Every month, compulsive gamblers from Maryland call a telephone hot line pleading for help. Their sad stories come in from nearly every major gambling venue in the nation -- Atlantic City, Dover Downs, Las Vegas, Pimlico.
But the operators fielding the pleas can offer very few options for help in Maryland.
"When the state runs a help line, you have to have places to send people," said Keith Whyte, executive director of the National Council on Problem Gambling, which administers the phone line. "Maryland provides practically nothing."
Gov. Robert L. Ehrlich Jr. intends to correct that situation with slot machines, one of the very culprits that exacerbate the compulsive gambler's affliction. As part of the overall plan to put thousands of slot machines at Maryland racetracks, Ehrlich proposes to set aside money to deal with problem gambling -- 0.1 percent of the $1.1 billion in revenues the machines are estimated to reap by the start of 2005. By then, state funding for problem gambling treatment is projected to grow to $1.1 million, according to state officials.
With the observance of the first National Problem Gambling Awareness Week beginning today, Ehrlich's proposal occurs as all 48 states that allow gambling -- only Hawaii and Utah do not -- are grappling with the question of public funding to treat pathological gamblers.
Oregon's answer last fiscal year was to spend $4 million for phone lines, counseling and therapist training. Surprisingly, Nevada paid nothing. Instead, casino companies financed several treatment options. And New Jersey parted with $700,000, far less than the $1.25 million Delaware spent. Maryland, although it has a state lottery and horse racing, finances nothing.
"I think it's a positive trend that more states are increasingly adopting this type of funding as public policy," said Tim Christensen, president of the Association of Problem Gambling Service Administrators. But, he added, "it is rather ironic that unless Maryland expands their gambling, then it won't pay for treatment."
Even more ironic is that more than 20 years ago, Maryland was the first state to finance a treatment program. In 1978, the state partnered with the Johns Hopkins University to provide residential treatment. State funding to deal with problem gamblers began to fizzle in the late 1980s and was cut off entirely last summer.
Funds for help cut
In June, Maryland's Alcohol and Drug Abuse Administration eliminated $21,000 that had paid for a telephone help line.
Joanna Franklin, executive director for the Maryland Council on Compulsive Gambling, won the contract in June 2000. At the time, Franklin said, the money was not enough to staff an in-state hot line. The operators who answer calls from Maryland's gamblers are based in a call center in Dallas.
Franklin, of Baltimore, said other state governments pay for her to train their counselors. "But I can't get any money from Maryland," she said.
Although pathological gambling is recognized as a disease, experts said, the disorder is stigmatizing in a way that prevents its sufferers from receiving the attention that drug and alcohol addicts get. Many health insurance companies offer no coverage for its treatment.
"Most therapists have not been trained in compulsive gambling," said Valerie Lorenz, president of the Compulsive Gambling Center Inc. in Baltimore. "You can't just treat it like any other addiction."
Recent comments from Ehrlich demonstrated the popular perception that gambling, more so than other addictions, is an individual choice rather than an impulse disorder.
At a recent legislative hearing, Ehrlich called gambling an "adult decision" like any other, including the decision to eat too many chocolate bars.
"We expect adults to appreciate their freedoms and abide by laws," he said. "We know adults who cannot handle Hershey bars. We know adults who cannot handle gin and tonic."
David Robertson, a board member and past chairman of the National Coalition Against Legalized Gambling, said states must stop building new gambling venues until the disease is better understood.
"Hershey bars do not cause people to kill themselves or to accumulate $100,000 in debt," Robertson said.
A glimpse at calls
The callers to Maryland's phone line offer a telling peek at how the addiction ravages families, rich and poor, and finances. They gamble on everything from Keno, horseracing and lotteries to sports, stocks and Delaware slots. They steal from family and friends, lose jobs, ruin marriages and miss house and car payments. For example:
A Columbia mother called to find help for a son who had racked up $100,000 in debt. "I'm afraid he is over his head and I think he's been gambling with some really bad people," she told an operator.
A 38-year-old Frederick woman called to say she lost $3,000 and had "to call her ailing mother for the money."
A 23-year-old Baltimore man told of how he consistently took his fiancee's car, drove to Atlantic City and spent his monthly paycheck on poker. "His fiancee is thinking of canceling the marriage in the interest of her own survival," the operator reported.
Determining how much money a state should allocate for treatment is an inexact science. Experts study several factors called "social costs" to calculate what a problem gambler's job woes, bad debts and crimes cost government and society.
"There are no definitive numbers" for any of these costs, said Christine Reilly, executive director of Harvard Medical School's Institute for Research on Pathological Gambling and Related Disorders. "We don't know enough about the disorder to even treat it properly."
That doesn't stop people from trying.
The National Gambling Impact Study Commission in 1999 estimated that pathological gamblers cost the nation $5 billion a year. Dozens of professors have also estimated the yearly costs of one pathological gambler on their state -- from $6,299 per year in South Carolina to $19,000 in southern Nevada. The costs vary widely for several reasons, including the different types of gambling offered and accessibility to those venues.
Maryland's Department of Legislative Services said the state's population of pathological gamblers could be 70,412. The social costs that may come with slots could reach $29 million when those gamblers, and thousands more at risk, end up in jail, court and treatment.
Gambling industry officials point out that gambling also offers many employment benefits for communities. In Maryland, slots would garner $643 million for the state's education trust fund, according to Ehrlich administration estimates.
Still, Frank Fahrenkopf, president of the American Gaming Association, agreed that governments should help aid treatment. "If you decide to add a different type of gambling to your state agenda, you should make sure that there is some provision to put money aside for counseling and treatment for that 1 percent" who are problem gamblers, Fahrenkopf said.
The state of Delaware uses 1 percent of its take on gambling revenues for that, said Linda Graves, deputy director of the Delaware Council on Gambling Problems. The council spent $1.25 million last fiscal year for an in-state phone line and counselor training. The grant also pays for 20 free therapy sessions for problem gamblers.
Nearly 180 clients -- some sneaking in from Maryland -- have been helped. The Delaware council has even hired Franklin, of Maryland's council.
"It's pathetic," Graves said. "Joanna is one of the best trainers in the country, and she doesn't have the money to help the people in her own state."
Sun staff writer Michael Dresser contributed to this article.