The Casino Trap

Notable high rollers

Earlier this year, the Hollywood Reporter devoted a cover story to one such pathological gambler—Emmy-winning television producer and writer David Milch, 71. Despite earning millions from the shows he helped create, including NYPD Blue and the critically acclaimed HBO series Deadwood, Milch ran up enormous debts betting on horse racing (also the topic of his short-lived HBO series Luck). According to a lawsuit filed by Milch's wife against the couple's business managers, between 2000 and 2011 his gambling losses reached $25 million, and he's now $17 million in debt.

For other high-rolling notables with well-documented gambling habits, such as NBA great Charles Barkley and actor Ben Affleck, sports betting and poker are the typical culprits. But the majority of everyday problem gamblers are camped out at the slot machines, which have evolved from the traditional one-armed bandits into highly sophisticated "electronic gaming machines" powered by proprietary computer chips. Slots are the biggest revenue producer for the industry and the most popular attraction for older gamblers: 3 out of 4 adults age 65 and older identify slots and video poker as their preferred form of gambling, according to a Harrah's survey.

Slot machines are the most addictive form of casino gambling, enticing users to 'keep playing' until they've suffered major monetary losses.

Naomi Harris

'Electronic crack'

Slots are also the most addictive form of casino gambling, with the machines designed to maximize your "time on device" until you're out of money. A 2001 study by psychiatrist Hans Breiter, then of Massachusetts General Hospital in Boston, confirmed that the machine's nickname—"electronic crack"—is an apt one. Using MRI scanners, he found that in subjects playing slots, the brain's neural circuits fired in a way that was similar to those using cocaine.

Several factors make gamblers particularly susceptible to addiction behavior as they age. Loneliness, social isolation and the loss of a spouse can encourage older people to seek relief in casinos. "For someone older who has been sick in the hospital or who is bored or lonely, that can have a big impact on them," says clinical geropsychologist Dennis McNeilly of the University of Nebraska Medical Center in Omaha.

More serious age-related cognitive decline plays a role, too. A 2012 study found that changes in the anatomy and chemistry of brains in dementia patients 65 and up, particularly in the frontal region—which controls executive functioning—"may render older adults particularly vulnerable to the stimulation provided by the slot machine." Dementia afflicts about 14 percent of the U.S. population over 70 years old, and an estimated half of those (nearly 2 million people) are undiagnosed. "With both the reward system and impulse controls impaired, that creates the perfect storm for someone to develop problems with gambling," says Michael Hornberger, a neuroscientist at the University of East Anglia in England. Cognitive issues can cause sufferers to lose their sense of money's value, and those with dementia often repeat a singular behavior such as pushing the button on a slot machine over and over. "They just keep playing as long as the casino lets them," Hornberger says.

In some cases, compulsive gambling behavior can emerge as a side effect of medications. Mark Stacy, a neurologist at the Duke University School of Medicine in Durham, N.C., noticed that several of his Parkinson's disease patients began reporting gambling problems after he had increased their doses of drugs called dopamine agonists, used to treat motor dysfunction. As many as 10 to 15 percent of Parkinson's patients who take the drugs exhibit this tendency, he says. "I believe these drugs do cause gambling problems where they otherwise would not occur. When you stop the drug, the behavior goes away."

Foes of casino gambling say that the industry actively targets vulnerable older patrons. For every 20 older patrons who walk through their doors, says Les Berna national director of the advocacy organization Stop Predatory Gambling, the casinos want to "find a couple of them that they can take for all they're worth."

From social gambler to addict

Beauford Burton's experience at Harrah's Cherokee Casino is typical of such relationships.

In addition to sending birthday cards and weekly mailings with ticket deals to shows and vouchers for free play, the casino assigned a VIP host who called Burton at home to invite him back for various specials. Casino hosts often lavish personal attention on high-rolling older charges, asking about their health, reminding them to take their medicine and eating meals with them.

"The whole premise of a host is to extract as much money from that player as possible," says ex-host John-Talmage Mathis, who worked as VIP marketing director at the Boomtown Casino in Bossier City, La. "For older people, the host becomes their friend, giving them attention they may not be getting from their children or friends."

Casinos award hosts bonuses based on how much the gambler loses. "The losses of your player," Mathis says, "are your success."

As the industry seeks to expand, more women are being enticed into casinos, and more are experiencing problems, according to a study published in the journal Psychiatry.

Many slot machines are now designed specifically for women players, who, like longtime slots addict Melynda Litchfield, sometimes feel bonded with their machines. Litchfield, 56, worked 27 years at a Chicago-area hospital, climbing from staff nurse to administrator with a salary of $100,000.

Yet she couldn't afford a prom dress for her daughter because she lost so much playing slots at the Grand Victoria Casino in Elgin, Ill., 10 minutes from their home. For Litchfield, the atmosphere was as addicting as the machines themselves. The staff treated her warmly and called her by name. "They gave me so much personal attention and TLC that you get the false impression these people—who are milking away all of your money—actually care about you," she says.

The casino also served as an escape, to a place where she did not have to tend to the needs of anyone else. "I didn't want to talk to anyone," says Litchfield, who quit gambling in 2012 and is now a national victims advocate for Stop Predatory Gambling. "I just wanted to get lost in my machine."

Pushed toward the slots

Amy Ziettlow, a Lutheran minister and affiliate scholar at the Institute for American Values, visited casinos in Louisiana, Iowa and New York for her investigative report, "Seniors in Casino Land."

"The whole aim of trying to cater to the needs of the least among us simply to take their money is abusive," she says. "Owners push them toward the slots."

Industry advocates such as Chris Moyer, director of public affairs for the American Gaming Association, tell another story. "If seniors are enjoying the entertainment product we provide, there's no reason why they shouldn't be able to enjoy that in a responsible manner," he says. He points out that casinos do provide education materials on addiction, displaying pamphlets that urge patrons with gambling problems to call a toll-free help number. The casinos also encourage problem gamblers to put their names on self-exclusion lists. "The casino gaming industry takes extraordinary measures to spot those who need help and connect them to treatment," Moyer says.

As his addiction deepened, Beauford Burton found one of those pamphlets and called the 800 number. As he recalls, the person who answered his call just told him he should stop gambling if he couldn't afford it. "There was no meat to it," he says. "Once your intent is not to come back to them, I think they want to be clear of you."

After declaring bankruptcy in 2008, Burton finally managed to quit with the support of his wife and his faith. He and Sharon now live in a two-bedroom apartment in Kings Mountain, where he has become an outspoken critic of a proposal to build a casino in his community. He regrets his gambling problems but takes responsibility for his behavior. "I can't put total blame on those people because I was the one ignorant about it," Burton says. "But the casinos do try to make things as exciting for you as they can."

John Rosengren is a freelance journalist who lives in Minneapolis.