Although Utah theoretically outlaws all gambling, studies suggest the state still may have 20,800 to 88,000 "problem gamblers" — people who do not responsibly control their wagering. Problem gambling can bring extra crime, divorce, suicide, bankruptcy and other social ills.

No formal study has been conducted that enumerates how many problem gamblers live in Utah or counts their social costs. However, extrapolations can be made from studies conducted nationally and in neighboring states; from professionals and groups who help local addicts; and groups that deal with resulting financial and family problems.

The fact that Utah could have problem gamblers — despite its gambling ban — is not a surprise. A new Deseret Morning News/KSL-TV poll by Dan Jones & Associates shows that 75 percent of Utahns say they have gambled in their lifetimes; 45 percent of those gamblers have wagered on games within the past year.

Gambling is available at casinos, race tracks and lotteries just over the state boundary; at bingo and poker clubs in Utah, which may or may not be operating legally; and on the Internet.

While other states usually set aside a portion of their gambling earnings to treat problem gamblers, none of that flows back to Utah when its problem gamblers return home or when they gamble illegally.

Gambling 'addicts'

Most gamblers consider the games to be a form of entertainment and do not descend into a financial and behavioral morass. However, if studies about Americans and nearby states are a guide, somewhere between 1.3 percent and 5.5 percent of Utah's adults could have serious gambling problems.

Three key national studies — by the National Research Council and the National Opinion Research Center in 1999, both for the National Gambling Impact Study Commission, and by Harvard Medical School in 1997 — provide estimates of out-of-control "pathological" gamblers and less-serious "problem" gamblers.

Most gamblers are neither. Pathological gamblers are essentially addicts. Problem gamblers may not be addicts, but they show some or many of the symptoms that pathological gamblers exhibit.

Dr. Michael Kalm, president of the Utah Psychiatric Association, believes that gambling can be as real an addiction as cocaine or alcohol.

The difference, he said, is the mechanism of action, because it doesn't start with ingesting a chemical. In addicts, the pleasure centers of the brain, the dopamine receptors — which are "behind virtually all addictions," he says — light up. When they are overstimulated, they burn out, requiring more and more to get a similar kind of pleasure. And a problem is born.

The behavior similarities are striking.

"The lies you tell to maintain the addiction. The havoc it creates on families, work environments; the lying, stealing, anything to support it. It becomes god, paramount, and you have to do it," Kalm says.

Also like other addictions, kicking it can be brutally hard. Gambling also comes with "triggers," certain situations or locations. And the other commonality, Kalm says, is the tendency to think that "just a little bit" won't hurt. " 'One sip of this wine won't hurt me.' And they're gone. Passing through the airport in Las Vegas, 'Playing one quarter won't matter.' And they're gone."

The national studies estimate the percentage of American adults who have been pathological gamblers sometime in their lives is between 1.2 percent (in the NORC study) and 1.6 percent (in the Harvard study). They say those who were pathological gamblers during the year the studies was conducted ranged between 0.6 percent (NORC) and 1.14 percent (Harvard).

They estimate the additional percentage of Americans who have been less-serious "problem" gamblers sometime in their lifetimes between 1.5 percent (NORC) and 3.9 percent (NRC). Those with such problems in the "last year" range between 0.7 percent (NORC) and 2.8 percent (Harvard).

Utah's adult population is about 1.6 million. So, if Utahns are like average Americans, the studies suggest that up to 25,600 Utahns are or have been pathological gamblers. As many as another 62,400 have been less-serious problem gamblers.

If the national studies serve as a guide, as many as 88,000 Utahns, or as few as 20,800, have serious gambling problems. Of note, the studies say problem gambling tends to increase as gambling opportunities are more easily available.

Studies about some nearby states — where legalized gambling is more readily available — say problem gambling rates there are sometimes higher and sometimes lower than national averages.

A 2001 study for Nevada, which legalizes most forms of gambling, says 6.4 percent of its adults are "current" pathological or problem gamblers, a figure higher than the 1.3 percent to 5.5 percent average nationally.

A 1997 study for Colorado, which has a state lottery, pari-mutuel betting and limited casinos, indicated 4.4 percent of adults there are "lifetime" pathological or problem gamblers, and 2.5 percent are "current" problem or pathological gamblers.

A 2003 study for Arizona, which has a state lottery, pari-mutuel race betting and Indian casinos, showed 2.3 percent of its adults are "current" pathological or problem gamblers.

Addiction's effects

Gambling is not something that Utah addiction specialist Dr. Michael Measom sees often. And he suspects one reason is that gamblers don't view it as an addiction, and they tend not to seek treatment.

But it "certainly makes changes in the brain pattern," just like other addictions, says Measom, one of three addiction psychiatrists in Utah and the medical director of the alcohol and drug unit at Valley Mental Health.

Not everyone who gambles is an addict, just as not everyone who drinks is an alcoholic. But gambling can be an addiction. And like any other addiction, it stimulates the reward center in the brain.

Someone who becomes addicted to gambling may have a genetic predisposition to an addictive disorder, just like an alcoholic, who may be more at risk for addiction to alcohol but is also at risk for other addictions, as well.

Mostly, in Utah, he said, where a "white, Mormon culture is not allowed to drink or smoke, etc., they may not view this as the same category, as an addiction," Measom says.

"But like other addictions, gambling can cause problems at home, at work, with avoiding responsibilities; it can create financial problems. And it can generate withdrawal symptoms, with varying levels of severity."

That is, in fact, one of the measures of whether gambling has become an addiction, says Kalm. The difference is not the person or the drug — and for an addict, gambling acts as a drug — but rather the relationship between one drug and one person.

"When someone can have a stable relationship (with gambling), where they maintain full functionality, are physically healthy and have good family, friend and work relationships, they are not in a situation of abuse, dependence or addiction," Kalm says. "But if they are unstable and use more and more or have serious effects from using just a little, it is an abuse-dependent relationship."

In other words, an addiction.

When Measom has been consulted about gambling, the problems generated are typically financial, or involve difficulties with work or in family relationships, he says.

While gambling opportunity is readily available via the Internet, pornography is the more common Internet-generated addiction he sees.

Unlike addictions to drugs or alcohol, which can severely impact a person's behavior, "these people are relatively high functioning and do not suffer consequences until later on. But eventually they get caught up in it."

One thing is clear, Measom and Kalm agree: Someone who has become hooked on gambling needs psychiatric, social, behavioral and spiritual support to successfully stop, just as someone addicted to drugs or alcohol or nicotine needs that support. It is rare that doing it all oneself cures an addiction, Measom says.

"Sometimes they are church things, treatment programs, therapy. It doesn't matter as long as something is in place," he says. Family support is important, but it's most effective when relatives become involved in programs like Al-Anon and learn how to help, rather than trying to do their own thing.

Giving someone who is addicted to gambling a lot of money, perhaps to resolve their financial problems and telling them "you have to promise not to do this any more" is not the way to help, he says.

For people with a gambling addiction, someone who is more than a casual gamer, the act of betting provides a temporary relief. "You can say you're feeling depressed, want to feel better and trying to win provides that."

Stigma is a major barrier for gamblers who have gotten out of control and need help. "These things are pretty hush-hush," says Measom.

"The culture around here is that addiction is a moral illness, not a biological illness." That's different in some other places, such as the European approach to an alcohol addiction. "You could get the same kinds of intervention with gambling, but I can't think of anyone that's an intervention specialist" for gamblers, he says.

Gambling's costs

The National Gambling Impact Study Commission said in 1999 that while studies disagree on how many problem gamblers there are, "all seem to agree that pathological gamblers engage in destructive behaviors: They commit crimes, they run up large debts, they damage relationships with family and friends, and they kill themselves."

The National Opinion Research Center estimated in 1999 that "the annual average costs of job loss, unemployment benefits, welfare benefits, poor physical and mental health, and problem or pathological gambling treatment is approximately $1,200 per pathological gambler per year and approximately $715 per problem gambler per year."

It figured that amounted to $5 billion to $6 billion a year nationally. When those numbers are extrapolated using maximum estimates of problem gamblers in Utah, the costs in here would be about $75 million a year.

Those numbers should be considered minimums, according to the National Gambling Impact Study Commission. It said the NORC study focused on "a small number of tangible consequences" and "did not attempt to estimate the financial costs of any gambling-related incidences of theft, embezzlement, suicide, domestic violence, child abuse and neglect, and the non-legal costs of divorce."

It noted that the $5 billion to $6 billion a year in costs from problem gamblers "appears smaller than the impacts of such lethal competitors as alcohol abuses (with an estimated annual cost of $166 billion) and heart disease ($125 billion)."

Impacts range from mental health issues to personal financial distress. They include:

Suicide and mental health: About 1 of every 5 pathological gamblers attempt suicide, according to a 1997 report by National Council on Problem Gambling. It also says the actual suicide rate for them is higher than for any other addictive disorder.

That means if Utah has between 19,200 and 25,600 "pathological" gamblers, as suggested by national studies and U.S. Census data, then 3,840 to 5,120 of them would attempt suicide sometime.

The National Gambling Impact Study Commission also said that a survey of 400 Gamblers Anonymous members showed two-thirds had contemplated suicide, 47 percent had a definite plan to kill themselves, and 77 percent stated they have wanted to die.

The Arizona Office of Problem Gambling said that among gamblers who sought help from it, 40 percent reported considering suicide. It said 5 percent had planned suicide, and 3 percent had attempted it.

The Arizona office also says that among gamblers who sought help to battle their problems, 33 percent suffered depression and 10.4 suffered from anxiety. It said 41 percent had a history of emotional abuse, 27 percent had a history of physical abuse and 19 percent had a history of sexual abuse.

Divorce and abuse: The survey of Gamblers Anonymous members also reported that 18 percent said they had a gambling-related divorce, and another 10 percent were separated as a direct consequence of their gambling.

The National Opinion Research Center study in 1999 said that 53.5 percent of identified pathological gamblers reported having been divorced, compared to 18.2 percent of non-gamblers and 29.8 percent of low-risk gamblers.

The National Research Council says studies show that between 25 percent and 50 percent of spouses of compulsive gamblers have been abused.

Substance abuse: The National Gambling Impact Study Commission says that estimates of the incidence of substance abuse among pathological gamblers ranges from 25 to 63 percent, and it said people admitted to chemical dependence treatment programs are three to six times more likely to be problem gamblers than are members of the general public.

The North American of State and Provincial Lotteries also says at its Web site, "In several studies approximately 50 percent of problem gamblers were found to also have drug or alcohol problems, while studies of people in treatment for substance abuse have found between 10 and 30 percent also having a gambling problem."

The same group says, "Various studies have found high rates of alcoholism, depression, anti-social personality disorder, mood disorders and other conditions in pathological gamblers, leading some researchers to suspect that problem gambling is often a symptom of an underlying condition."

The Arizona Office of Problem Gambling says many of its clients have showed signs of various other compulsive behaviors, including 32 percent with tobacco; 31 percent with alcohol problems; 22 percent with drug problems; 17 percent with food compulsions; and 11 percent with shopping compulsions.

Debt and bankruptcy: Gambling debt doesn't appear to figure significantly into Utah bankruptcy filings.

"My rough and dirty guess would be 5 percent to 6 percent (in which) gambling is a significant factor," said Duane Gillman, an attorney and bankruptcy court trustee.

"Is it a big deal among other factors? No, it is not. It's not like tapped out health insurance," which accounts for about 30 percent of filings.

The National Opinion Research Center in 1999 said 19.2 percent of the pathological gamblers identified in its research reported filing bankruptcy, compared to rates of 4.2 percent for non-gamblers and 5.5 percent for low-risk gamblers.

The National Gambling Impact Study Commission said a survey of 400 Gamblers Anonymous members showed that 22 percent of them had declared bankruptcy.

The Arizona Office of Problem Gambling said in a recent report that among gamblers who sought help from it, 24 percent had filed bankruptcy.

"It's definitely a problem in other states," said Jean Lown, a Utah State University family and consumer studies professor who specializes in bankruptcy. "I get the sense it's not a big deal in Utah."

Local bankruptcy attorneys say they don't often have chronic gamblers as clients.

Draper lawyer Russ Blood said he could only think of one in 22 years of practice. But, he adds, people aren't anxious to report gambling debt, even when filing for bankruptcy.

"I don't think it's something people would be proud to 'fess up to," he said.

Whether any monetary loss was due to gambling is among a list of questions filers are required to answer on paper as part of a bankruptcy case.

Attorney Justin Burton files 80 to 90 bankruptcy cases a month. He said he sees a chronic gambler every couple of months. They typically file Chapter 13 and set up a repayment plan, he said. Until lately, they all were Nevada casino gamblers. But one recent client, a 40ish woman, ran up an $80,000 tab playing online.

Gillman says those who do admit a gambling debt are almost always what he calls "working class" gamblers, not high rollers. Typically they are men and women who spend a quarter of their $40,000 annual income on gaming.

"They're your poor but honest debtors," he said. "They're weekend gamblers in Wendover. They're weekend gamblers in Mesquite."

When gambling has led to a client's financial destruction, Gillman said he hands them a card for Gamblers Anonymous.

Midvale attorney Phillip Dew recently had a man come to him wanting to file bankruptcy.

Though unemployed for a year, the man had a "wonderful time" running up a $160,000 casino debt. Dew refused to take the case.

"I told him there's no forgiveness for that in this world or in the next world," he said. "Judges don't look too kindly on people who run up credit card charges on frivolous things."

Dew files about 40 personal bankruptcy cases a month. Only one so far this year has involved gambling.

Part of the reason for lower rates in Utah may due to the fact there is no legalized gambling in the state.

A Creighton University study released in April found that personal bankruptcy rates increase over time in counties with casinos.

Though rates drop slightly and level out after a casino first opens, they go up 2 percentage points annually over nine years compared to counties where there is no gambling.

The U.S. Department of the Treasury investigated the issue at the request of Congress and released a report in July 1999 finding "no connection between state bankruptcy rates and either the extent of or introduction of casino gambling."

Credit issues: The Deseret Morning News contacted local debt reduction and credit repair services listed in the Yellow Pages to seek their estimate of how many of their clients had financial problems that resulted, at least in part, from gambling.

They estimated that between 1 percent and 5 percent do.

"We estimate it to be between 4 and 5 percent, but that is a self-reported number," said Preston Cochrane, executive director of the AAA Fair Credit Foundation.

"Some may have an addiction to gambling and not disclose that to us," he said.

Estimating that gambling may be less of a problem is Mike Peterson, vice president of the American Credit Foundation. "We've not run into that (gambling-related debts) an awful lot. It may be in the 1 percent range. It's not as prevalent here as in other states," he said.

Several newspapers nationwide have reported in recent years that debt reduction services in their areas often estimate that about 5 percent of their clientele have debts that resulted at least in part from gambling.

Of interest about financial problems by gamblers in a nearby state, the Arizona Office of Problem Gambling said in a report about gamblers who sought help from it that 12 percent had automobiles repossessed and 11 percent had lost homes. It said 88 percent had debts of more than $10,000 — and 10 percent had debts of more than $100,000.

The National Research Council reported in 1999 that "roughly one-fourth to one-third of gamblers in treatment in Gamblers Anonymous report the loss of their jobs due to gambling," while the Arizona Office of Problem Gambling said that among gamblers who sought help from it, 21 percent were actually unemployed.

The homeless: The National Gambling Impact Study Commission said that in a survey of 1,100 clients at Rescue Missions across America, 18 percent cited gambling as a cause of their homelessness.

It said that interviews with more than 7,000 homeless people in Las Vegas showed 20 percent reported a gambling problem. But the commission added, "Whether this is caused by gambling or by other factors related to addictive behavior is unclear."

Resorting to crime: Several national studies have linked pathological gambling to increased crime.

As the National Research Council wrote in 1999, "As access to money becomes more limited, gamblers often resort to crime in order to pay debts, appease bookies, maintain appearances and garner more money to gamble."

In the survey of 400 Gamblers Anonymous members, 57 percent admitted stealing to finance their gambling. They reported stealing an average of $135,000 each.

The National Opinion Research Center said in 1999 it found that a third of problem and pathological gamblers had been arrested at some time, compared to 10 percent of low-risk gamblers and 4 percent of non-gamblers. Further, it said 23 percent of pathological gamblers had been imprisoned at some time, as had 13 percent of problem gamblers.

The Arizona Office of Problem Gambling reported that of gamblers who came to it for help, 38 percent had written bad checks and 14 percent had committed other thefts or embezzlement.

In nationwide hearings in 1998 and 1999, the National Gambling Impact Study Commission heard testimony about crime by pathological gamblers that included some shocking examples.

In one case, a Detroit man faked the kidnapping of his son to pay a $50,000 gambling debt.

An Iowa hospital employee embezzled $151,000 for gambling.

And a Louisiana man robbed and murdered six elderly people to fund his gambling.