As the state is poised to add several new casinos and possibly table games such as poker, the University of Maryland School of Medicine said Thursday that it would create a center aimed at training thousands of health professionals to help gambling addicts, operate a telephone hot line and launch a public awareness campaign.
The center — billed as the first of its kind in the state — aims to recruit from a broad range of medical disciplines.
"The dentist may notice it because an appointment is missed or a bill goes unpaid. The doctor may have to ask, 'Why aren't you taking that high blood pressure medication?' only to find that the money to buy it had been gambled away," said Joanna Franklin, the center's deputy director. "We've got to educate all sorts of medical personnel."
The center, to be established with a three-year, $5 million grant from the state health department, will teach social workers, psychiatrists, psychologists and others to identify and treat problem gambling. It also will produce educational materials for other health care providers and offer a place for people to turn to if they or someone they know is addicted to gambling.
Maryland has three casinos — Maryland Live at Arundel Mills mall, Hollywood Casino in Perryville and the Casino at Ocean Downs near Ocean City — and two others are planned for Baltimore City and Allegany County. A sixth casino, to be in Prince George's County, could be approved by voters in November. That referendum item — Question 7 — also would allow table games at all Maryland casinos.
With additional slot machines installed at Maryland Live earlier this month, the state has 7,050 slots in operation.
Franklin said table games and slots attract different types of problem gamblers. Skill games like poker tend to draw young men to the casino, while slots generally appeal to middle-aged women and retired men, she said.
"Your luck gambler operates on the feeling of hope, while the skill gambler is convinced they have the talent to win," she said.
Franklin, who has worked with problem gamblers since 1979, said Maryland can expect to see an increase in problem gamblers now that casinos are available as entertainment destinations. A small percentage of those people who otherwise wouldn't travel to casinos in other states will visit one now that they're in Maryland and discover they have a problem with gambling, she said.
"If they've been to the Inner Harbor enough times, or don't want to go to the aquarium again, maybe they decide to go check out a casino," she said. "Or if the in-laws are in town and they want to show them something, maybe they go down to Maryland Live."
The center has arranged a two-day training session for mental health professionals on the Eastern Shore next week and aims to conduct another session in the Baltimore area by the end of November. The center also will assist the Maryland Council on Problem Gambling with operating a 24-hour help line staffed by trained counselors.
Maryland's efforts to assist problem gamblers have been criticized as insufficient in the past. Funding lagged because the problem wasn't as evident before the legalization of slot machines, Franklin said. Gamblers were confined to horse-racing tracks or illegal back rooms, or they played lottery games, she said.
But with the advent of slots casinos, casino owners are required by law to pay a $475 per-machine fee each year to support the Problem Gambling Fund, which made the grant to the center possible. State law also created a voluntary exclusion program, in which gambling addicts agree to be arrested if they are found at a casino. More than 120 people have signed up.
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Casinos also take steps to encourage responsible gambling and offer resources for problem gamblers to seek help.
Pathological gambling is classified as an impulse-control disorder by the American Psychiatric Association, and a 2011 UMBC study to establish a baseline analysis of gambling prevalence in Maryland found that 150,000 adults — 3.4 percent of those who had ever gambled — experienced moderate to severe difficulties stemming from their gambling.
But the percentage of those who struggle to control their gambling may spike with increased access in Maryland, and a proactive approach can better control the problem, Franklin said.
Mike Gimbel, who has served as the director of substance abuse for Baltimore County and Sheppard Pratt Health System, said Maryland has the opportunity to create a new standard for education and treatment of gambling issues.
"There's been so much focus on drugs and alcohol, so gambling maybe hasn't gotten the same attention because it wasn't as sexy," he said. "But with the casinos around, there's a real chance for Maryland to take what we've learned about those issues and apply it and really take a creative, fresh approach. It's got to be about education, getting the message out there and being very direct about the problem."