AS VEGAS — What happens when scientists who study gambling addiction descend on a casino-sponsored medical conference?
I went to the Las Vegas Strip to find out.
It wasn’t your typical Sin City trip. Upstairs, in the Venetian and Palazzo casinos, slot machines whirred and roulette wheels spun. In our conference room, meanwhile, researchers debated diagnostic categories and pondered brain scans. At one point, they all closed their eyes for a group meditation.
The conference this week was shadowed, of course, by grief and shock at the mass shooting that left 59 people dead and more than 500 injured at a country music festival just a couple miles down the street.
But attendees tried to focus on the meeting’s goal: Finding ways to help the 1 percent of adults in the U.S. thought to have a gambling disorder, including withdrawal symptoms when they try to cut back.
The National Center for Responsible Gaming, which is funded by leading casinos, has organized the conference for the last 18 years. The industry’s role was hardly a secret. The company that operates the Venetian and the Palazzo sponsored a poster session. The company that runs Caesars Palace sponsored a refreshment break. And MGM sponsored a lunch.
This two-day conference drew about 200 treatment providers, academics, regulators, and casino operators from across the world.
Here, some of the most intriguing questions they raised:
1. Do women gamble differently as their hormones fluctuate?
In one study presented at a big poster session, Canadian researchers asked women to self-report on their gambling behavior at different points in their menstrual cycle.
Turns out, the subjects reported spending more time — and money — gambling while they were ovulating. They also drank more while gambling.
Kayla Joyce, a masters student in psychiatry research who led the study, said she hoped the research would eventually help women with gambling disorders by targeting specific treatments to them at different stages in their menstrual cycles.
2. Do we offer enough support to people with gambling disorder?
The consensus here was resounding: No.
In New Hampshire, for example, the state’s two-year-old hotline for problem gamblers sends calls to just one place: the cell phone of Ed Talbot, the 75-year-old head of state’s commission on problem gambling.
“We have very little funding and resources for gambling problems,” said Heather Gray, a gambling researcher at the Harvard-affiliated Cambridge Health Alliance.
3. Is gambling research rigorous enough?
On this question, red flags abounded.
Luke Clark, a gambling researcher at the University of British Columbia, cited a systematic review published earlier this year that looked at the methodological rigor of more than 2,500 studies on gambling conducted over more than five decades.
The researchers found that just six of those studies were conducted in real gambling environments with real gamblers, used a control or comparison group, evaluated participants over time, and used a validated measurement scale.
“If we’re trying to evaluate [responsible gambling] tools, we need to get our hands dirty and get out there into the field,” Clark said. “So I like to think of this paper as a sort of warning message to us as a field, and hopefully one that will encourage some self-reflection and self-appraisal going forward.”
Much of the research in the field is funded by the casino industry. NCRG, the group that puts on the conference, has handed out $18 million in research grants over the past two decades, including about $500,000 last year, according to Christine Reilly, the group’s senior research director.
Dr. Marc Potenza, a Yale psychiatrist and one of the top researchers on gambling disorder, called the NCRG the field’s version of the National Institutes of Health — with a lot less money, of course. (Potenza has received funding from the NCRG and also consults for a number of drug makers.)
4. Can we use animal models to study gambling?
Given how rarely these studies use real gamblers in real casinos, this is an important question.
In one of the studies presented at the poster session, lab rats stood in for gamblers. Here’s what the researchers did: They trained rats to recognize that if they pressed one lever (a safe option), they’d always get one sugar pellet and hear a neutral sound. If the rats pressed a different lever (a risky option), they’d either get two pellets and hear a rewarding “ding! ding! ding!” sound — or get no pellets at all and hear a sad sound. Then, the researchers played the different sounds before the rats made their choice and watched what happened.
It turned out that the “ding! ding! ding!” sound made rats more likely to make the risky choice.
Next, the researchers turned to optogenetics. They injected a virus into the brains of the rats and shined a laser light to inhibit neurons in the part of the brain that’s central in rational decision making. It turned out that when the rats had this part of their brain inhibited, they were more likely to make the risky choice.
The hope? That understanding how rats behave in casino-like settings can inform efforts to help people, said Charlotte Freeland, a Ph.D student in biology at Wesleyan University who led the study.
5. Do gambling researchers hit the slots when given the chance?
Not so much.
One attendee said she’d allocated herself a nightly $100 entertainment budget to spend on the casino floor. She was down $200 after two nights, but she was expecting that, she said.
But most of the attendees interviewed by STAT said they were steering clear of slot machines and card games.
Sara McMullin, a cognitive neuroscience Ph.D student at Saint Louis University, said an academic mentor had given her $10 to gamble — but she was thinking about spending it on an overpriced Americano coffee instead.
Potenza, the Yale psychiatrist, said he’d be skipping the casino because he finds gambling to be “a little anxiety-provoking” and would rather use that money for a nice dinner.
“When you study gambling,” said Gabriel Brooks, a Ph.D student in clinical psychology at the University of British Columbia, “it sometimes takes the fun out of it.”