With the depth of painful personal experience, Owen Baily explains why gambling treatment is still a lottery.
With sweaty hands, deep physical anxiety in my chest and a sense of panic, I committed to placing my last bit of money on the roulette terminal in the casino. With acute anticipation, I watched the ball spin chaotically around the wheel and waited for it to land. It landed, as the ball always eventually does, but not on a number I had placed the bet on. I lost, and I had no more money. Literally.
Right there and then, the emotional roller coaster of a journey I had been on for the past two months came to a sudden and abrupt stop and it hurt badly. I was winded. I couldn’t breathe. The panic turned to dread. Starting to comprehend what I had just done and not quite knowing what to do I walked, numb to my surroundings, out of the casino, completely consumed in a self-flagellating internal dialogue.
Two months earlier things couldn’t have been any better. Just a few days before Christmas I was in the same casino and had fulfilled a fantasy – I had had a ‘Big Win’. Confident, flush, feeling powerful and with the freedom of having so much money to spend, I had a very enjoyable Christmas.
It was not to last. I became intensely consumed with recapturing the potency of emotions attained by the ‘Big Win’ and I began to gamble as often as I could, dangerously and chaotically. For the next two months, my dopamine levels were experiencing unnatural and extreme peaks and troughs, ending abruptly with that moment when I placed my last bit of money on the roulette wheel and lost.
That experience was 17 years ago. I was 18. And the experience of the ‘Big Win’ and subsequent loss of all the money I had was, and said with no exaggeration, traumatic. I became depressed, with no confidence or self-esteem and even became suicidal. To cope I escaped and bought into the fantasy of going on a working holiday in Europe. I quit my job, left home, put my belongings in storage, bought my ferry ticket to Holland and went.
Naturally excited, I boarded the ferry, forgetting the past and looking forward to the adventure that lay ahead – except, when I explored the ferry, I came upon a roulette table. Unaware and unable to challenge the gambling thoughts and cravings, and despite my previous experience, I began to play.
A few hours later the ferry docked into the Hook of Holland. And again, I lost all my money. Only this time, I was in a foreign country, with no home and no job.
After spending a day talking to the British Consulate in Amsterdam, I was given enough money to travel back to the UK. Fearing being street homeless in London I got off the coach at Canterbury, Kent. I sought help from the nearest homeless shelter and with what I had just put myself through, I found a will to seek help to try to stop gambling.
But I came up against a problem. I realised that there was no accessible face-to-face support at all for those who have gambling problems. And what became evidently clear as well, was that knowledge and awareness around problematic and excessive gambling behaviour among staff was very poor, bordering on non-existent. Here I was, with a serious problem, desperately wanting help, but because there was no help and staff were unknowledgeable, I felt excluded and marginalised.
Unintentionally, and by some odd fortune, I developed an alcohol dependency. And straightaway, treatment options opened for me. I was referred to what was then a dedicated NHS alcohol Treatment service and periodically, for the next few years, I participated in a whole array of help and support that is commonly found in addiction treatment services. And because I was engaging in treatment, I was able to take a good look at my gambling behaviour too.
I managed very successfully to address my alcohol use and in a matter of months was able to get to a point where I was able to abstain – and I stayed stopped for four years. My gambling, however, persisted. I felt something was missing and I still felt marginalised. I wasn’t getting something from the all the treatment I was receiving through the alcohol service.
As with thousands of other people facing the challenges of overcoming addiction, I had a serious relapse – time for rehab. I began the search in October 2009 when I was 27 and come March 2010 I was walking up the drive to the therapeutic community where I stayed for 20 months. It was a therapeutically difficult and painful experience but one which I am so grateful for. But still I felt marginalised because I had a predominant gambling problem – and just as with my experience of the workers in the homeless hostel, I felt this recurring sense that awareness and understanding of gambling-related harm (GRH) was inadequately low.
Although I’d make positive advances in areas of my being and recovery, I struggled to maintain my 20-month abstinence from gambling, and relapsed.
This was when, after ten years of trying to get a handle on my gambling, I decided to approach the Central and North West London NHS Foundation Trust (CNWL) National Problem Gambling Clinic (NPGC) – currently the only dedicated NHS service that provides gambling-specific support. I self-referred and in a few weeks joined an eight-week cognitive behavioural therapy (CBT) course.
Unlike all the hours of CBT I had done previously, this course has been brilliantly modified and refined to meet the needs of individuals with gambling problems, just as the person with issues relating to alcohol or opioids needs tailored support. Furthermore, I was able to meet others like me and for the first time didn’t feel excluded or marginalised. I found the something that was missing. And I haven’t looked back.