Ontario’s only in-patient treatment program for gambling addiction contends with rise of online betting

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Diana Gabriele, a certified gambling addiction counselor at the Residential Centre for Gambling and Technology Addiction at Hotel-Dieu Grace Healthcare in Windsor, Ont., stands inside the common area of ​​the center on June 6. Today’s clients, Ms. Gabriele says, tend to be addicted to online casinos and sports betting.Dax Melmer/The Globe and Mail

When Diana Gabriele began working as a counselor at Ontario’s only inpatient treatment center for problem gambling a decade ago, her clients were mostly trying to break free from their addictions to slot machines and other casino games.

Their profiles fit perfectly with the original raison d’être of the Problem Center. Game and Digital Dependency at Hôtel-Dieu Grace Healthcare in Windsor, a program established in 1994 when the border town was granted the first casino in Ontario.

But in recent years, there has been a sea change in the nature of addictions that send people to the provincially funded three-week inpatient recovery program and related outpatient program.

Today’s customers, Gabriele said, tend to be addicted to online casinos and sports betting. Some have even tried to sneak smartphones into the device-free recovery program by sewing them into the lining of their suitcases.

“It’s a nightmare,” Gabriele said, highlighting online sports betting as a particular challenge because of the tsunami of ads portraying it as a natural part of fan culture.

“With the merging of online activity with gaming activity, the lines have become incredibly blurred,” he added. “Online activities have become so normal that, for the most part, people don’t recognize how incredibly harmful they are,” until they find themselves broke and estranged from their families.

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It remains unclear how the rise of legal online gambling in Canada (a phenomenon boosted by Ontario’s opening to commercial casino and sports betting websites in 2022) has affected gambling addiction rates. Earlier this week, the Canadian Centre on Substance Use and Addiction He called for a national strategy to curb gambling advertising and control harms such as gambling-related suicides, bankruptcies and divorces.

The group also urged governments to offer more counseling to gamblers whose vice is always just a step away. For advice on how to do that, health leaders could turn to programs at the Hôtel-Dieu Grace, which has pivoted toward treating smartphone-addicted gamers while also helping those addicted to casinos and real-world video games.

Customers’ underlying problems are often similar, regardless of their preferred gambling game, Gabriele said. Betting can offer a dopamine-fueled experience. escape from trauma, loneliness, depression and other ills.

“It was always emotional,” Lesley, 41, said of her online slot machine addiction. “I never wanted to go and gamble. [online] slots if I was in a good mood. Then I got excited every day because I had a cloud hanging over me for having lost this money.”

Lesley joined the Hôtel-Dieu Grace outpatient program last October (to protect her privacy, The Globe and Mail is not using her last name). She is a remote tech worker with a husband and three children who stayed up for hours every night playing slots on websites like Party Poker, Jackpot City and BetRivers.

She found she couldn’t manage her bankroll like she did when she was a former poker pro at real tables. Once she moved to online slots, “the difference was that logic and my brain just shut off. I just ran away and pressed buttons.”

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At one point, she won a $100,000 jackpot on a slots website that, as far as she knew, only allowed her to withdraw $10,000 of her winnings per week. After cashing out the first installment, she gambled most of the rest back to the same site. She gambled more, hoping to recoup her losses, but found herself further in debt.

Lesley’s husband feared she might harm herself, so he urged her to call the Hôtel-Dieu. Because she was from Windsor, she was able to live at home while attending individual and group therapy sessions, during which counselors explain addiction theory and teach clients how to set boundaries, communicate with their families and confront the emotional struggles that led them to gamble in the first place.

They also gave him practical advice, such as signing up for services that block gambling websites on all devices whose passwords are held by friends or family.

Lesley has abstained from gambling since joining the program. The most recent one-year follow-up data revealed that 75 percent of participants achieved the same success, Gabriele said.

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The Hôtel-Dieu Grace outpatient program saw 119 patients in 2023-24, 87 of them male and four of them 17 years old or younger. That total is up from 93, 70, 37 and 85 in the previous four years.

The inpatient program, which sees five or six patients at a time for three-week cycles, treated 57 patients in each of the past two fiscal years, compared with 41 and 40 in the worst years of the pandemic. In 2019-20, the last year before COVID-19 struck, the inpatient program treated 85 clients and often had a waiting list.

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Clients entering the inpatient center on the Hôtel-Dieu’s verdant grounds are greeted by a thank-you board with sticky notes from past clients reading “I am grateful for a second chance” and “I am grateful to fully understand that the past does not equal the future.”

Each patient has his or her own simple bedroom during the three-week cycle, with access to a kitchen and common room. Each day, participants take part in group therapy sessions that include preparation for Family Day, when family and friends confront participants in often hurtful ways about the harm the game has inflicted on the people they love.

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Wayne Ladouceur, 38, sits on a bench outside the Gambling and Digital Dependency Residential Centre at Hôtel-Dieu Grace Healthcare in Windsor, Ont., on June 6. Mr. Ladouceur has been in recovery from digital dependency for five years.Dax Melmer/The Globe and Mail

For Wayne Ladouceur, now 38, entering the inpatient program’s digital dependency stream allowed him to break free from the dawn-to-dusk video game habit he developed after a childhood in and out of foster care.

Living at the center “was the complete opposite of what it had been like up until then,” Ladouceur said. The staff was firm about structure and routine. They taught him to be open with others and to fill his days with fulfilling in-person activities.

“This was the first time in my life that I knew what it felt like to be loved unconditionally,” she said.

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