Interview with Peter Ferentzy, PhD (Part 2 of 5)

SBO.net interview with Peter Ferentzy, Ph. D, about gambling addiction, changes and trends within the gambling world. (Part 2 of 5)

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Peter continues on below talking about how gambling and substance abuse many times go hand in hand, unbeknownst to the addicts themselves.

GAMBLING AND SUBSTANCE ABUSE

Peter Ferentzy:  Sometimes gambling is also very hidden.  Sometimes people are more, people have a drug problem, and this is something that we, when we did a study of gambling and the crack users of downtown Toronto, some others aside Flora Matheson did this.  Many people were simply unaware of the problem gambling that occurs among these people, but it does occur.  But many people, even front line people, would say, “No, there’s not much gambling going on, nothing to mention.”  I would have to emphasise that it’s not, it’s not in absolute dollars and cents, but it’s in relation to how much you can afford.

If somebody regularly takes a pass on cigarettes, bus fare or just a sandwich in order to buy scratch tickets for some kind of instant win, then we can call that a gambling problem, whereas a pro athlete could spend $10,000 in a night and we might not call it a problem, but the gambling among many of these crack users is compulsive, and often they’re gambling because they’re hoping to get up $40, $50 together just so they can buy a little bit of dope to get through the next hour.  But it seems to be hidden.  It’s overshadowed by the substance use, and we found that we were uncovering gambling problems all over the place, and I’m not a professional denial sniffer.  I’m not looking for trouble where there isn’t any, but there was really a lack of awareness.

SBO.net: Was there a lack of awareness amongst the drug users themselves?

Peter Ferentzy: We would ask them questions, questions that don’t lead, but just questions that would make them think, and by the end of the interview many of our participants were saying, “I never really thought about how much I gambled.”  One woman said, “It’s just occurring to me now that almost every time I smoke crack, the dope is being scooped up with a scratch ticket or something, because there’s always lottery paraphernalia all over the crack places.”  She had never thought about that before, but she reflected upon it during the interview.

SBO.net: So are they closely linked in the way they affect the mind?

Peter Ferentzy: Yes.

SBO.net: Is it that gambling is closely linked with substance abuse, or is it that substance abuse is closely linked with gambling?

Peter Ferentzy: Well, both, both. Look at it this way, a drug can only act upon systems that are already present in your brain.  It cannot create a system.  It’s not like that, so opiates, cocaine and stimulants like cocaine will act upon your neurons, it will act upon your synapses and you will get certain highs.  There’s a hijack brain theory of drug addiction.  The idea is that when drugs enter your system they hijack natural, well, the systems associated with natural pleasures, sex, food, fun, things like that.  The drugs will hijack these systems and play upon them.  Gambling can have a very similar effect to drugs.  Some gamblers who quit cold turkey have been known to experience the shakes, diarrhoea, sometimes you would look at them and you would not be able to tell which one is the junkie kicking the heroin and which one is the gambler kicking the gambling, because the symptoms are very similar sometimes.

SBO.net: Is that the gambling has the same effect on hormones in the body or different functions in the body?

Peter Ferentzy: Yes, all of that. You get to a point where there is only one thing that takes you to a place where you feel blurred.  Maybe that’s your beer, maybe that’s your vodka, maybe that’s your shopping, maybe it’s your gambling, but for whatever reason, with you that one poison is the one way you have a feeling good, a feeling whole, and you’ve been dependent on it for years.  If somebody takes that away your system will collapse.  You might sweat, you might shake, you might vomit, you might experience diarrhoea, and there are times when withdrawal from a purely behavioural addiction has the same kind of symptoms that you see as marked in withdrawal from a chemical addiction.

SBO.net: So, is gambling then, would you consider gambling addiction to be genetic or would it be a learned behaviour or how would somebody become a gambler as opposed to-?

Peter Ferentzy: Okay, okay, the answer to questions like that is that genetic determinants play a role, but genetics can never explain everything.  Nobody is genetically hardwired, doomed to becoming an alcoholic or a compulsive gambler, but some are at higher risk than others and Alexander Blaszczynski has done work on this.  Now, there’s, he has offered a pathways model of gambling, of problem gambling, so that there are different types.  With some pathological gamblers the genetic or the biological determinants are more significant.  For others it’s more of a learned behaviour.  In every case it’s going to be a mix of all of those things.  Sorry I can’t give a final answer, but it’s always a mix of that.

GAMBLERS AND DRUG ABUSERS CHASE THE ORIGINAL HIGH

SBO.net: No, of course not. But in terms of, learned behaviour, I would have thought substance abuse would have been more a form of escapism in a way. You’re saying with gambling they’re actually chasing something?

Peter Ferentzy: They are chasing.  They are chasing.  The substance user is chasing the original high.  The gambler might also be chasing the original high, but on top of that the gambler is chasing the money he lost.  It’s a different kind of chasing.  Gamblers chase in two ways.

Nobody, yeah, nobody smokes a bunch of crack thinking, “I’m going to get my money back that I wasted on crack because I’m smoking this crack,” but a gambler really thinks that he might get his money back, the money he wasted.

SBO.net: So how is it possible to change the thought processes and activities of an addicted or a pathological gambler, curing them, per se?

Peter Ferentzy: Well, cure is a big word.  I don’t know, some people consider addictions to be lifelong.  That’s probably not true, but the truth is that, all psycho behaviour disorders are chronic in the sense that if you’ve ever been there before you’re at higher risk than average for going there again.  How do you cure a compulsive gambler?  It’s person specific.  A lot of people grow out of their addictions over time and many in the treatment industry don’t want you to hear this, but often when people go to treatment and they get better, they’re getting better because they’re ready to change; it’s their time, and the treatment itself is peripheral to the change.  We’re starting to understand this more and more.

For instance, a long time ago if you had the flu, you were living in a time when we didn’t understand that the flu just runs its natural course.  You have the flu, you go to your doctor, the doctor gives you this or that, he might even bleed you.  Four or five days later your flu is gone and you think the doctor did it, you thank the doctor, you give him some money and you’re grateful.  In a similar fashion, people grow out of many of their behavioural disorders over time.  Often when people are ready to change they hit the treatment centres, and then the treatment people will get credit for cases of recovery that probably were on the cards in any case.  I’m an historian of addiction among other things and I’ll tell you that if you had a habit in 1905, before we had the 12 steps, before we had the treatment in place, your chances of kicking were about the same as they are today.  We’ve put a dent in it, but it’s a small dent.

SBO.net: And do you see this changing in the future or is it still the same attitudes or ideas that are prevalent within the sort of treatment community?

Peter Ferentzy: I think that treatment people understandably exaggerate their own importance, and that just simply means that they’re human.  What treatment can do is tweak a process that has its own life, give it a little nudge.  You can’t control the wind, but if you’re a good sailor you can use the wind and maybe steer the boat a little bit this way, but if you’re crazy enough to think that you control the current or you control the wind, you’re not going to get anywhere.

SBO.net: So they can only really assist the person in the decision they’ve already made.

Peter Ferentzy: Exactly, exactly.  It’s an organic change that happens over time.  It’s a natural process.  People grow out of, mature out of their addictions.  That’s the good news.  Over time people usually get better.  The bad news is they don’t get better when we want them to.  Somebody might get five, six years or ten years of slipping and sliding ahead of them and you can jump up and down, you can scream, you can smack them, but there’s not much you can do, except shove them in a trunk, tie them up.  Then they’ll stay clean.

SBO.net: (Laughs) Unless they get out….. 

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