POINT OF VIEW/ Hosei Hahakigi: Ignoring ills of gambling addiction a risky bet

Addiction to gambling is an illness officially known as "pathological gambling," an internationally recognized designation. Despite the critical nature of the illness and the serious effects it has on those close to the sufferer, few other diseases are as disregarded as pathological gambling by both the psychiatric medical society and the administration, compared with other diseases.

U.S. diagnostic criteria officially recognized pathological gambling as a mental illness in 1980. The World Health Organization also classified it as a disease 15 years ago. The prevalence of pathological gambling in industrialized countries is between 1.5 percent and 2.5 percent among adults. In Japan, too, an estimated 1.5 million to 2 million people suffer from the disease.

The shockingly large number of patients is not so surprising given the fact that the Japanese gambling industry is worth between 30 trillion yen and 40 trillion yen a year, which is more or less the same as Japan's overall medical expenses.

In the last two years, 100 new patients visited my clinic. The average amount they spent on gambling up to the time they sought medical treatment was 14 million yen. Most of them had debts with consumer finance companies and quite a few had even borrowed money from loan sharks. A quarter of them had taken some measures to reduce their burden from debts before seeking treatment. It is my guess that pathological gamblers make up 30 percent of multiple debtors.

Slightly more than 80 percent of pathological gamblers who came to my clinic exclusively played pachinko and slot machines. All of my female patients exclusively played such machines. In fact, patients who were not hooked on such machines accounted for less than 5 percent of all cases. This is not surprising, either, considering the fact that Japan has nearly 5 million pachinko and slot machines.

The total number of gambling machines in the world excluding those in Japan is half that figure. In Japan, playing pachinko and slot machines is not thought of as gambling, but rather, as a form of recreation.

Since it is not regarded as gambling, there are no rules to regulate it, unlike officially recognized gambling, and it goes practically unchecked.

The two major symptoms of pathological gambling are debts and lies. Every time families pay debts on behalf of a pathological gambler, the disease worsens. The patients tell every conceivable lie to their families and even cause them to become sick in some cases. The greatest misconception shared by both patients and families is the belief that the disease can be overcome by willpower and awareness by the sufferer.

In fact, the disease is not so simple. Since patients are obsessed with how to find money to pay their debts and satisfy the urge to gamble, willpower no longer works. Their characters also change and they refuse to see, hear and speak: They come to turn a blind eye to the reality they face; refuse to listen to others or speak their minds; and lose their humanity.

Even if their debts are adjusted, unless they receive medical treatment, their gambling habits are sure to eventually resurface.

At a time when there are no effective drugs to cure the disease, the most helpful therapy is for sufferers to attend self-help (mutual-aid) group sessions at least once a week and visit a doctor once a month. One of the best-known self-help groups is Gamblers Anonymous (GA).

If patients stick to this regimen, they will get better without fail.

Unfortunately, however, only about 70 GA groups are active in Japan. Ideally, I believe there should be one GA to every city across the nation, and one to each ward in ordinance-designated major cities.

Psychiatrists, who should be taking the lead in providing diagnosis and treatment, are also showing little interest in the gambling problem. Unless all psychiatrists develop the ability to deal with the disease effectively, there is little hope for patients and families to see a light at the end of the tunnel.

It is also time for the administration to implement necessary measures, instead of averting its eyes from the harsh reality.

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The author is a writer and a psychiatrist. (IHT/Asahi: July 11,2008)