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Gambling’s Effect on Military Veterans | Dr. Nathan Smith, Executive Director at Kindbridge Research Institute

Table of Content

Table of Content

Dr. Nathan Smith is the founding Executive Director of Kindbridge Research Institute, a nationally recognized scientist and science communicator, and a leader in the field of behavioral addiction research and theory.

In this episode we discuss the importance of understanding how gambling addiction effects various segments of the US population and how the Kindbridge Research Institute is laser focused on supporting our Military Veterans.  Nate’s passion for the study of gambling addiction really shines throughout the episode including: the importance of epidemiology and how it allows us to “get it right” and how the terminology we use to describe a gambling addiction needs clarification.  We’re fortunate to have an advocate like Nate who is championing the study of gambling disorders.

Call Gateway Foundation: 855-723-0963

Gambling Problem? Call 1-800-GAMBLER



00;00;03;08 – 00;00;33;02

Speaker 1: Welcome to Wager Danger. I’m Shane Cook with the Gateway Foundation, and my guest today is Dr. Nathan Smith. Dr. Smith holds a Ph.D. in psychiatric epidemiology and is currently the executive director of the Kindbridge Research Institute, where he applies a scientific approach to the study of gambling disorder. We cover several topics in today’s episode, including a subject he is most passionate about, which is veterans and their addictions to gambling.

00;00;33;04 – 00;00;57;27

Speaker 1: He discusses how active duty service members are often exposed to gambling, but rarely receive information about it or any follow up after they’ve been discharged. So much information from an extremely knowledgeable and compassionate professional. It’s comforting to know that he wakes up every day with the goal of improving the lives of people with gambling disorder. And he’s definitely playing the long game.

00;00;58;07 – 00;00;59;13

Speaker 1: Welcome to the show, Nate.

00;01;00;14 – 00;01;02;03

Speaker 2: Thanks for having me. Happy to be here.

00;01;02;12 – 00;01;24;24

Speaker 1: Yeah, well, we’re fortunate to have you join us. I’ve had an opportunity to speak and some of our pre-show meetings, and I’m looking forward to this episode, looking forward to hearing some of the some of the great research that Kindbridge has been involved in. And some of your thoughts and experiences along the way dealing with problem gambling.

00;01;26;01 – 00;01;26;20

Speaker 2: Absolutely.

00;01;26;27 – 00;01;40;16

Speaker 1: So I’d like to start off with and just kind of provide an explanation to the listener. What is epidemiology and what is what does that entail from a study standpoint?

00;01;40;29 – 00;02;04;00

Speaker 2: Yeah, So epidemiology is part of public health, right? So you can think of medicine. There’s, you know, when you go to see your doctor and take care of your individual problems, you can. That’s medicine. And so public health is when we’re thinking about not just the individual, we’re thinking about the health of the public. Right. Population model. So everything in epidemiology, you know, traditionally has been at the population level.

00;02;04;02 – 00;02;29;13

Speaker 2: So epidemiology is the foundational science of public health. It has to be somebody’s job to count the outcomes, both bad and good happening. And so with that counted, then then you can have public health. Right. So when you think about what does an epidemic do? So one of the classic studies would be the first time there was a connection made between lung cancer and smoking.

00;02;30;04 – 00;02;53;07

Speaker 2: Okay, that was an epidemiologist. It’s the only time you see X percentage in a population, you know, 40% of Americans are experiencing, you know, depression. Right. So anytime you see rates of cancer, you see rates of positive explains to. Right. Any time you see anything that’s population level that has to do with health, that’s epidemiology. And so there’s kind of two parts in epidemiology.

00;02;53;08 – 00;03;20;23

Speaker 2: One is chronic disease, which is kind of what I was just explaining and things like cancer, things like psychiatric issues like I worked on. But then there’s there’s also infectious disease epidemiology. So during the coronavirus pandemic, like you might have heard epidemiologist speaking about how the disease spreads to populations. And so we’re kind of two there’s kind of two halves to EPI and there’s, you know, we’ve got our cousins over who do the infectious disease side.

00;03;20;25 – 00;03;41;05

Speaker 2: So what we do in psychiatric epidemiology is so our job is to count the amount of mental health problems in the country at its most basic level. Right. So if you see you ever seen that stat, you know, one in one in five people, it’s mental illness at any given time. So the person whose job to go out and do that counting is a psychiatric epidemiologist.

00;03;41;05 – 00;04;05;11

Speaker 2: And it’s actually, you know, trying to count all the people in America with like major depression, you know, it’s it’s simple, right? It sounds simple, but it’s not particularly easy. Right? It’s a complicated seat. Sure. And so at its most basic, that’s psychiatric epidemiology. We’re looking at using epi tools to look at population levels of different disorders. And we’re focused on mental health, We’re focused on addiction.

00;04;05;25 – 00;04;21;13

Speaker 2: And then within that, you know, kind of the higher up your guard education, the smaller your field gets. Right. So as you go up there, it’s, you know, so I get bit, but then I focus on addiction. I focus on behavioral addictions. But my particular expertise is gambling disorder, which is we both ended up on this call.

00;04;21;18 – 00;04;51;04

Speaker 1: Right. Right. Well, thanks for that explanation. I feel like we’ve all got a crash course in epidemiology over the last few years. Not something that we sought, but it’s something that we at least have some idea of what that entails. So I appreciate the explanation there. In terms of the Kindbridge Research Institute and the types of activity that you’re involved in with gambling.

00;04;51;06 – 00;05;01;24

Speaker 1: What is it that Is there anything in particular that you look for when it comes to gambling and the study of problem gambling or gambling disorder?

00;05;02;20 – 00;05;29;24

Speaker 2: Yeah. So we look at both problem gambling and gambling disorder. So just to clarify, so Kindbridge Research Institute is a nonprofit research institute, and we focus on research improvements, creating new technology. So we also are associated with Kindbridge Behavioral Health, which is a clinical telehealth company that focuses on treatment for folks with gambling disorder. And so Kindbridge Behavioral Health is a is a nationwide.

00;05;29;24 – 00;05;54;11

Speaker 2: I think it’s, I don’t know, 35 states maybe now. So so KBH is the clinical side and then we are the research side, but we’re really addressing the same the same underlying problems, which is trying to improve outcomes for people who are experiencing harm from gambling. And just so there’s a lot of different you hear a lot of different terms kind of gets thrown around in the in the game sort of words of you.

00;05;55;09 – 00;06;15;24

Speaker 2: So when we talk about gambling disorder, that’s the DSM five clinical definition. That’s somebody with a Ph.D. in psychiatric epidemiology like me, when I see gambling disorder, all lowercase, I’m like, okay, I know exactly what that means and I know what it’s on. On the DSM. I can go and look at it. It has a specific meaning, a lot of times, and people are using that term.

00;06;15;25 – 00;06;44;26

Speaker 2: They don’t mean it that way. They kind of mean the broader purpose of problems associated with gambling, which is a much bigger thing. Media disorder is a very specific diagnosis. It’s a medical diagnosis, right. It’s created by a psychiatrist. So a lot of times that’s not exactly what we’re interested in, Right. We’re sort of interested in if someone is having a lot of gambling problems or a lot of problems with their gambling and their community, but it doesn’t meet that criteria for gambling disorder, we’re still interested in it, right?

00;06;44;26 – 00;07;04;08

Speaker 2: This is still something that’s harmful, that should be addressed, should be taken seriously. So I’d say right now there’s a really good word. The field has settled down for that. Okay. Has any sort of real meaning meaningful description? A lot of people use problem gambling and in that kind of universe of things, you know, harm is associated sometimes.

00;07;04;08 – 00;07;21;02

Speaker 2: Again, the related harm and what I’m speaking sort of to lay audience, as I just said, gambling addiction, because basically everybody knows what we’re talking about with gambling addiction. There’s that that’s not a definable thing. That’s not a medical thing. I’m not going to write a, you know, paper for a journal that’s a gambling addiction because it’s not definable.

00;07;21;23 – 00;07;39;01

Speaker 2: But I think it’s useful in that, you know, if I’m on a plane and somebody says, what do you do? Like, I’m a scientist. I focus on gambling addiction. Back like that gets it right to the heart. So it it really is it’s somewhat the language in this field still is chaotic like we’ve been it’s been chaotic since like the early eighties.

00;07;39;20 – 00;07;58;23

Speaker 2: And it is still chaotic. But I just I recommend to people, you know, pick something like my default is if I’m talking to lay audience, it’s it’s gambling addiction So they understand what we’re talking about. And if I’m talking scientifically or specifically, I use gambling disorder when that’s what I’m talking about. And then other times when we’re in between, I said gambling related harm.

00;07;59;10 – 00;08;21;18

Speaker 2: But you know, this is something so epidemiologists spend an awful lot of time on measurement. So this is something we we are hyper focused on, you know, what the language is, how it’s used. But for me, that little that click rule of thumb, that’s gambling addiction or gambling related harm, which is the broad universe or gambling disorders, the specific thing, if you follow that, you’re going to be on the money about 90% of the time.

00;08;21;24 – 00;09;02;11

Speaker 1: Okay. All right. Well, I appreciate that I learned something there because I use all those terms interchangeably as you suggest, and without truly understanding the meaning of it. The gambling disorder being a specific thing, as you mentioned, I tend to default a little bit more to problem gambling. And in some ways I’ve been resistant to gambling addiction and I’m not sure why other than people might interpret that as a bad.

00;09;03;08 – 00;09;07;29

Speaker 1: It’s I don’t even know where I’m going with this comment. But, you know.

00;09;08;07 – 00;09;09;15

Speaker 2: No, it feels funny, right?

00;09;09;15 – 00;09;11;10

Speaker 1: It does. Yeah.

00;09;11;16 – 00;09;20;12

Speaker 2: It’s it’s like it’s when you talk about you don’t want to say stuff we’ve gotten away from like the term addict. Right. Because it’s very stigmatized using language.

00;09;20;13 – 00;09;22;19

Speaker 1: That’s that’s the word I was looking for.

00;09;23;06 – 00;09;41;07

Speaker 2: Yeah. So we moved away from calling a person. So calling a person an addict is a label that’s very stigmatized. So as a field, not just in gambling, but in, you know, sort of medicine, we moved away from that type of terminology. I still think if you talk about the city, you talk about it sort of conceptually as a broad thing.

00;09;41;07 – 00;10;00;12

Speaker 2: Talking about addiction, I think is okay. Although, you know, we’re learning more and more about what it matters to people and what is and the kind of good news and the news of being a scientist is I’ll change my terms tomorrow if something changes and I need to change them like this is you know, it’s right now today, this is what I’m doing because I think it’s the best.

00;10;00;13 – 00;10;21;21

Speaker 2: Right. And if something else replaces that is better tomorrow and not married to these terms, I’m married to trying to do the best, you know, use the best, most precise language that I can or the most accurate language I can that’s not stigmatizing. And so, you know, it’s like you’re going to be wrong. And the great scientist from the go use language that we would never use now and the folks ten years before that did, too.

00;10;21;21 – 00;10;33;03

Speaker 2: And that’s just the way it is. When folks look back on this interview, they’re going to be like, man, I can’t believe they used the term gambling disorder. That’s just stunningly bad work. But it’s like, you know, you’ve got to have grace for the people who came before you because we came.

00;10;33;15 – 00;11;02;10

Speaker 1: Right. Well, and that’s a good point that I feel like, you know, we were talking earlier about our crash course in research in epidemiology is the science is evolving. We can’t you can’t just place in an anchor and say we’re done. It’s going to constantly evolve over time. The more people you talk to, the more research you get, the more you understand the research you’re obtaining.

00;11;03;13 – 00;11;35;27

Speaker 1: It changes and we’ll go through it like you. Like you pointed out, we’ve come a long way since the early the mid 1960s to where we are today. And with the pace of change and the introduction of more and more gambling opportunities that are available across the U.S., I can only imagine that, you know, we’re poised for a rocket ship ride in terms of the amount of information and study that we’re going to have.

00;11;36;18 – 00;12;03;21

Speaker 1: So with that in mind, I’d like to focus in on one area that I think you have quite a bit of research on, and that’s working with the veteran population when it comes to problem gambling. Can you can you tell us a little bit about the studies that you’ve done, what that research is indicating and how you’re making a difference within that community?

00;12;04;18 – 00;12;22;03

Speaker 2: Yeah, Yeah. No, I’d love to. So when I first started, I was finishing up grad school. I was at the University of Florida and in terms of being in my kitchen at the University of Florida, reading a review. And so I, you know, I’m going to be the founding executive director of this, you know, new research institute where we can do anything.

00;12;22;03 – 00;13;04;28

Speaker 2: The world is open to us. I mean, as far as what we can work on. And so I was just reading two studies going, you know, where, you know, what is what is a really important, crucial idea. We can learn a lot from. But that’s understudied and I was reading this, this review by a researcher to you and I have eaten and eaten last name it took we funded amongst other people, but I was reading a review that he wrote about the clinical work of of so the clinical research on gambling disorder in America in the last 25 years and in the last 25 years, there had been two peer reviewed studies of gambling disorder,

00;13;04;28 – 00;13;30;15

Speaker 2: research on veterans outcomes to peer reviewed stats on veterans outcomes. Now to to put that in context, so my mentor, when I was a student in concert was who is a genealogist, published about 45 papers a year and by himself now keeping in mind, you know, so this was a feature of coaching at Harvard. He’s a monster, you know is incredible for his like papers.

00;13;30;15 – 00;13;54;17

Speaker 2: This is tremendous production. But in 25 years to have to study is it just this this field is being basically completely ignored by the field, by the feds, by D.O.D., by Veterans Affairs from a research perspective. And so we came into this and said, I mean, at some point you read something like that, you just go, this is not acceptable.

00;13;54;18 – 00;14;15;23

Speaker 2: Like, this is this is simply not acceptable that this group that has sacrificed so much and we’ve asked so much from comes back from service and is having problems are it’s the gambling and they do have a couple of places that they can go and those folks are doing really good work, but the scientific community has left them.

00;14;16;06 – 00;14;37;29

Speaker 2: So we started with this idea and so I’m the first program we created based on this concept is called 54 Vets. It’s to try to increase the rate of research by 50 times in the next four years. So instead of two papers every 25, you want to have 100 papers in the next 25 years just to completely transform the research.

00;14;37;29 – 00;15;04;27

Speaker 2: And then so there’s sort of a strange thing about once you get into this field and start looking around this man, that it’s these everywhere, there are problems everywhere. When you starting to look at what’s happening with the veteran community. So just a couple of a couple of high points. So the on a colonist bases, which are mostly the overseas bases you know the US DOD run 3000 slot machines that bring in about $110 million a year.

00;15;05;12 – 00;15;29;26

Speaker 2: Right. So this is happening. So active duty soldiers and their families, contractors and anybody who lives on base has access to it. These are the folks who are who are feeding it $110 million a year. And that probably is low if we’re being honest, because that number is from 2016 and they haven’t released the numbers again. So when you work at military know, sort of outside the military on military projects, you can only work at the data you have.

00;15;30;09 – 00;15;53;04

Speaker 2: Right. Whatever you and you can’t really ask for anything and you can’t really get anything. But that’s what we know. We know in 2016 it was around $10 million a year. So people are developing problems on base and then coming home and not having the support they need for treatment. And that’s you know, that’s as you look at the field, it’s just you have to say that’s unacceptable.

00;15;53;04 – 00;16;15;11

Speaker 2: We do not accept that. And so we went to I went to some researchers at UNLV and I’ll be I’m Shane Krauss and bowling Green State University and worked with. So there’s two places in America where there’s very little centers that do inpatient treatment for people with gambling disorder. And one’s Cleveland, VA and one is in Las Vegas.

00;16;15;23 – 00;16;42;03

Speaker 2: So we now have and I was at Bowling Green and I directly with this population to just to see what works and what’s not working and what you know, to try new treatments, to do all of the things that you would do to prove clinical outcomes for folks. And that’s that’s an it’s been an investment of probably about $1.3 million broad strokes.

00;16;43;11 – 00;17;07;20

Speaker 2: So from mostly from so Playtech is one of the corporate funders and DraftKings is one of the corporate funders who have really supported that project, both companies that are very interested in taking care of veterans. And so that was sort of the first the first wave research we started, which is we just to get the research ball rolling and if we start it, other people will jump in too.

00;17;07;20 – 00;17;32;24

Speaker 2: That’s the theory. And as we did that, we actually found that there’s all kinds of other things that can also be done, because once you get into this, universal just starts rolling, right? So it that there’s very few veterans who are in leadership positions in research labs as medical director is, you know, most of the people making decisions about veterans health are not veterans And so interesting.

00;17;33;14 – 00;18;06;25

Speaker 2: Right. So it’s yeah, a little bit right. So if you want to really make a difference. So you know I was thinking the research should make a difference maybe on a 5 to 15 year timeline. That’s when that’s really going to, you know, make it make a difference. It’s going to start making a difference immediately. But the prince is going to come after three years now for for the second program that this program turned out to be the military research associate program the MRAP and this really started when I we started looking around going, well, if there’s nobody at the top, you know, top tier medical schools or research centers who are veterans, then

00;18;07;10 – 00;18;29;16

Speaker 2: we’re never going to make the really big the really big progress that we want to make. Right? Right. So and so we started for so now we started the MBA program. So then transition who are leaving the military and gotten to med schools or want to do a PhD? Maybe you want to do population health. They’re not really sure if they want to come and study gambling.

00;18;31;01 – 00;19;01;27

Speaker 2: We will train them. I will train solely in research methods and how to write scientific papers will help them do posters to go to conferences, will help them write scientific papers and get them published, will teach the methodologies all the things that they need to get into the very top schools. Because 20 years from now, 30 years from now, the big difference is going to be from having veterans, people who serve to understand the two of them and experience in the top tiers making those health decisions.

00;19;02;25 – 00;19;23;22

Speaker 2: And so that program started last year. Our first our first in a test pilot candidate ended up in a dual degree MBA MPH at Johns Hopkins, which is one of the best public health schools on the planet. So we’re happy about that. And we’ve got our second class in now for individuals all looking to go to med schools.

00;19;25;07 – 00;19;45;06

Speaker 2: And so right this is so the research is maybe a 5 to 15 year. This program maybe has as a long term payoff, you know, a 10 to 20 year payoff. It’s going to help immediately. But if you want to really change a space, right, this is the kind of way you have to think like, how are we going to make the future leaders who are really going to make huge changes?

00;19;45;06 – 00;20;14;03

Speaker 2: And so and we went through went back to DraftKings with after we had the preliminary data and just said, I know you guys are really interested in veterans. This is going to take some money we didn’t have necessarily. Would you come and support this program? And they did. And so they picked up that program. Programs so Dratf Kings is the funder of that program and it’s really allowed us to, you know, transform the lives and careers of people who just with this little bit of extra help.

00;20;14;03 – 00;20;37;25

Speaker 2: This is the kind of program, right, is people who serve and four years of of schooling paid for by the federal government right. So they don’t need us to pay for them and carry them all the way through med school or all the way through their Ph.D. that they have that covered by the GI Bill. Right. They just need help in this new narrow window where they’re leaving the military and the training.

00;20;37;25 – 00;20;59;26

Speaker 2: You know, they don’t have the writing experience. They don’t have the recent experience that open to publications. They’re competing with these young students from like top universities groomed for this. And they don’t speak the language maybe, and they’re a little uncomfortable in the conferences and all of these little things that end up being a barrier to getting people with with military backgrounds into these top tier programs.

00;21;00;06 – 00;21;19;28

Speaker 2: But what we offer them is just a way to overcome these barriers. And once you do that, you know, the sky’s the limit because, you know, we’re taking people we’ve got in this class, we want to Navy SEALs, we’ve got a Navy rescue swimmer which is in the sea in other movies where there’s, you know, the guy jumping out of a helicopter, Right.

00;21;19;28 – 00;21;49;05

Speaker 2: You know, into the ocean. That’s a Navy rescue. Some are like these are incredibly talented, smart, hardworking people. They just need a little bit of help with these weird barriers that get. And so that’s the that’s the military research associate program with a m MRF. And then finally, as we were going started these programs, we started getting calls from people who are in active duty or veterans and saying, I need help today and I can’t get into that for whatever reason or I need help today and I don’t have access to the VA for whatever reason.

00;21;49;17 – 00;22;11;04

Speaker 2: And so that’s that’s another thing that, you know, we needed to in addition to the help five years from now or in ten years, those people need help today. And so we have the military treatment fund. So the military to and from this is somebody comes to us and needs help today with their gambling disorder, we can get them treatment paid for by by Kindbridge Research Institute.

00;22;11;04 – 00;22;35;20

Speaker 2: You know it’s not forever. It’s not and it’s, you know, a nice set of at least eight meetings with a high quality person who’s trained, licensed experience with military folks. And we you know, we pay the bills of that. And that’s that’s been really that’s been really rewarding because you hear the stories and you you know, if they’re like me, that the emails are folks who are struggling.

00;22;35;20 – 00;23;02;20

Speaker 2: And it’s like before we had this and I said, man, you know, I really wish I had something for you. You know, try this, try that, try this. And now to be able to say, we can do this as long as the funding holds out, you know, there’s it’s not a it’s not in perpetuity for everyone. I wish it was, you know, the day that we we have the money just to accept everyone will accept everyone, but we try and help as many people as possible as long as there’s funds in that account.

00;23;03;05 – 00;23;22;23

Speaker 2: You know, we want to offer free services for some because there are again, it’s this it’s there’s barriers and sheer. There are so many barriers to treatment. It’s like, well, if I go to the VA, they might, you know, they might change something in my file or, you know, maybe I was I had a gambling addiction in while I was serving and I dishonorably discharged.

00;23;22;23 – 00;23;39;26

Speaker 2: They don’t have access to the VA. It’s like, well, that’s a problem. So they can’t go to the VA and get the treatment that you should have earned. And that’s a whole other set of problems that we could talk about, as, you know, making the system fair for those folks who develop a problem using military slot machines on military bases.

00;23;39;27 – 00;23;40;17

Speaker 1: Right.

00;23;40;17 – 00;24;04;24

Speaker 2: But then get dishonorably discharged. Right. That seems unfair to me. But, you know, that would be my opinion. But so so you sort of understand our our programs are all across the the spectrum of people who need help from today to hopefully building the leaders that 20 years from now are going to put me out of business. I mean, just, you know, replace civilians who are interested in this work, you know, actual veterans who have who know it deeply

00;24;04;26 – 00;24;25;21

Speaker 1: Right. Well, that that seems like an important step to to have people that are actually veterans in those leadership positions making decisions for other veterans. It just comments sense would dictate that or at least you or at least I think it would.

00;24;25;28 – 00;24;45;21

Speaker 2: Right. That’s our superpower. I think that’s our superpower. It is common sense. It’s trying to be like what needs to be done today that can help people’s lives. And that’s kind of we try not to get too caught up, you know, and go too far afield. But, you know, what is it? All these people have built in the military problems.

00;24;45;21 – 00;25;00;10

Speaker 2: There’s no research. We’ll do research, Right. Like it’s not a C, like it’s not super genius, you know, massive big brain stuff. It’s like just connect the next dot, you know, take the next step. That’s what that’s what we’re focused on.

00;25;00;17 – 00;25;28;04

Speaker 1: Yeah. And that’s comforting to hear because I often think sometimes our common sense meter is in very short supply these days. So to hear you say that is heartening in a lot of levels. So the research research that’s being done is is very necessary. And it makes sense, right, where folks are because.

00;25;29;04 – 00;25;49;16

Speaker 2: Yeah, I should say that theory. So the rates of gambling disorder in naturals is in the 3 to 5 times higher than the general population range. Again, very difficult to measure because you don’t have access to the population. You on an inactive duty is at least on that high could be in the 5 to 10 x actually of the general population.

00;25;49;16 – 00;26;12;24

Speaker 2: But again, very difficult to get a good accurate measure of that because the daily would have to give you access to their files to do that and they’re not willing to do that. So doing the kind of best research we can, I would say. So my opinion this is, you know, I’m a scientist. I have to distinguish my opinion from actual set facts, actual said facts.

00;26;12;24 – 00;26;30;05

Speaker 2: Right now, I would probably say in the 3 to 5 range. I think some of the things I’m seeing in the early research that we’re going to see that number go into the 5 to 10 X range when we get some better numbers now. But, you know, it’s a lot of a lot of young folks, a lot of me have a lot of downtime.

00;26;30;05 – 00;26;55;18

Speaker 2: They’re under a lot of stress. Like this is a lot of the things, a lot of risk factors put together. And then if you think back to Vietnam, you know, in Vietnam there, when you think about heroin in the Vietnam era, the my mentor, her her mentor, the very famous I now I think did not heroin study and the number of people who were U.S. service members using heroin in Vietnam was very, very hot.

00;26;55;23 – 00;27;16;11

Speaker 2: Right. Like 10%, 15%. And there were all these weird factors associated that it was easier to get that alcohol if you were under 21, You know, it was a few cents, $0.25 for a hit. You could smoke it right in your gun, barrel it was everywhere. You were under incredible stress. And then you also had a huge amount of down a lot of downtime.

00;27;16;16 – 00;27;16;25

Speaker 1: Yeah.

00;27;17;04 – 00;27;39;26

Speaker 2: It’s just, you know, this was and it was just everywhere. And in some ways, you know, in some ways it’s similar where you have all the downtime, all the stress, like those things haven’t changed, but hopefully the heroin use has gone down that. But you know, you’ve got the gambling on business, someone’s out in the field, super stressed out, they come back, they had access to alcohol access to gambling.

00;27;40;01 – 00;27;59;14

Speaker 2: Right. And so in some ways, you know, I understand that there’s a need for distraction and games and, you know, alcohol and bowling. And there are all these things. And then it’s not that it’s not that it shouldn’t be anywhere, but it’s that if you’re going to offer, you know, something with the potential for serious addiction, you need to offer support.

00;27;59;23 – 00;28;28;18

Speaker 2: Well, and that’s we have a whole set of studies that we’ve started doing on that to look at the support being offered to folks who are active duty, who use the on base slot machines. And, you know, spoiler alert, the news was not very good. On one poster we published last year, we put every state and the DOD on a like we scored them all for okay whether they meet the basic so every state that offers casino gambling and then the DOD and put them all in order.

00;28;28;18 – 00;28;48;02

Speaker 2: And this is I mean, I’m sad to say the DOD was dead last in the protections offered for people. I’m betting in slot machines. And the reason is, I think because all of these states have state gaming commissions whose job it is to make sure that there’s some kind of reasonable legislation and some do a better job and some do a worse job.

00;28;48;02 – 00;29;06;26

Speaker 2: Sure, The DOD, it’s not really clear whose job, whose responsibility it is, who has expertise in it. It’s not clear that anybody is in it thinking about this. And so when we we use the American Gaming Association, they have this kind of, you know, list of these are the ten things that you should do if you have slot machine gambling in your state.

00;29;07;19 – 00;29;27;01

Speaker 2: And the DOD was doing one of that, and I think the average was like five or six just dead last. And that’s so we presented that poster last year. They’re working on the right up to they’ll be coming out hopefully in the next nine months. But the it’s just a whole another set of problems.

00;29;27;10 – 00;29;32;15

Speaker 1: How has that information been shared with the DOD and is there a response to it?

00;29;33;09 – 00;29;54;13

Speaker 2: I don’t we haven’t had a lot of success speaking directly to the D.O.D.. Okay. I don’t expect that we will have a lot of success speaking with them. Our strategy right now is really to speak with them. Our strategy right now is to do the best science we can. Okay. Both on the on the treatment side, I’m looking at the slot.

00;29;54;13 – 00;30;23;00

Speaker 2: And so this study was done by one of our MRAPs, one of our folks in the military research associate program who wants to go on to a career of public mental health. Okay. And so we really just started doing this work to give them ways to improve research methodology and get some publications. And the fact that we’re kind of accidentally running into this thing where no matter how we try and test what the D.O.D. is doing, they’re always dead last and protecting people kind of any way we look.

00;30;23;00 – 00;30;58;29

Speaker 2: And we’ve tried, I think, three or four different. They are always doing the least. They are always dead last. And you know, I’m thinking at some point somebody is going to notice. But I’ve been told that this is something that, you know, it’s going to get anywhere and they’re never going to pay attention to us. And my response to that is, as a gym near my house and cardio on, you know, twice a week, I do an hour of cardio because my goal is to live for a long time, not I think I got about 40 years ago now as I keep on, you know, eating lots of fruits and vegetables and doing cardio.

00;30;59;00 – 00;31;12;07

Speaker 2: So, you know, let’s look at 40 years, man. You’re going to have to you know, the DOD is going to outlive I’m going to wear them out over the next 40 years. I’m going to see how they do. So we don’t have a you know, we’re worried about them attention to us now or in two months or three months or five months.

00;31;12;07 – 00;31;25;16

Speaker 2: You know, we’re going to keep on producing high quality work. And it’s just as it gets as there’s more of it and it sort of enters the bloodstream of society more, I think changes will happen, but we’re not, you know, this is not a sure project for us.

00;31;25;26 – 00;31;50;25

Speaker 1: Yeah, well, it’s it’s interesting. And the first time I heard this that the availability of gaming on overseas military bases was from a mutual acquaintance, a friend of yours, Dave Yeager. I heard him speak at a conference I was at. Oh yeah. And I was with him over the last couple of days, too, by the way, here in Chicago.

00;31;51;01 – 00;31;51;23

Speaker 2: So. Yeah, yeah.

00;31;52;10 – 00;32;22;05

Speaker 1: Yeah. He was at he was at this conference that brought together some of the leaders throughout the state to do some advanced training on problem gambling and gambling addiction. So it was good to reconnect with him, but I heard it first from him and he’s he’s in recovery as a result of him being introduced to gambling while he was stationed overseas.

00;32;22;15 – 00;32;55;23

Speaker 1: And it’s I mean, as with all of these stories, it’s heartbreaking story to listen to. But to understand and hear from you that there’s not a whole lot that’s being done from the inside to help address the problem. So I think the work, the work that you all are doing is is fantastic. The work that Dave’s out there doing on a daily basis also much needed because it is a population that we owe our veterans everything.

00;32;56;10 – 00;33;09;01

Speaker 1: Right? And to the extent that we can provide services for them, I think that’s a worthy cause. And it’s it’s hard to say no to those, at least in my opinion.

00;33;09;11 – 00;33;27;12

Speaker 2: Yeah, and it’s worth noting about Dave. So we speak to we speak to Dave pretty regularly. He’s sweet when we are doing work. We like to have scientific advisors and Olympic experience advisors because both sides of the coin are very important. We want to be doing the best science. We don’t want to lose track of the lived experience, the on the ground experience.

00;33;27;23 – 00;33;46;03

Speaker 2: And so all of the programs we have made have been in conjunction with input from Dave because there’s really no other way to understand and we really don’t want to get to the point where science, we can go off treadmill, a lot of scientists, we can go way off track really quickly and just start chasing shiny things and chasing new methodologies.

00;33;46;03 – 00;34;05;18

Speaker 2: And, you know, we can kind of you can kind of lose track. So we always go back to days. And then so we just started Grant from from Colorado state of Colorado to do some work on with the veteran population in Colorado. And part of that is we’re going to you know, we’re going to hear Dave on a plane and we’re going to send him out to two colleges to talk to the ROTC.

00;34;06;09 – 00;34;31;22

Speaker 2: You know, the young the folks who are going to be the officers, the folks who are going to be in charge, you know, of of enlisted people for the next ten years. And so, you know, it’s amazing because the military talks about alcohol constantly, like thousands of hours. If you Jaker you’ve heard thousands of hours of talks about alcohol, but basically zero most of the time the audience is there.

00;34;31;22 – 00;34;59;27

Speaker 2: So I spent 0 minutes learning about gambling disorder, you know, or gambling problems, gambling addiction, probably the addiction in this case, which is strange because there’s, you know, thousands of hours of in on gambling. So we’re saying, well, how about for free? We send you a person who’s an expert who has lived experience of this problem and developed this problem while serving actively, and he can talk to the ROTC, then just make it so they understand when they see money problems that don’t make sense in enlisted folks.

00;35;00;18 – 00;35;21;24

Speaker 2: Maybe it’s money problems, but maybe, you know, dig a little deeper and see if you can you can suss out the times that it’s going to be gambling some amount of the time. It’s going to be playing as the true underlying cause. And so we’re really excited about this. This Colorado program is really it’s giving us an opportunity to try some things that have never been done before, like this ROTC thing has never been done before.

00;35;21;24 – 00;35;40;19

Speaker 2: But we’re going to you know, we’re going to send out, you know, drive around the state to the ROTC. And you know, I’m just he’s the right messenger. And this is a really important topic. And I think it’s a perfect time that 18 to 22 when you’re training to be a leader. Yeah. You know, they’re used to studying ideas.

00;35;40;19 – 00;35;53;25

Speaker 2: You know, if someone’s been a leader in the force for ten, 20, 15 years, right, maybe you can go in and make a change. But man, is it easier to start with a 20 year old just developing as a leader?

00;35;55;04 – 00;36;03;11

Speaker 1: Yeah. Boots on the ground, right? Boots on and and coming up through the ranks. So, yeah.

00;36;03;28 – 00;36;32;16

Speaker 2: Solid strategy for short money too, right? Like it’s not that much. I mean, God bless them. Exactly. And but it’s not, you know, this is not a $300,000 project, right? This is like, I don’t know, it’s maybe 50 k put aside for it and we’re going to reach, you know, all of the RTCs in Colorado, either with Dave or with his content delivered electronically for not that much money and covered that whole generation of folks right from that state for relatively reasonable money.

00;36;32;17 – 00;36;46;04

Speaker 2: This is what I’m saying is like, this is not again, not another genius idea that the ROTC people are in training all the, you know, the brief all the time. We’re just sending someone for free to brief on this important topic, free to that.

00;36;46;04 – 00;37;23;06

Speaker 1: We’re like, yeah, well, and hopefully that’s a program that can expand and expand out to other institution that’s across the country. Because, I mean, let’s face it, the accessibility for online gambling, it’s pervasive and it’s affecting it’s affecting that age group who are very well embedded with technology. They much, much better than the older population in many cases because have grown up with it.

00;37;23;20 – 00;37;32;19

Speaker 1: They’ve grown up with the phone in the hand. They can access anything anywhere, any time. So very important, very important work.

00;37;32;25 – 00;37;48;07

Speaker 2: Yeah, that’s exactly right. That’s exactly right. And it is work. So we are doing an electronic version. So the goal is to be able to offer that nationwide. Okay. Any state that wants boots on the ground, we’re going to be able to do for them. But you got to pay for that because, you know, boots got some money.

00;37;48;27 – 00;38;06;22

Speaker 2: But as far as you know, if you just want to use the electronic version and we’re doing some you know, we’re doing the the research on it to verify that additional pieces work as well. But the goal is to make that freely available to all of the ROTCs nationwide, because that’s the whole that’s the whole point is to get into people’s hands.

00;38;06;22 – 00;38;29;08

Speaker 2: But no, that’s a it’s a great point about and nobody really understands generationally what this means yet. And it’s it’s unclear how long it’s going to take us to get a really good understanding because science takes time. And so to be really consider one that’s going to take time. But we actually I mean, this is kind of the state of the world that we’re in.

00;38;30;09 – 00;38;56;15

Speaker 2: We need new methodologies right? Like the methodologies we have now in slow to find something like. So I live in Massachusetts. You know, we had the sports open maybe, I don’t know, a few maybe a couple of months ago. There’s no lake. So if you wanted to do an EPI study of the states, it’s really hard to track what that means.

00;38;56;15 – 00;39;27;13

Speaker 2: You actually wouldn’t you wouldn’t track that at all because you kind of do one, you know, you do like a daily ten week or a 12 week window. Right. So what happens if there’s a spike right after some some new gambling is is put in right. We think probably, you know, looking at the other research, we we suspect that there will be you know, there’s there’s almost always a spike and then it generally levels off for a variety and some good and some bad as far as prevalence and or so if you think about incidents.

00;39;28;11 – 00;39;53;11

Speaker 2: So again, you know, so it’s not kind of like when there’s more generally expansion, there isn’t kind of this steady stream of more problems because if there was, then you know, the difference between when you could only gamble in Vegas and Atlantic City to now would be massive. And what we generally see is kind of curve where it goes up steeply and then coming down relatively quickly.

00;39;53;11 – 00;40;13;25

Speaker 2: And when it comes down, there’s both good reasons and bad reasons to come down, though some people come down because they start to experience problems and they went, Oh, this is not good. I need to find a way to not do this. And so they sort of come down on the run. Some people get treatment. That’s good. You know, some people lose everything and end in, you know, in a maybe an inpatient setting.

00;40;13;25 – 00;40;33;04

Speaker 2: That would be bad. You know, there’s both good reasons and bad reasons that that that peak comes down. But with the current on the population level, we kind of have no way to measure that. That’s another thing that we’re thinking about is it’s almost like, you know, we’re trying to do something new, but we don’t have the tools.

00;40;33;11 – 00;40;47;07

Speaker 2: So we’ve got to build the tools. It’s like, all right, we’re going to do, you know, stick on the military thing we’re going to do, you know, error jumping. But like, we haven’t invented the airplane yet in the cycle. Okay. Well, it’d be really hard to see a person on a parachute. That’s great, but I don’t know how to get them.

00;40;47;07 – 00;41;17;27

Speaker 2: I take up arms so kind of. You’ve got to invent the tools to to answer the questions while we’re trying to answer the questions. And so for me, it’s really exciting because we get to create new things and it’s it’s kind of just a whole set of problems. But then it’s also, you know, that the opportunity we had to measure what’s happening in Massachusetts has gone at least the you know, to know what happens the month before and the month after is gone.

00;41;17;27 – 00;41;41;20

Speaker 2: Because that time period is gone. So we’re seeing a lot by not having the tools we need. But it really is it’s it’s as you describe it, it’s I think it’s even more dynamic, even more hard to understand the even more complicated, frustrating, maybe even more potential for good May be right. Like all of those things are true.

00;41;43;04 – 00;42;18;05

Speaker 1: Okay. So so is there anything that we can look at? I mean, pick Australia, for example, or Canada or in Europe, this online gambling gaming has been available for quite some time. So is there a possibility to look outside our borders and learn from some trends or studies that have been done in those countries that we can perhaps maybe anecdotally apply here in the US?

00;42;19;11 – 00;42;45;26

Speaker 2: Yeah, no, that’s really interesting. So so yeah, has the highest sort of steady state rate of gambling disorder in. The definitely in the English speaking world, it’s maybe two and a half to three and a half times higher than in the States and there’s not, there’s no really good explanation for why that is. But that’s, that’s kind of been a steady finding over the past 25 years and what’s happening in the UK.

00;42;45;26 – 00;43;02;09

Speaker 2: So just to clarify one point, so when I say gambling, I’m talking about gambling, and when I say gaming, I’m talking about video gaming because of course in video gaming, you know, disorder and gambling disorder. And so I’m assuming that when you’re saying gaming, you’re also referring to gambling. But I’m not.

00;43;02;10 – 00;43;08;02

Speaker 1: I think I am. Yes. I’m using the industry term. The industry, broad term.

00;43;08;16 – 00;43;27;01

Speaker 2: Yeah. Yeah. For you can use whatever you want your show. Right. I but so we’re not going to be consenting when I say games like I’m gambling let me get into just to clarify for the audience that we’re not like just to get us if we’re not going to use the same language you guys talk. So the UK case is really interesting.

00;43;27;01 – 00;43;48;28

Speaker 2: I don’t understand it that well, but what’s happening over there? So we’ve been waiting for this white paper for like two years and then it just came out sort of nobody seems totally happy and it’s a little bit happy and I’m not really so it’s going on. But definitely but the gambling is it’s strange, too, because it’s really deeply ingrained in culture, right?

00;43;49;12 – 00;44;13;02

Speaker 2: And so it’s we could say you could it would be a very risky business to say, what if we expand the way the UK expand and what happened in the UK is going to happen here, and that could be true. And now it’s also true that if you look culturally so like witness gambling in China, right? What does gambling mean in India?

00;44;13;02 – 00;44;52;17

Speaker 2: So I went to a I went to India on a suicide study probably three years ago now and had a just a whole series of fascinating conversations about what gambling in particular in Hindu context in India. And it was a whole fascinating education for me that was totally, totally new to me. So going all the way back and I’m I’m not going to try and, you know, give the story accurately, but the impression of my recollection was that in one of the foundational stories of the Hindu culture of gambling as a central part of it, you know, some some folks were gambling and lost.

00;44;52;17 – 00;45;16;11

Speaker 2: I think they lost horses and maybe also family members. I don’t remember exactly. But this whole idea of risk taking and gambling is goes all the way back, you know, 5000 years in this in Hindu culture. And it just has a different cultural meaning than it would in, you know, in the states and, you know, sort of Mountain Dew populations in the states.

00;45;16;23 – 00;45;32;24

Speaker 2: And so when we think about what is going to happen in America, it’s like, well, you know, America is kind of like big you know, it’s kind of a big it’s a lots of different cultures. You know, I’m from Boston, where we have we have all kinds of weird gambling culture here. My three year old, I probably should say.

00;45;33;00 – 00;45;56;17

Speaker 2: But, you know, it’s the my three year olds just learned how to play bingo at a school fundraiser. My wife said so at a school fundraiser. She sent me a picture and they’re teaching them how to play bingo in a real lives money game for charity, for, you know, for a school of, you know, people who are the oldest kids in the school are 11, and they’re doing a charity bingo.

00;45;57;01 – 00;46;18;24

Speaker 2: And my three year old little card there, he’s really good with letters and numbers. And so he’s like, oh, gee, 25 bucks. I can do that. And he’s learning at three an end. But the thing is, Boston has a very deep gambling culture. Most successful lottery per capita in America is Massachusetts. It’s which you may or may not know because, you know, we have a deep gambling culture here.

00;46;18;24 – 00;46;40;20

Speaker 2: So it’s one of those things you ought to be careful with, because I’ve heard a lot of people, particularly some sometimes at the gaming commission, people will say things like, Oh, you came to Massachusetts in 2012, and I’m like, I don’t know about that man. Like to live in Massachusetts. You know, I’m pretty sure when George Washington was here, you know, in the early days doing, you know, Washington was a big poker player.

00;46;41;02 – 00;47;00;07

Speaker 2: You know, when Washington was here in the 1700s setting up the, you know, the first Navy right here where I live in Beverly Hills, I’m pretty sure they were gambling there. So this idea of gambling arrived in 2012. I don’t know about that. This is the thing where I’m kind of obsessed with getting the measurement done properly and getting it out.

00;47;00;07 – 00;47;21;06

Speaker 2: So it’s timely because what is going to happen in different communities is, is going to be fascinating. And it’s a very reasonable hypothesis to say it’s going to it’s going to be bad like it was bad in the UK. And I think that’s totally reasonable. And then also, I think if you look across America, it’s true probably that it’s going to be bad and it’s also true it’s going to be really horrendous.

00;47;21;06 – 00;47;28;04

Speaker 2: Some places there may be other places not as bad. Health problems do not distribute equally across the American population.

00;47;28;24 – 00;47;29;07

Speaker 1: Right?

00;47;29;19 – 00;47;53;05

Speaker 2: Basically, no health problem is distributed across the American population. That’s the that is not the exception. That’s the rule is it is never equally distributed. Right. There’s always different pockets and things worse than others, depending on all kinds of different factors. And that’s what we expect here. And so it’s not even really, to me, a question of what it’s going to be, you know, if it goes from 1%.

00;47;53;06 – 00;48;16;08

Speaker 2: So, you know, something happens. We go from this steady state of 1% gambling disorder to like 3%. It’s not going to be 1%, 3% across the whole population. It’s going to be 1% a lot of places and 6% or 8% in certain populations, right? Yeah, it totally changes the way you think about how you get the care there.

00;48;16;08 – 00;48;43;00

Speaker 2: How do you get the resources there? Like what are there underlying things that add risk to those groups that can be addressed? Right? So that’s something, you know, we have another another grant from Colorado. God bless Colorado, too, to kind of go into that state and look and say, okay, so Colorado is an interesting state because it has a large Latin population, a large military population, a large college population, a large rural population, a large indigenous population.

00;48;43;02 – 00;49;04;24

Speaker 2: Right. All of these groups that could possibly experience either higher rates of gambling disorder depending on all kinds of things that are going on their community. And so part of what we’re doing is looking in those communities at the resources that they have and seeing if there’s sort of seeing the landscape and then being able to offer solutions.

00;49;04;24 – 00;49;22;18

Speaker 2: If it seems like there are places where the bears are just not going to be there. But that’s always important when you think about America, right, is it’s not it’s not 1% across the board. Everything is equally distributed all over the place. That’s just kind of how it’s kind of the nature of the beast when you’re working, when you work.

00;49;23;08 – 00;49;43;07

Speaker 2: And also the other thing to keep in mind with America is we are way bigger than the UK. Yes, we are. You know, they drive across, they get sort of angry when I have to drive 2 hours, You know, when I used to live in L.A., 2 hours for a hotdog, like we’re just we’re just a way bigger, a reasonable way for people.

00;49;43;14 – 00;49;46;02

Speaker 1: And that was only five miles down the street, right?

00;49;46;09 – 00;49;56;01

Speaker 2: That’s exactly right. It was a it was pigs hotdogs in Hollywood. And it would be 2 hours to. But it was worth it. Totally worth it.

00;49;56;01 – 00;50;32;14

Speaker 1: Yeah. Agreed. Well, some fascinating stuff here, Nate. And, you know, through through your time, there is is there anything that you would point out to? As you know, this is probably the most interesting thing that I. I hadn’t recognized that was uncovered through some of the research that has been conducted that you’ve been a part of. And if there’s anything like that you would care to share about gambling addiction.

00;50;34;25 – 00;51;00;18

Speaker 2: Yeah. So I’ll give you the taste. Keeps me up at night. Okay. So there’s this story. There’s not a study we did here, but it’s a piece that we’re working on, you know, working on active. There’s a problem. So there’s this and there’s kind of classic study by this researcher named Wendy, who’s who’s the Midwest, great researcher. And she did the study looking at treatment, seeking with people with gambling disorders.

00;51;00;18 – 00;51;29;15

Speaker 2: So anybody you know, it’s a large population study and well funded. Well done. Well. And so if you look at all the people with clinical gambling disorder, it was called pathological gambling at that time. But for our purposes, disorder, what percentage sought treatments? And so the rate of treatment seeking for people with gambling disorder was, I think it was 7%, 7%, so seven per 100.

00;51;30;03 – 00;52;12;22

Speaker 2: And then there was another handful of folks, maybe 6 to 8% who who had gone to jail. And so, you know, it’s kind of, you know, do you want accountants treatment seeking or not? It’s kind of this kind of isn’t right. But so you’d say all in maybe 10 to 15% of folks had done anything at all by any definition, to get the treatment they needed for the serious disorder, which means and this is what keeps you up at night, it means 85 out of 100 people are not even looking for the treatment that they need, which means, you know, the work that y’all do, the work that we do, we’re providing the resources for

00;52;12;22 – 00;52;33;25

Speaker 2: the people who who come seeking for it. But how is it that we can. And so, you know, the big question would be why? So there’s there’s access, there’s stigma, there’s understanding yourself, There’s understanding that it’s a disorder. That’s, you know, there might be people who out there who still believe like, oh, this is you know, it’s a moral failing or it’s something else.

00;52;33;26 – 00;52;48;17

Speaker 2: And you don’t go to the doctor for a moral failing, right? You don’t get counseling for or failing. And we’ve moved away from that, I think, as a field. But I don’t know the ways that as a society. And so this.

00;52;48;29 – 00;52;54;16

Speaker 1: Move your way. Can I can you clarify that moved away from it. What do you mean by moving away.

00;52;54;24 – 00;53;23;24

Speaker 2: Yeah. So so there were things so maybe 50 to 60 years ago you would have doctors who would say maybe gambling disorder is a is a moral failing. Right. Okay. So as a as a field, as a medical field, as a, you know, medical or psychological fields, you know, 50, 60, 70 years ago would have been something that maybe your doctor might have said to you or there were or would have been believed by your psychologist or psychiatrist at this point.

00;53;23;24 – 00;53;47;11

Speaker 2: Because because gaming disorder entered the DSM in 1980 and then was moved into the addictive position in 2012, I feel like it’s sort of we’re getting to a point where pretty much everybody is on the same page in the mental health research field that gaming disorders an addiction. Although there is a fascinating discussion on that, is it actually better understood as an impulse control disorder rather than an addiction?

00;53;47;22 – 00;54;08;18

Speaker 2: And there’s actually good evidence on both sides for that. And it’s kind of a fascinating discussion, but everybody kind of agrees it belongs in the DSM, but that 85 folks and some number of those folks are sort of they’re experiencing what’s called natural recovery, where they’re kind of just they’re crossing the lines and then coming back on their own accord.

00;54;10;00 – 00;54;42;27

Speaker 2: And that’s great. Some so that’s not everybody, but that’s maybe 30, 33, 40% somewhere in there. And that’s great. It’s people who, you know, I went to and now I realize that I’m just getting some support from my family or, you know, something else within myself. And I’m coming sort of back across on my own. That’s great. But if even if you take those folks out so, you know, of the 60% of people who are not recovering on their own, only 15% or even speaking treatments, there’s this huge population, right?

00;54;42;27 – 00;54;43;24

Speaker 1: Folks do.

00;54;44;25 – 00;55;09;00

Speaker 2: It. Yeah. And that gap. So that study was done in the early 2000. So as my recollection and I don’t know that we’ve really gotten better and that’s that’s it’s that’s to me when I started the field in 2009, that’s what I thought was the most important piece. And today I still think that’s the most important piece is that we just haven’t done enough because you can’t you know, the goal is to reduce harm.

00;55;10;05 – 00;55;25;27

Speaker 2: You know, to to I know people don’t like that term reduction, but, you know, sorry, the goal is to there’s harm in the universe. We’re trying to make it less. That’s what we’re trying to do. And if you like, you can like it. But that’s what I’m trying to do. We’re trying to reduce the amount of pain and people, right?

00;55;26;12 – 00;55;43;24

Speaker 2: That’s the goal. And so and so that that idea, all of these folks who are not even seeking any help or in our meeting aren’t even aware that they’re experiencing this harm from something that is help write something that is treatable. Man. That’s one that it really gets me.

00;55;44;19 – 00;56;12;01

Speaker 1: Yeah. Boy, that’s a good one. And at least anecdotally, I don’t know if it can make any inferences from the the study and the research that’s available on that. But I would add anecdotally here in the state of Illinois, one of the things that that we’ve been very focused on over the last couple of years is public outreach.

00;56;12;09 – 00;56;57;22

Speaker 1: So just getting out and getting messages out to people and being consistent with those messages about how do you define gambling addiction and where you can go for help, you know, and those messaging, the messaging behind that has been hopeful as opposed to hurtful. So try to avoid the stigmatization that comes with gambling addiction, but providing at least a message of hope to the people across the state that there are places where you can go to seek treatment for a gambling addiction.

00;56;58;02 – 00;57;12;27

Speaker 1: So I would I would tend to believe that that’s true in many of the states with legalized gambling that that they’re out there promoting these messages. So hopefully that’s an effort to start closing that gap.

00;57;13;28 – 00;57;31;24

Speaker 2: Yeah, And there’s this funny thing. Maybe you experience this, too, where you say, you know, if you meet somebody new, like at the gym or something and they say and they’re you know, you’re talking about what you do. And I say, you know, well, you know, I’m an expert in gambling. Usually they will say, well, you know, I have a cousin who actually could use your help.

00;57;31;24 – 00;57;33;24

Speaker 2: Like they almost always after some.

00;57;33;26 – 00;57;35;07

Speaker 1: Everybody knows someone.

00;57;35;09 – 00;57;57;24

Speaker 2: Yeah, it’s universal that they know somebody is like a gambling addiction. I don’t think my brother in law really you know, he’s been betting on the Steelers a lot. You know, it it just the stories do start coming out and it’s it’s it’s everywhere. And yet there’s still this small group that actually seeks treatment. And that’s the gap that that I think about maybe that’s maybe you’re implying and humble same experience.

00;57;58;06 – 00;58;20;14

Speaker 1: Yeah yeah I think I think we all do it’s how do we how do we treat the most people that we can and how do we get that message out, at least from the provider standpoint. That’s that’s what we think about. That’s what I think about on a daily basis. How can I reach more people? It’s one of the reasons for this podcast.

00;58;20;21 – 00;58;28;23

Speaker 1: It’s just another avenue to reach a segment of the population that we may be missing through traditional media.

00;58;29;29 – 00;58;49;08

Speaker 2: Yeah, and I wake up and I just think, you know, because I’m a population health guy, so there’s this much, you know, whatever the amount of harm from gambling is right now, today, that is what it is. And at the end of the day, I want to have done things that are going to make it lower, probably not today, but definitely in a few months or a few years.

00;58;49;08 – 00;58;59;06

Speaker 2: And so every day, you know, wake up, you know, kiss the baby on the forehead, make, you know, like, let’s to work. There’s a lot of, you know, we’re going to do Well.

00;58;59;25 – 00;59;26;12

Speaker 1: Speaking personally, I’m glad you’re doing what you do, Nate. It’s God’s work and appreciate appreciate you hopping on our program today and talking a little bit about what you do. And I’m hoping that we can continue this conversation at another time and come back and maybe when some new research is available, we can have a chat about that.

00;59;26;21 – 00;59;38;19

Speaker 2: Yeah, love to come. Hopefully I make it out to Chicago for one of these. You got around a lot of greetings. I’m hoping. You know, I got a newborn, but maybe eight months or nine months from now, I’ll be able to get out to Chicago and catch up and chat.

00;59;39;21 – 00;59;46;01

Speaker 1: Definitely. Well, thanks again, Nate. I appreciate it. Appreciate your thoughts.

00;59;46;20 – 00;59;50;02

Speaker 2: Thank you, Sean. And thanks for having me. It’s it’s a great show. I’ve listened to a number of them.

00;59;51;15 – 01;00;25;14

Speaker 1: We love hearing from you. So please take a moment to like, share and comment on our podcast. You can reach out to us directly via email at Wage of Danger at Gateway Foundation, DOT org. Look for us on Facebook and Twitter at Recovery Gateway on LinkedIn, at Gateway Dash Foundation, or through our website at Gateway Foundation. Dot org Wager Danger is supported through funding in whole or in part through a grant from the Illinois Department of Human Services and the Division of Substance to Use Prevention and Recovery.

01;00;25;26 – 01;00;41;23

Speaker 1: And remember, recovery is a lifelong process. If you are a family member struggling with a gambling problem, call Gateway at 8449753663 and speak with one of our counselors for a confidential assessment.

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