Two years ago, Garnet Rhyno, a
young husband and father from Bedford, NS, took his
own life after struggling with an all-consuming addiction
to video lottery terminals (VLTs). "Like many others
with VLT addictions, his started with innocently dropping
some quarters in a corner store machine, not realizing
it would take his life," said his wife Sherry, who is
now campaigning with other families blighted by the
machines to have them banned.
Mr Rhyno's death shines a glaring
spotlight on the dark side of gambling. In his singular,
final act, the link between gambling and suicide seems
undeniable. He even left a suicide note for his wife
in which she says he made it clear he was ending it
all because of his addiction. Yet, she says no one investigating
his death made the connection between his suicide and
gambling.
Many experts think these suicides
are slipping under the radar right across the country.
Some even say the provincial governments, hooked on
gambling revenues, prefer it that way.
It wasn't meant to be like this.
At a meeting of the Intergovernmental Conference of
Chief Coroners and Chief Medical Examiners in June 2003,
an agreement was made that all provinces would begin
tracking suicides caused by gambling. Most provinces
complied, but in BC and PEI tracking of gambling deaths
by the coroners' offices is still not standard protocol.
Nova Scotia began tracking but stopped in 2004. According
to Jeff Dolan, assistant deputy chief coroner for BC,
the coroner's office considers the involvement of gambling
an important factor for consideration in a death from
suicide. "It's important to identify stressors in a
person's life. In some cases, gambling has been identified
as one, along with other issues. It's very rare that
there's just one stressor involved in a suicide." PEI
Chief Coroner Dr Charles Trainor agrees, saying his
office often considers gambling as a cause in a suicide
investigation, but it's not a hard and fast rule they
follow.
Indeed, pathological gamblers often
cultivate more than one vice. Data from the 2006 Canadian
Community Health Survey show that 2% of Canadians are
moderate/high-severity problem gamblers. Additionally,
comorbidity with other problems is common, such as mood
and anxiety disorders, or alcoholism. However, Jack
Smith, of the Canada Safety Council (CSC), points out
that suicides are more common in pathological gamblers
than they are in other addictions.
TIP
OF THE ICEBERG
Given this added degree of gravity of pathological gambling,
whose DSM IV diagnostic criteria closely resemble those
for alcohol and drug dependence — including signs
of cravings, tolerance and withdrawal — the concern
of some for the gambling factor in suicide cases comes
as no surprise. "There are over 200 gambling-related
suicides per year in Canada and this is, if anything,
an underestimation," says Mr Smith. "Don't forget that
for every suicide there may be five other people turning
up in the emergency room with self-inflicted injuries."
According to Mr Dolan, five BC
suicide cases have been confirmed as gambling-related
since 2004. He insists his office takes the issue seriously.
"We're not specifically tracking gambling, but are currently
developing a new protocol to have a more standardized
approach to investigating suicide in general." He doesn't
expect gambling-related suicide numbers to increase
with the new investigation protocol, but says better
record-keeping, including details on the type of gambling
involved, should follow.
BROADER
IMPACT
As with other addictions, problem gambling brings on
social turmoil, poverty, physical neglect and poor eating.
An article published in the April 21 BMJ stresses
that governments need to better assess the implications
of any increases in gambling accessibility.
Dr Christiane Poulin, MD, Professor
and Canada Research Chair in Population Health and Addictions,
couldn't agree more. In a recent CMAJ article
she highlights the disproportionate representation of
problem gambling in already-disadvantaged groups.
Many are quick to point out the
conflicted position of provincial governments, which
both regulate and profit from the 'gaming' industry.
The nation-wide profits from these so-called "voluntary
taxes" are $12 billion annually, according to StatsCan.
Sol Boxenbaum, CEO of a non-profit organization dedicated
to assisting problem gamblers, suggests that governments
might not want to know everything about the impact of
gambling on suicide and health.
"We need a much stronger social
commitment to gambling addiction, but we don't have
the data," says Mr Smith. "What we're trying to do at
the CSC is promote a culture of responsibility."
MIXED
MESSAGES?
This isn't to say that nothing has been done. The provinces
dip into their gambling profits to fund addiction awareness
campaigns and counselling programs (you might catch
the TV spots running alongside ads for the newest scratch
cards). Ontario has even put an addiction treatment
kiosk in at least one of its casinos, and Alberta has
a similar pilot project in two of its casinos.
But Dr Poulin says these campaigns
are wrong-footed. "They place the onus of self-control
on the shoulders of the very individuals who have a
serious disorder of impulse control," she writes in
the CMAJ. She'd prefer to see shifts in public
policy, specifically strict restrictions on VLTs and
a moratorium on new casinos.
These policy shifts can make a
difference, argues Dr Poulin. She cites the 30% reduction
of VLTs in Nova Scotia in 2005 as an example. While
the province lost $15 million in VLT profits —
a decrease of 11.4%, Dr Poulin says the effort's been
successful and cost-effective, noting that policies
don't have to be continually funded like ongoing campaigns.
Newfoundland is currently rolling
out a similar plan, which includes a more modest 15%
reduction of VLTs over five years. They'll also slow
down the play and flashing lights on the terminals,
which are thought to contribute to VLTs' reputation
as the "crack cocaine" of gambling. Gary Parsons, a
St John's gambling addiction counsellor, says about
90% of his clients are hooked on VLTs. He adds that
he's heard anecdotally of at least 15 VLT-related suicides
in Newfoundland in the past year. "The other problem
for gamblers is, if you're trying to get away from the
machines, there's no place to go," he told the Globe
and Mail. "You go to a restaurant, they're there. You
go to a dance, they're there. The mall, they're there."
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