Midwest Consortium on Problem Gambling and Substance Abuse: Upcoming Conference Celebrates 15 years

March 20, 2018

Carol Spiker, LAC, CPP, KCGC
Problem Gambling Program Manager
Behavioral Health Services Commission
Kansas Department for Aging and Disability Services

Gambling is an activity in which something of value is risked on a chance that something of value might be obtained, the outcome based on chance. Organized gambling has grown tremendously in the U.S. since the 1980’s because many people have been willing and eager to spend money in exchange for a chance at something bigger and better than what they have.  States have legalized and expanded gambling with the promise of substantial economic benefit and tax revenue.

Responsible Gambling Programs

March 13, 2017
Christine Reilly
Senior Research Director
National Center for Responsible Gaming

Warning messages on gaming machines. Self-exclusion programs. Programs to limit money and time spent gambling. These are just a few responsible gambling strategies in use around the world. Responsible gambling (RG) refers to programs that seek to prevent or reduce gambling-related harms. The impetus behind these programs derives from the public health shift from a reactive posture of trying to eliminate disorders that have already occurred, to a proactive force that seeks to promote positive health behaviors and prevent diseases before they emerge (or at least mitigate their effects).

Source: Independent Gambling Authority

The rise in responsible gambling strategies is a response to this trend of health promotion. Enacted in government regulations, as well as in voluntary programs developed by gambling operators, responsible gambling programs have proliferated in legalized gambling jurisdictions throughout the world. However, are these programs safe? Are they effective? A review of the scientific literature by the leading gambling researchers indicates a dearth of science-based, peer-reviewed programs in this area. Why is peer-reviewed research important? Quality research will answer questions about safety and effectiveness. For example, is self-exclusion an effective intervention? Are limits on time and money wagered safe or do they in some cases cause people to gamble even more than they intended? These questions must be answered to protect people and to ensure that the considerable expense of these programs can be justified as effective. Here a few examples.

March 13, 2018:
 Gambling Disorder Screening Day

Voluntary self-exclusion programs, typically operated by
casinos, online gambling sites and gaming regulators, give individuals the opportunity to exclude themselves from gambling opportunities. Typical programs remove the enrolled person from marketing databases. Some authorize staff to remove the enrolled person from the premises and to deny cash prizes to those on the self-exclusion list.

What the research says

Research indicates that self-exclusion is safe and, for some gamblers, an effective intervention. However, more research is needed to ascertain the long-range impact of the program and to determine the most effective features of the program. For example, it is not clear what the optimum time limit for the ban should be.

Another responsible gambling strategy is to educate gaming employees about responsible gambling and gambling disorder. Research indicates that employee training can improve employees’ knowledge of responsible gambling. However, there is no evidence that increasing knowledge among casino staff can help employees accurately identify casino patrons with a gambling disorder.

In conclusion, the field does not yet have a systematic approach for assessing the quality of research on RG. Instead, a haphazard approach to developing and adopting RG programs has characterized RG efforts. Policymakers and the gambling industry should take a cautious and conservative approach to RG until quality scientific research provides a roadmap to safe and effective programming.

Winning Reads for Problem Gambling Awareness Month

March 5, 2018
Maureen Fitzerald
ATTC Network Coordinating Office/NIATx

We've rounded up a few great resources to help you stay up-to-date on the latest in prevention, education, and treatment for problem gambling--not just during Problem Gambling Awareness Month, but year-round:

Everything you need to know about medications for treating opioid use disorders: SAMHSA TIP 63

February 20, 2018

Maureen Fitzgerald
ATTC Network Coordinating Office/NIATx

Finding the most up-to-date information on how to support people with opioid use disorder (OUD) just got easier with the release of SAMHSA's  TIP 63: Medications for Opioid Use Disorder.  An expert panel of researchers, policy makers, treatment providers, and others helped to develop TIP 63. 

Research supports the use of the three FDA-approved medications—methadone, extended-release naltrexone, and buprenorphine—for treatment of OUD. As TIP 63's Executive Summary states, randomized controlled trials have shown these medications to be effective in reducing illicit opioid use and overdose deaths.  (You'll find citations to latest research throughout TIP 63.)

Patients with OUD should have access to mental health services as needed, medical care, and addiction counseling, as well as recovery support services, to supplement treatment with medication.   SAMHSA TIP 63, Executive Summary 

Source: SAMHSA TIP 63

Yet these medications remain underused in the United States. Researchers from the Foundation for AIDS Research (amfAR) shared an analysis of SAMHSA's National Survey of Substance Abuse Treatment Services in a recent post in the Health Affairs Blog, Where Multiple Modes of Medication-Assisted Treatment Are Available. They found that of the 12,029 U.S. treatment facilities:

• 41% of treatment facilities offer only one of the medications
• 23% offer two or more 
• 2.7 % report offering all three medications

The Health Affairs blog post  includes information on geographic availability of medication-assisted treatment with a link to amfAR's interactive map, Facilities Providing Some Medication Assisted Treatment.

TIP 63: Developed by an expert panel

With TIP 63, SAMHSA provides an essential resource to treatment organizations that want to start or expand their use of medications for opioid use disorders. The TIP includes an Executive Summary followed by five sections:

Part 1: Introduction to Medications for Opioid Use Disorder Treatment, presents information on medications, their effectiveness, how they're prescribed, and barriers to their use.

Part 2: Addressing Opioid Use Disorder in General Medical Settings, covers OUD screening, assessment, treatment, and referral.

Part 3: Pharmacotherapy for Opioid Use Disorder gets into the specifics of prescribing and dispensing OUD medications.

Part 4: Partnering Addiction Treatment Counselors With Clients and Healthcare Professionals,  offers guidance on how substance use disorder counselors and other health care professionals can work together to help people with OUD.

Part 5: Resources Related to Medications for Opioid Use Disorder, includes a glossary, a resource list, and sample forms.

Download for free today 

SAMHSA Tip 63 is free, and you can download digital versions of each section or the entire document from the SAMHSA website. You can also place an order for hard copies on SAMHSA's Publications Ordering page. 

Have you started to use SAMHSA TIP 63?  What's been most useful to you in starting or expanding your use of medications for OUD?  Let us know in the comment section below. 

Understanding Substance Use Disorders: New online course covers the basics

February 6, 2018


Heather Gotham, PhD
Associate Research Professor
Mid-America ATTC

The newest course on HealtheKnowledge, Understanding Substance Use Disorders, is a collaborative effort between the UMKC-SBIRT Project (a SAMHSA-funded SBIRT health professions training grant; www.sbirt.care) and the Mid-America ATTC. Through UMKC-SBIRT we had several requests for a basic training on substance use disorders, as several of the health professions training programs with which we work did not provide even basic instruction on SUD. They wanted a primer course that students could take prior to SBIRT training (SBIRT for Health and Behavioral Health Professionals, also on www.HealtheKnowledge.org).

In addition, through Mid-America, we had received multiple requests for basic SUD training that could be used during the orientation of new behavioral health staff, as well as training for child welfare, corrections, or other allied professionals. The course is also currently being implemented in baccalaureate nursing and health studies curricula. We hope that other programs will find value in the course and will use it with other student groups.