As one of the nation’s foremost experts on addictive gambling, Larry Ashley of the University of Nevada-Las Vegas is acutely aware of the vulnerability of combat vets to pathological gambling. So the problems faced by Gordie Greco (see my previous blog, “Vets Gambling, Part II) were no surprise.

“Gambling kills time and gives the vet an adrenaline rush,” says Ashley, director of the Problem Gambling Treatment Program at UNLV. “Plus, when they gamble, they get alcohol for free.”

Problems associated with vets gambling have become so severe that Keith S. Whyte, executive director of the National Council on Problem Gambling, recently asked VA Secretary Eric Shinsecki to study the severity of this problem.

“It is highly co-occurring with other serious conditions and complicates the treatment of these disorders,” Whyte wrote. “In addition, gambling addiction has disastrous consequences for the veteran and his or her family.” He noted that 1 percent to 3 percent of the American public experience gambling problems in any given year, but studies of veterans utilizing VA treatment services found 10 percent were pathological or problems gamblers.

Video gambling machines are the most insidious forms there are, agrees Ashley. “They have a soothing, calming influence,” he told me recently. “Vets sit there, hypnotized by the gaming machines and let time fly by.”

Oddly, the machines have contradictory effects on vets gambling. “These young studs come back from combat all wired up,” Ashley says. “This gives them an escape from anxiety, but it also gives them an escape from boredom.”

Many vets picked up their gambling problems while in the service.

“The Army is making hundreds of millions of dollars in gambling revenues in their service clubs around the world, and they don’t provide treatment for the problem gamblers they helped create,” Ashley charged at a recent conference, “From Their Point of View,” at UNLV.

Gambling is banned from service clubs in the United States, but slot machines and video poker machines that provide a payout are permitted overseas, with at least 93 percent of machine play being returned to patrons as winnings.

Net gaming revenue of approximately $85 million was reported in fiscal 2012, according to DoD spokesperson Leslie Hull-Ryde. That’s down from about $184 million in 2007, according to Stars & Stripes. “Gaming machines provide a controlled alternative to unmonitored host-nation gambling venues and offer a higher payment percentage, making it more entertainment-oriented than that found at typical casinos” Hull-Ryde says.  “In addition, controls established over the program stress its recreational nature and ensure revenue obtained from the program goes to benefit military community members.”

But the anger, guilt and shame that most vets bring home from the battlefield provide a fertile field in which to grow gambling problems. “Gambling can be a way of inflicting pain on others, but it can also be a way of inflicting harm on yourself,” says Ashley. “And one of the big problems with pathological gambling is that there is no natural reason to stop it. If you’re on alcohol or drugs, sooner or later you’re going to pass out or die. But if you’re gambling, there’s nothing to make you stop.”

Treatment needs to incorporate the same soothing effects of the video gaming machines with the high adrenaline of betting, but it needs to do it in a more benign fashion. Extreme sports like whitewater rafting or mountain climbing could fill those needs.

“Gambling is a permanent change in the brain so treatment has to be a re-programming of the brain,” says Ashley. “The adrenaline rush in itself isn’t bad – it’s what you have to do to get it. So we need individual treatment plans to substitute for that gambling rush. I’ve known women who’ve taken up prostitution to get support for their habit and men who turn to robbing banks. That sounds just like a drug addiction to me. Gambling re-wires your brain, and we have to find ways to re-program it.”