention. Learn about the policy changes and resources that could help service members struggling with gambling-related harm.
Engage with Dr. Shane Kraus:
Email: shane.kraus@unlv.edu
Faculty page: https://www.unlv.edu/people/shane-kraus
Research page: https://www.researchgate.net/profile/Shane-Kraus?ev=hdr_xprf
X: @kraus_phd
Engage with Wager Danger:
Call Gateway Foundation: 844-975-3663 (DONE)
Follow Gateway Foundation:
Facebook: @RecoverGateway
LinkedIn: @Gateway-Foundation
Gambling Problem? Call 1-800-GAMBLER
Text GAMB to 833234
SHANE COOK
Hey, this is Shane. Just a quick heads up. This particular episode discusses suicide, suicide attempts, and related topics. So please proceed with caution. If you’re struggling, please reach out to the National Suicide Prevention Hotline at 988.
SHANE KRAUS
Gambling is like bananas, right? So when someone I treats them for gambling disorder, their problems come in bunches.
SHANE COOK
Hello everyone, and welcome to Wager Danger, a podcast where we discuss gambling addiction and recovery. I’m your host, Shane Cook, gambling disorder program director at Gateway Foundation. On today’s episode, we’re speaking with Doctor Shane Kraus, a leading researcher on gambling disorder from the University of Nevada, Las Vegas. We’ll be revisiting an important topic that we’ve covered before in Wager Danger, and that is gambling disorder
among military veterans and active duty service members. Doctor Krauss has been leading groundbreaking research in this area, and he shares what he’s discovered about the connections between gambling, PTSD, alcohol abuse and other mental health challenges that veterans and servicemembers face. Some of what he discovers is shocking, from learning that overseas military bases generate over $100 million in annual gambling profits from enlisted personnel, and often without any education or safeguards to the higher rates of addiction and suicide among our soldiers.
As a counter attack, Doctor Krauss brings plenty of possible solutions to this problem. From policy changes to screening programs that could catch problem gambling and other traumas early. He’s a fierce advocate for our veterans, and we’re so happy to have him join us as a guest. Welcome to the show, Shane.
SHANE KRAUS
Thanks.
SHANE COOK
Thanks, It’s all I don’t often get to say that I know. Welcome to the show, Shane.
SHANE KRAUS
Thank you.
SHANE COOK
But, once in a lifetime opportunity, or, you know, maybe it will happen again sometime. But, I really appreciate you jumping on and sitting with us here and talking through some of the activity and some of the research that you’re doing at UNLV We just recently you’ve had several research studies that have come out and been published.
Could you just to the high level, tell us a little bit about each of those? Where the focus is, and then we can dig in on some of those as we move forward here.
SHANE KRAUS
Yeah, sure. So happy to do it. So, you know, we’ve kind of done, you know, in the last three years, we received some, research funding from this called the Kindbridge Research Institute. And it was really to do work with veterans that they kind of pinpointed veterans as a priority service members for gambling, which, you know, we, backstory about five years ago, we wrote a review on that and said, hey, there’s no research really, or not very little research.
And they said, hey, that seems like good to us. And that’s been really helpful for us and what we’ve done in the last, I’d say three years. And so we’ve published, oh gosh, maybe 5 or 6 publications really specifically on a couple of things. So one was looking at that. Cleveland has a residential program from gambling for problem gambling.
And it’s one of the, I think really the only true residential program right now. It’s been around for, gosh, since the 80s. I think it’s very good, well established. And we wanted to understand what what what are the experiences of veterans who go there, what’s their mental health? It look like things like that. And we’ve been publishing a series of papers looking at that and that data was telling us a couple key trends.
And one of that is that, people who go to that treatment program, many have substance use disorders, you know, 30%. The PTSD rates among those who seek treatment for gambling is 40, 50% across the sample. That’s very high. There’s just a lot of mental health issues. And I always tell people I do a lot of treatment as I’m a clinical psychologist, I do research.
Gambling is like bananas, right? So when someone I treat them for gambling disorder, their problems come in bunches. So it’s not just gambling, it’s. It’s going to be probably substance use. It’s going to be depression, anxiety for our military veterans. We have a high relationship with PTSD. We can talk about why we think that is. But generally in our in our clinical, you know, in our clinical samples or community samples, we see higher rates of PTSD or trauma with gambling in military populations.
So so that work is done that we also found we just published a paper a couple of weeks ago on suicide and suicide attempts, which is really sad. Unfortunately, those who struggle of gambling often try to kill themselves or attempt suicide. And in our in our publication that we published, we found that about sick. About 40% of the sample, who had gone to seek treatment had attempted suicide.
And among women veterans, 60% had tried to kill themselves. So suicidality is a reality, for many veterans who have gambling. And again, the reason why we think that is, is because the financial hardships, you know, if it takes you ten, 15 years to finally get help for gambling, think of how much you know, if you’re hundreds of thousand dollars and and, you know, financially burdened if you lost your relationships, your children, everything around you is part it’s not that surprising.
People think they want to kill themselves. And luckily, you know, people. These are people who attempted but didn’t weren’t successful. But I imagine there are veterans who kill themselves every year or sadly, because of gambling or untreated gambling.
SHANE COOK
Let me break in right there because with the number of people that attempt suicide or that have suicide ideation and are thinking about it, it sounds like a higher prevalence among veterans or enlisted or military personnel in general. Or when it comes to gambling, how does that compare with the general population like overall gamblers and order of magnitude on this makes it much higher?
Does that make sense?
SHANE KRAUS
It does. So. So I think it’s a great question. So the question so what we know. So just across the literature there’s always been a pretty strong relationship with suicide in gambling. Right. So and that is the people who experience gambling often attempt suicide. Now the amounts could be 20, 30% are a nonmilitary sample. Some of our work is maybe 20, 30%, which is still a lot of people wanting, you know, if you know, 1 in 4 one have attempted suicide or are struggling with suicidal ideation.
But when we look at our veterans, so those who are veterans who are in treatment, when we look at our, base rate of 44%, that’s a lot higher, right? And and that is consistent. And I think what explains that is, is, is the bunch metaphor. So veterans who have gambling have a lot of other mental health.
They have 2 or 3 other mental health disorders. So by the time they finally get treatment they’ve had depression and substance use. And you know, they’ve had all these other issues. And when you have a lot of mental health burdens and challenges, you’re feeling overwhelmed, hopeless. These things make sense. So so why that’s why it’s so important for us to catch gambling problem gambling really early for for active duty members or veterans who were just coming out of service, who don’t have a gambling disorder but are just having some issues and treat their mental health issues quickly and early, because that’s going to help also avoid, you know, developing gambling, if that makes sense, and
also reducing risk for suicide rate and right.
SHANE COOK
So yeah how easy is that to catch early on. And where are the intervention points where we might be able to catch.
SHANE KRAUS
That okay okay. So this is that’s the that’s like a the million dollar question. Right. So so what we know is that screening is good. So what we know so let’s talk about the Act service members first. We’ll talk about the military first. So what we know there’s been reports that have come out last couple of years and say you know we need to screen and we don’t really we screened and we have a very low prevalence rate in the military.
But then when you look at how they screen, they didn’t do a very good job. It was inconsistent. They also told that the screening wasn’t anonymous. So if I’m an active duty service member, I have a problem and I say I have a problem and they pull my clearance and immediately, you know, I’m in trouble, you’re not going to see a problem.
So the screening process in the military are very poor. I would say across the board they’re not consistent with doing it. So that’s one thing. So if we’re actually screening military and we’re saying, hey, if you got a problem and you come early to me as a commanding officer, I’m not going to toss you out. I’m going to get you.
I’m going to fix you and get you well. And we have to create that culture which we don’t have yet. That’s something I’m trying to work on. And then the other thing is, when they come out of service, right when they become back in civilian life, and there’s some of them are having transition, you know, mental health challenges, some of them who had many of the, deployments and maybe have some trauma stuff, how do we help them get engaged in treatment and also be screening that group for problem gambling, which we don’t do.
Right. So that’s the problem. So it’s only many years later when they go in for substance use treatment for alcohol and they go, oh you have a gambling problem. Okay, I’ve had this for ten years and we should have been screening for alcohol and gambling ten years earlier. Does that make sense? So part of it is, is our approach is just not there.
I would say we make good headway. I think there are as a culture changing. I think now I think I’ve been beating this drum the last year saying, listen, if we create a path where someone in the military comes really quickly with an issue, that I think that the less vulnerability for them to be exploited by a form and for an outside person, right, like if you’re $50,000 in debt, I can exploit that from a, you know, from an outside, you know, group.
And that is a real vulnerability and a risk for, you know, security clearance. That’s a real issue. So let’s avoid that by getting people early and and protecting their careers, but also getting them healthy. Right. So I think that’s an area that we’re trying to have a conversation with the military. I don’t say that. I don’t know that we’re there yet, but I would say that I’m seeing a shift there in the VA, the veterans hospitals, I think there’s a greater awareness of gambling.
But we’re not consistently screening for it like we do for gambling or like for suicide or depression or something else, if that makes.
SHANE COOK
A substance use. Yeah.
SHANE KRAUS
And substance use rate. Yeah.
SHANE COOK
Okay. So some really good points there. And I appreciate that. Just having a kind of a broader perspective of this. But in terms of working with the leadership, within the military to gain earlier access to do earlier screening, what has been the response there?
SHANE KRAUS
You know, it’s been challenging because a couple of years ago I’ve had interactions with the military, but because of high level court martials and other legal things. So, okay. And I’m always like, hey, let’s not have you come in, you know, when there’s a problem like that. I would say that it’s been it’s been a I think there’s been some openness.
I would say that I haven’t seen substantial people from high level leadership, you know, do that yet. But I think I also know that our work is being read. You know, we’ve been publishing quite a bit and, you know, people are reaching out for it. So I think it’s it shows like this, these conversations that we’re having with people all over and, you know, different shows to just say, look, let’s have this conversation now.
We really want to get in front of this. And, you know, and also our research too, and we have a publication, we have an article we just submitted that’s under review. So it’s not published, but we actually are looking at active duty veterans and civilians and gambling. And we really see active duty members have a lot of online gambling, sports betting.
And they have some real risk factors there. And I and I think that’s something the military needs to be, you know, aware of right and right. So, you know, you have a lot of young people who are deployed and away from their family or very young and not always the best with their money because they’re still working through those young guys, a young person, I don’t think I was always great with my money.
And I think there’s opportunities to really spend that in ways that could necessarily get people in trouble, you know?
SHANE COOK
Yeah, yeah, that makes sense. So, another aspect that that you brought up is the differences between, male and female. I was surprised to hear that women had a higher ideation rate of suicide than men. If I, if I understood that correctly. So you.Did.
I was just I’m just kind of curious if that’s across the board or if it’s just kind of I know interesting points here and there.
SHANE KRAUS
Yeah. So broadly we know that, you know, men more men struggle with problem gambling, gambling disorder than women, right. In the military and and the we see the same trend miniature higher. And this is whether even British or, you know, military, other military, you know, outside the U.S. sample show this. But women, veterans or women in the military have higher than female women in civilians.
Right? So there is an elevated risk. Women. Okay. The issue when we look at the treatment data is that those women have a lot of mental health issues, their rate up for PTSD. I don’t have it atop my head, but it was really high. There’s a lot of trauma. Some of them had military sexual trauma. There’s a lot going on.
And I think gambling often develops later. And we could talk about this. But as a coping strategy, as a way to kind of avoid, you know, other things. So so I’m not really surprised. I think there’s also a lot of stigma for women, just even today to get help for gambling, because, you know, we really judge a lot of people for getting help.
If you say, I have a gambling problem, people judge you. But if you’re a woman and you say that or you’re a woman who served in the military or, woman from with children or something, society’s going to treat you differently. And that’s really not acceptable. Right. So so I think there’s extra hurdles for, for these women to jump through.
But I would say, yeah, I think, you know, the rate that we have 44% across the sample is way too many. And these are people who attempted suicide. This is not just thinking passively. I want to die right? These are people who’ve tried to kill themselves. And that was generally for gambling reasons. Now, most of that, most of these people are veterans, you know, 20, 25 years after their service and their gambling developed much later.
But I as we see sometimes these habits happen. So, I’m not sure if you want to talk about the slot machines on basis, but, you know, when you have these young individuals who are deployed and we know that marriages fall apart, relationships fall apart, early in your military service sometimes and you’re overseas and overseas, they have bases on slot machines.
It’s legal and and it’s part of recreational and entertainment. And if you kind of get into habits of spending money on slot machines and drinking and kind of you’re away from your family under stress, you may not have a gambling disorder, you know, when you’re 21, 21, 22, but those are habits that maybe not so great to make.
And as you come out later in your life and you form, you learn to gamble for stress or to avoid stress, or to cope with stress or trauma or whatever things. Right? Those factors eventually will develop into a gamma disorder. Right? So so our issue, my my big issue with the military bases is, is they have the slot machines, but there’s no knowledge, there’s no education.
I mean, they bring in about $100 million in revenue or profit.
SHANE COOK
Not in. Yeah, I think that’s shocking for a lot of people to hear.
SHANE KRAUS
And it’s a small group of people we’re not talking about millions of people overseas. You know, our military’s what, 2 million. And I’m not sure how many are deployed, but it’s not that big. But that’s a lot of money. 100 million. That’s the profits. Not not not all the handle. Great. I think they handled like 500 million. So it’s a lot of money.
And again some people they spend their money differently. I’m not here to judge that. But if you don’t provide knowledge warning signs say hey, here’s what you need to look for. If you’re gambling, if you start seeing yourself gambling more than you want to, you’re losing money. You’re chasing your losses Hey, let’s stop and slow down. Well, if you don’t provide anything to this branch, you don’t have any trainings, you have no debriefings, you have no materials anywhere on the base or in the slot machine parlors.
Then I think that’s a problem. And that’s currently what we’ve seen. And and we did a qualitative study and, it’s been published that came out a couple of months ago. And it’s also, I think, free and and publicly available so people can find it. And we interviewed 28 veterans, in service. So for four, I think four were active duty.
And they talk about being on the base as they talk about these early relationships with gambling when they’re, you know, in the military and how that kind of stuck with them. So so I think there’s something there. Does it mean all the slot machines are getting people addicted to gambling? Absolutely not. But I think we have a risk there that we have to talk about.
And how do we educate young people and say, hey, you know, just like we tell you, when you go out and, you know, on your liberty and you have a pass, don’t drink too much. Be smart. You’re in a foreign country. Make good choices. Well, it also means just because you’re on the military base doesn’t mean you should also drink too much, gamble too much, too right.
We need to have that kind of balance. Right. And and we’re not. And that’s it. That’s a challenge, right?
SHANE COOK
Yeah. Yeah. We’ve had the opportunity to talk with Dave Yeager.
SHANE KRAUS
Yeah okay. Great.
SHANE COOK
And so and go through his story. And it’s fascinating to to understand that, you know, that exists on overseas overseas bases where they can go in and gamble legally. And sometimes you have, you know, people 18, 19 years old on a foreign base and it’s they’re able to access it as well. So in terms of that particular population that might be overseas versus what we’re seeing onshore here in the U.S, where access to sports, gambling and other types of mobile forms of gambling or gaming are available here.
What’s is there a difference? Do you see a different, response from people overseas versus with onshore, or is it pretty much, you know, broad strokes. We we’ve got a lot of people that are participating in gaming, whether it’s online or whether it’s slots.
SHANE KRAUS
Yeah. Yeah. Okay. So I think that’s a great question. I’ll answer. But I’m going to try to do a broader point, and I’ll do another point. So we know so so we know I teach addictions, you know graduate school you know to graduate students. I’m a clinician. You know, all that work I study addiction. And what we know is that when we increase access to something like alcohol, cannabis, gambling, different path for the more you increase access to things, the higher disordered use goes up.
Right. So here in Vegas and Nevada, we have a legal cannabis, for example. And it’s not surprising our clinics are starting to see a little bit more people come for cannabis use. So that makes sense as places in the in the throughout the United States increase ways for people to access gambling and online is a huge one for young people.
You’re going to see the potential to have more people with issues. Okay, so it’s not that surprising. I think the thing with veterans that’s interesting is that often the people who go in the military, you know, to serve our country, it’s amazing. We’re grateful. But you know, we’ve done the research. When I did a lot of writing published on, the 911 veteran, you know, post 911 veterans.
And what we found is all these people’s within the military, you know, voluntarily and did this amazing the, you know, all these hard deployments. But many of them had trauma before they went in the military as kids and other challenges. And then we deployed them four and five times. And they had. Yeah, about PTSD and and the same thing.
So if you a lot of the what we see in the data, some of these veterans come from families that have high trauma or had a lot of gambling and their history. And so they kind of have some of these risk factors already. And then if, you know, if you’re in the military, some of these areas have a little bit more impulsive, you know, a little more drinking.
And these risk factors kind of kind of combine together. I don’t know that that makes it unique to the military. I think young people often make risky decisions. Young men particularly, they love doing that. But when you have them separated, when you have them access to a lot of other resources, I think this is where people put their money and, you know, and in different ways.
And I think that’s a challenge. Right. And I think sports betting is just so everywhere, you know, I mean, I was just talking to a group from Michigan and they were saying that before Michigan legalized a bunch of stuff, the sport ads companies spent over $1 billion in ads to, to market, you know, online and sports betting in Michigan after got legal.
And I mean, that’s a lot of money and ad well, that’s happening everywhere. So I don’t know that veterans or service members are any different per se. But when you have people away from their family who are under stress, who are under isolation, those are kind of those are environmental stressors that might contribute to engaging in behaviors to relieve stress.
Or you know, whatever and boredom. And and that can be lots of things. It could be gambling, it could be online sexual, it could be buying stuff, it could be drinking. You know, people cope with stress differently. And often people do healthy things. But sometimes people use alcohol, they use cannabis, they use, you know, gambling. It’s so I think it’s us having that conversation with the military and Europeans, and we’re not having that conversation.
Right. We’re not just saying like, hey, I want to I want to give people the tools up front so they know. And if you know, often you make different choices, right? But we’re not doing a good job of that.
SHANE COOK
So what should we be doing? Yeah, I’ll give you a just it’s a very small example. One of the things that I tend to do throughout the state of Illinois is I’ll travel throughout the state to various communities, and I always try to put VFW halls up my on my, list so I can drop in VA hospitals, clinics, same way, just to go in and drop off information to make sure they have access to information.
But that’s only one part of it. We’re only capturing a certain crowd or a certain number of people through that method. There’s got to be a more, a more, you know, top down, bottom up kind of meet the middle approach here. Well, have you thought about that. Yeah.
SHANE KRAUS
So I have a couple of thoughts on that. And I agree with you I think the VFW is those places are great. So okay. So for the for military side again what one thing is I want the military has a statue that if you have a substance use issue and you get help, in a sense it kind of freezes you where they can’t just get rid of you.
But you got to do treatment. If you say I don’t do treatment, well, they can toss you out, right? Right. But I want that to be amended for gambling as well. You’re going to do gambling treatment and you got to do it if you don’t want to do it, they can toss you out. I’m okay with that. But if you got a problem, I want them to try to help you first.
Right, right. So I want them in that that’s actual that would be changing a statute within the military code okay. So that’s one part two is I want to see standard training. So you know I hate to torture service members, but I want to see some kind of you know, when I talk about financial literacy, I want to see one quick training on gambling literacy.
Just what are some ways to make sure you’re you’re using your money? What are what’s gambling, what to look for for risk factors. And then I want to see screening an actual discussion through the military around, hey, let’s get in front of this, not behind it. So for the VA, which is a largest health care provider in the United States, we have over two.
They have ten over 10 million veterans in care. It’s awesome. Yeah, I want to see them have more standardized screening. I would love to see an angle screening for gambling or something like that, or at least screening and all trauma, all addiction clinics, because that’s where we’re probably seeing it. So I love to see and also homeless programs, there’s lots of areas where we know there’s gambling.
I want to see us actually having a national campaign, a stigma campaign on gambling broadly, which incorporates veterans and service members to be part of that, and then also women and all these other unrepresented folks in the commercials and ads. Right. I also want us to engage with families and community. So service members, spouses, veterans, spouses in the community work with our veterans every day.
They know them. And I want to give them resources. If their partner doesn’t want to go and I want to help them drag them in or drag her in, right, and, and create those resources for them. So I think there’s ways that we can engage, family members, you know, the veterans, and work with our local. You know, our state, our state resources as well as, you know, local providers.
And again, we’re getting there. I mean, I would say, you know, we’ve published a lot. I mean, you know, five years ago we didn’t have a lot of this information, right. And so I think we’re getting there, and I hope that the people listening to this realize, like, you know, I should, you know, think about if someone has a gambling problem, they seek help if they’re if they know someone who has only talked to them about it, the if if the best thing you can do for gambling to help someone is to have a conversation with them, right?
Make it speak for someone to say, hey, I think you might have a problem right? And that’s the thing to do. And we don’t do that because gambling makes us feel uncomfortable, right? Yeah.
SHANE COOK
I, I am encouraged though. Shame because in talking with folks like Nate Smith at the Kindbridge Institute and some of the work that they’re collaborating with Dave Yeager on, they’re going out and working with ROTC units, kind of at the collegiate level and, and spreading this message. There are just points where, it seems like we’re making some inroads here and at least raising awareness.
So hopefully it’s got to start somewhere. And why not start middle out, right? That’s why I consider ROTC is kind of middle out. Right. Because they’re on the verge of of coming in and taking over a leadership role in many cases. And they have that ability to. So it seems like a perfect point, to, to press, I don’t know if you’ve if you’ve had any conversations about that or if you’re familiar with what they’re doing.
Oh, yeah, I’m sure.
SHANE KRAUS
And some good work. Yeah, I think, I think like you said, everywhere we can spread the word. I think getting at different stages. So one of the issues we have is we want prevention. So a lot of stuff I tell a lot of people upfront stuff like I often will tell clients or patients about something or I didn’t know that and then very quickly make a difference.
Listen, they change their behavior. So we need to be putting, a lot of prevention education. Young we haven’t talked about young people, but man, gosh, really. You know, I have a middle elementary school child, but we need to be educating kids who all they see are sports betting ads and think, you know, like ten year olds can tell you the name FanDuel.
They can name all these apps. That’s a little weird that they can name all these apps for sports betting. So we need to have a better understanding of education to it. Right? Because in some ways we’re creating maybe some false understandings of gambling, risk that gambling does have. So I yeah, I think it’s across the spectrum. But we also want the veterans who are in the community who’ve had a problem for 20 years to finally get help, you know, to kind of across the board.
SHANE COOK
Hey. Yeah. And and that’s an important one, too, that you bring that up there, that may be the most difficult demographic to reach. Because a lot of rural communities, are involved here, or at least that’s what I see when I’m out. And, you know, we were talking about VFW. A lot of them are small.
And remote communities that may not have access to that type of care. So, just just spreading the word, I think is, is probably an important aspect of this at this early stage that we’re in. So I appreciate your thoughts on that. So, in terms of, in terms of some, some of the other research, I mean, we covered a few more recent things that you’ve done.
Is there anything else that you have on the horizon that you’re looking to? Besides, you know, it might be you had mentioned what off air that you’re looking forward to. A slight sabbatical here.
SHANE KRAUS
But I am when you come back, we’ll come in in January. So I would say we have some papers. You know, I’m an old school academic, so, you know, you don’t kiss and tell. So we have some things that we’ve been writing or about to submit for, for review, for scholarship. But I would say we have a couple papers that are very close, to being under review, which hopefully they’ll be published, early in the spring.
You know, it’s a process. And there’s two things. They’re qualitative studies and they’re based on interviews. And we looked at two things. One is a pathway. What is the pathway for veterans who have gambling like what happened and what we saw, in the data in their interviews, is that a fair amount of veterans had a lot of gambling in their childhood, had childhood traumas, had stressors.
So not all the veterans who developed gambling problems that we interviewed had that. But there was a really a trauma narrative there that was well before the military. And then in the military, if they had some challenge, the military was like, don’t tell us, keep to yourself. We want to hear about it so that perhaps and then, you know, later on, you know, 20 years later we’re doing the interview.
So so we have that it’s a called a pathways paper. And we want to say, well, what are the things that were happening before and during and after? Because if we understand the way, if you understand the way the river is flowing, you can make changes to change direction. Right? And that’s kind of that, that the other paper that’s pretty much finished is hopefully going out next week.
Gosh, Rudy’s I hope and it is a very much specific recommendations paper. So we interviewed okay service members and veterans and said what. Tell me what we should be doing differently. And they gave us gold. They told us very clear recommendations to reduce stigma, to engage military, what recommendations they want in terms of like engaging peer support, you know, peer support specialists on the bases, incorporating family services with, with on the bases, really good recommendations, as well as ways to kind of engage veterans in the community.
And with VA. So that paper, it’s much more of a policy slash kind of marching orders for the VA and DoD, as I would say.
SHANE COOK
Yeah, it’s a kind of a vision paper.
SHANE KRAUS
Yeah. Very much. It’s concrete. It’s like, I want this, we want this. I want this. And that’s kind of how I work. And so I’m going to try to give a blueprint of like, like I said, military. I want to see some legalization change. I really want us. If someone has an issue and comes early and, and they’re honest, if they have an alcohol substance use problem, we’re going to help them get them sorted.
But if they don’t want to get sorted, then they’re out, right? I want that for gambling too, right? I want to I think so. So that amendments that are required literally Congress to change up that to it’s going to be and I think that’s not that bad to do. And if we do that, we protect service members to have that disclosure rate.
And we have to acknowledge military is unique. There is miltary service security clearance. We want to be thoughtful around that. And the military should have the discretion to also keep our security there. So, so good to not try to tell the people how to keep our secure in our. But we also want to balance with getting people to say they have a problem very early rather than waiting 20 years later.
Right? Wrong. And so that, so that, that and then and then also again recommendations and how they do it for increasing screening public awareness campaigns, how to have more discussion for people who have gambling. I think broadly, we don’t really know that we have kind of, not really great idea who has gambling problems. And what you’ll find out is everyone can have gambling problems.
Gambling affects every demographic, every income, education, it doesn’t matter. It’s going to get you. And I think that we have to change, you know, and even if you’re a tried and true warrior who had four deployments, there’s any you’re not going to be vulnerable to gambling. Just like someone who had no military service would be.
SHANE COOK
Exactly.
SHANE KRAUS
So so they they’re both a true, and I think have that conversation. So those are from the big papers, you know, we have and then. Okay, we have one more paper, which is a longitudinal paper. And what we’re understanding is over two years is did active duty members, veterans or civilians, how did their gambling change over time?
And what we find is that civilians kind of do. Okay. But our service members of veterans don’t get better. Their gambling problems don’t go away. And that’s what I expected, is that for veterans, if they have an issue, it’s not going to resolve itself. They really do need to get help. It’s not like it’s going to be more severe and it’s not going to be going away.
SHANE COOK
Is that due to the culture?
SHANE KRAUS
I don’t know. So that’s a great question. We don’t know that. I think there’s a culture not to disclose to be the warrior. Say nothing right. Until you’re literally, you know, wanting to kill yourself. Right. I think that that’s true. I also think, you know, some of those individuals have more mental health issues because again, it’s like, that’s bananas, right?
I think most people with gambling have lots of issues. You know, they have the alcohol or the depression and anxiety and financial issues. But I would say with our veterans, we see a little bit more trauma. We see a little bit more PTSD. We see a little bit higher alcohol use. Right. So when you have 2 or 3 problems, it’s just makes it harder to get for any of them to get better.
But what we know is if I start treating the alcohol and gambling, the trauma gets better, vice versa, right? If I treat the trauma, I’m like, you also work on the alcohol and gambling, right? Because they’re all connected. They’re all kind of connected in the big circle.
SHANE COOK
So I’m going to go back to an earlier question that I had when when we talk about the leadership within the military, is, is there a willingness to treat substance use and trauma and to to look at and explore? You had mentioned peer services that might be available, could be available on bases, things like that. Are they exploring that as not that.
SHANE KRAUS
Not that I know of. So I’m this is a this was actually the word from our people who like we want this. So when we published this we’re going to be going to them. And this is part of my research, you know, some of our future research. We want to look at you know, maybe Department of Defense funding or VA funding to say, okay, let me do more work on this area.
But yeah, I’m not sure, but and I know, you know, if you ask me next summer after my sabbatical, I’ll have an answer for you, because these are things that I’m passionate about, and I believe that I’m not going to ask for something of I don’t push for it. And now I have people’s words. I have their lived experiences.
I have we have lots of good data that says, hey, this is not this is this is important. And that helps you kind of have a conversations that people don’t like to have, you know?
SHANE COOK
Sure. Well, I mean, if one of the barriers is the shame and stigma and you have the opportunity to provide peer support on base, that’s going to eliminate the barrier, the stigma.
SHANE KRAUS
So you got I think it was a brilliant idea. I didn’t even we didn’t think of it. We were like this is why we do research, because people who live that experience will tell you things that you if you don’t have that lived experience, like I’ve never struggled. Gambling is not something that I personally myself know. So I only know it through my patients and other experiences around me.
But they’re going to tell you these amazing things that like, this is why I love science, because, you know, you’re going to miss a lot of stuff. And now it’s like like you said, this is pretty obvious. Like, yeah, this is a great idea. And they might be open to it. I don’t I’m not I don’t assume that the doors will be closed, but I’m at the point now where the scholarship is good enough to say, hey, we’re not making this up.
Let’s not have a real conversation about yeah, that’s a good point. And I think, you know, sometimes people have these wonderful academics. Professors do this all the time. They come these amazing ideas, and they’ve never tested any of them. And they don’t mean anything. And I’m old school. It’s like, no, go prove it. Get, get, get the proof first and then go back to the table.
And now I’m, we’re going to go to the table again and say, here’s where we’re at. And my hunch is I’m optimistic that we’ll have a, you know, more meaningful conversation. You know, that that makes sense.
SHANE COOK
Excellent. Yeah. Well, man, I appreciate I appreciate all the efforts, your efforts, in this space and what you’re doing and the research you’re pursuing and everybody you’re interacting with, in a perfect world, perfect scenario. What’s your vision five years down the road here?
SHANE KRAUS
Oh, man, that’s a tough one. Like, oh, you know, so I would say so my vision I think is humbling. So one for the military is I want this statute changed. I want to actually see, training implemented. I want to have resources for service members and their spouses and family members. But what if they have a partner who has a gambling problem?
Well, that service members spouse needs to be taken care of too. So I want to see more resources. Like you said, I want to see really concrete things, the slot machines that are still there. Okay. But I want to see education knowledge there. I want to just kind of give people a heads up on that. So I want to see that really.
I want to see us to actually do a real study to know, what are the barriers to care? What are I want to interview commanders and say, what do you need to be successful to be your troops? And what is service members need to be successful, right?
SHANE COOK
Is is it a challenge to get to that group?
SHANE KRAUS
I think, you know, I to be fair, you know, I haven’t push too hard because I kind of felt because I, I’ve worked so much closer with the VA and the VA. You know, the VA and the DoD are very connected. And I do the strategy of work pushing the VA farther. And we’ve made great progress. But because they’re both contractually together, that if you change one, you change the other.
Okay. But what I want to do now is we really have to go early on. We have to get from the line, and that’s our early service members. So, so, yeah, I don’t know that I, I don’t feel like I’ve gotten massive pushback, but I’ve also wanted to have things to tell people I don’t. I’m the kind of person I want to have a conversation on a meeting.
If we don’t have a real discussion and an agenda, this is pointless. And I think now we have things to go to the table, you know, for the D.O.D.. So I want to see that I’d love to see some research funding allocated from DoD Department of Defense for gambling and gambling related harms for service members and research, for the VA.
I would love to see, like, substandard screening, better screening, screening everywhere, better research, more. You know, we have very few treatment studies on veterans despite having lots of issues with gambling. And I want to see better clinical trials. I want to see treatment studies. I want to actually see, you know, research funding for those areas as well.
And that just hasn’t happened. So I’m hoping all those things, you know, right now, gambling is, you know, is, gangbusters. Everyone’s cashing in. But very few states have a lot of funding available for their not most states don’t have free treatment. They don’t have clinics. They don’t have resources. Very few states Nevada make a lot of money in gambling, but we definitely do not put enough in for treatment.
I think, and also for research I want more. So I think we have a long way to go. I think we love the legislators, love the money from gambling, but they don’t want to have to deal with the consequences of gambling.
SHANE COOK
Right.
SHANE KRAUS
And they’re going to have to no matter what.
SHANE COOK
So so it’s my starting. Yeah. That you’re starting to see more and more reports and more and more news stories. I mean, we had a big one last week, that kind of rocked the NBA’s world. Yeah. And, you know, that may be just the tip of the iceberg. I suspect it is.
SHANE KRAUS
I think it’s the tip of the iceberg.
SHANE COOK
Yeah. And we’re going to see more and more of that. I think over time, people will start to realize that this is an area that needs more attention and needs more funding to get out there and do the screenings to do the education, keep your communities aware and and on guard, really for problem gambling because it’s coming.
And I, I’ve been telling people that for a while now. It’s coming. It’s here.
SHANE KRAUS
You’re going to be very right soon. Yeah, I think, and, you know, and that’s the thing I find so concentrating is that, you know, the NBA and all these other, you know, sports stuff, they can spend, they can allow, you know, hundreds of millions of dollars ads. And it’s just interesting if, you know, if we had the five, $500 million in vaping ads on television, people would be like, it would not be good.
Parents would be losing their mind. And and it’s so interesting that we can allow for gambling. And gambling is an addiction. And it is an addictive disorder, right? It is a real thing. And again, most people don’t have gambling is a smaller amount of people who have it. But it’s it’s just incredible that the money being spent to really get people to gamble.
And there’s no, you know, the, the not really that and like, oh no, we have a problem. And it’s like now we spent billions of dollars on advertising alone. You know, if, if the cigaret companies were spending, you know, that much money, the world would be on fire. Right. And same thing for cannabis is a good point. And somehow, magically gambling is different.
And yet it’s still in the DSM five, which is our diagnostic bank is still in it. Right? It’s in there next to substance is problem no different. So so that’s where I find I think I’m shocked at how people are so surprised that it’s like, how could this happen? Yet the amount of money being spent is really incredibly high.
SHANE COOK
Really? Yeah. Yeah, I think I think it’s interesting. I just I just want to point this out in conjunction with the news that broke last week with the NBA. At the same time, the NCAA, a, league I legalized. I don’t know if that’s the right word for it, but, they are allowing college athletes now to participate in pro sports betting.
So that’s that’s a that’s a dramatic shift from the stance that they had previously. So and I just thought it was ironic. It happened to at the same time as this big story broke.
SHANE KRAUS
Yeah I think they were trying to for years. It’s a lot. It’s because of money. They want more money. But you know, it’s you know, you have to really think about it. I just thought, so I teach, psychology of addiction and for clinical students and we last week we just talked about this week talked about opioid use disorder and what that means for all the opioid.
We’re still living through the opioid pandemic and all all the money the pharmaceutical I mean, it was really the I mean, at one point there’s hundreds of millions of prescriptions a year. And it’s like, yeah, we have more prescriptions and human beings and, you know, the U.S and and then it was like, oh no, we have this really horrific and we’ve had this horrific issue.
And it’s like, if you look at that initial signs, it was pretty clear that things were the train was off the tracks. And I think it’s something similar here too, where it’s kind of like, you know, let’s slow down again. You know, you can have sports betting, but let’s think about ways to have it more responsibly or to let’s educate people around the risk of parlays or prop bets, which is really where they make most of their money.
And that’s where the risk is for most people. Let’s have that conversation right. You know, putting money on a game per se may have lower risk, but all the prop bets, all the parlays are very, quite risky. And that’s what they’re pushing on young people particularly.
SHANE COOK
Yeah, definitely. No I agree 100% with that. And you know, the reality is, and you’ve alluded to both have throughout the conversation, the majority of people can treat gambling as a recreational activity. But it’s, you know, it’s a certain percentage of people that. Yeah, it affects very differently than the then a lot of other people.
So, it’s just being on, being on the lookout and having those safety nets in place for the people that are experiencing harm with it. So I appreciate the work that you’re doing. And, really enjoyed the opportunity to have our conversation and get to know each other a little better. Would love to have you come back on and share a future.
You know, maybe a year from now we come back and perfect. We have another conversation.
SHANE KRAUS
Sounds great. I love to, it’d be great.
SHANE COOK
All right. Thanks a lot Shane. Enjoy your sabbatical. I’m sure we’ll see each other though in the in between you.
SHANE KRAUS
Well, thank you so much.
SHANE COOK
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