Each year, approximately 6 million (3%) of U.S. adults engage in problem gambling—gambling that compromises, disrupts, or damages their personal, family or vocational pursuits.[i] Many of these individuals also struggle with related behavior health problems, including substance use disorders. Recognizing these connections, states and communities have begun developing systemic supports that address these related problems in a coordinated way.
Iowa is one of these states. In 2018, IDPH established the Substance Use and Problem Gambling Services Integrated Provider Network (IPN), a statewide, community-based, resiliency- and recovery-oriented system of care for substance use and problem gambling services. Under this initiative, 19 funded communities have been tasked with reducing substance use and gambling problems through public education, evidence-based prevention, and early intervention services; and increasing remission and recovery from substance use disorders and problem gambling through timely, accessible, ongoing, and effective treatment services.
To prepare these communities for this important work, IDPH reached out to PS@EDC.
“We were thrilled that Iowa was approaching problem gambling and substance misuse in such a thoughtful and comprehensive way,” says PS@EDC Trainer Rebecca Bishop. “In so many ways, they are ahead of the curve. But we also understood that this was new territory for many in the IPN network. They needed the basics—a solid foundation for moving forward.”
To provide this foundation, Bishop delivered a two-part webinar series to more than 40 contractors and IDPH staff in early April. Part 1 explored the scope of the problem gambling—in both Iowa and nationally, factors that place individuals at increased risk—including social determinants like poverty and racism—and the intersection between problem gambling and substance misuse. Part 2 focused on available strategies to prevent problem gambling—including policy change and advocacy and approaches for selecting strategies where evidence is limited.
“We explained that when evidence is lacking, it’s often helpful to apply lessons learned from preventing other behavioral health problems,” says Bishop. “For example, we know that limiting alcohol availability has been an effective strategy in reducing underage drinking. So it’s reasonable to assume that limiting the “availability” of gambling—that is, reducing hours of operation, restricting the number of gambling establishments, enforcing zoning restrictions about where gambling can take place—could help to reduce problem gambling.”
The second webinar also explored best practices for developing a comprehensive prevention approach—that is, an approach that includes multiple strategies targeting individuals at different levels of risk. For example, a comprehensive approach might include a school-based program for high school students on gambling risks, dissemination of gambling prevention resources at substance misuse treatment facilities, and trainings to prepare people working in gambling establishment to identify persons exhibiting problem gambling behavior.
“No single prevention strategy is going to provide the answers,” say Bishop. “We have to address the acute needs of people who are engaged in problem gambling, and provide the supports needed to get them into treatment, when they’re ready. But we also need to think upstream, and educate people about the dangers of problem gambling before it becomes a problem.”
To learn more about PS@EDC’s problem gambling work in Iowa, contact Rebecca Bishop at firstname.lastname@example.org.
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