You can hear the sounds of excitement from afar -- before you see the vast well of games and the legions of children (and adults) swarming around the scores of hyperbolic machines with brilliant flashing lights and swelling sounds that rival modern atonal music. You have arrived at a casino for kids.
Of course, they are not called casinos. I am not sure what they are called -- and it doesn't matter. It's what they deliver -- not what they are named -- that counts. Look around. Is there a window? A clock? A rectangular wall? Nope. You are in a rounded cocoon without boundaries of any sort that might ground the visitor in reality. A number of business franchises have made these settings ubiquitous and highly successful, in this and other countries.
Addiction traditionally was defined as "a chronic, relapsing disease characterized by compulsive drug seeking and abuse and by long-lasting changes in the brain" (National Institute of Drug Abuse, http://www.drugabuse.gov/). Scientists have come to understand addiction as not confined to alcohol and drugs. Broader definitions of what produces addiction are necessary to account for the variety of compulsive behaviors in youth and adults that, like drug and alcohol abuse, persist despite harmful consequences. While gambling certainly occurs without compulsiveness or harm, just as drinking does, both carry the risk of addiction. Some predictable percentage of people who use or gamble will escalate to the uncontrolled behaviors that cause profound distress and disruption in their lives as well as that of their families and communities. The need to manage these addictive behaviors has produced not only AA (Alcoholics Anonymous) and NA (Narcotics Anonymous) but also GA (Gamblers Anonymous -- http://www.gamblersanonymous.org/qna.html).
The Director of the National Institute on Drug Abuse, Dr. Nora Volkow, has written that there is good evidence for non-substance induced addictions. Dr. Volkow wrote the brain is:
"... composed of a finite number of circuits for ... rewarding desirable experiences ... So it is almost by necessity that we'll find significant overlaps in the circuits that mediate various forms of compulsive behaviors. We have yet to work out the details and the all important differences, but it stands to reason that there will be many manifestations of what we can call diseases of addiction. Thus, addiction to sex, gambling, alcohol, illicit drugs, shopping, video games, etc. all result from some degree of dysfunction in the ability of the brain to properly process what is salient, accurately predict and value reward, and inhibit emotional reactivity or deleterious behavior."
In casinos for kids, in addition to the games there are drinks and food everywhere you turn: high-sugar and high-fat foods, including huge glasses of sugary beverages, nachos and potato skins in which cheese and bacon swim, sour cream like it was running water, and chicken and buffalo wings as plentiful as kudzu. These foods fuel the brain and body for the high intensity, electronic world of video games (and the few retro toss-the-ball games embedded among the digital delights). These are foods that antecede (and later accompany) the nicotine and alcohol that youth will graduate to further stimulate the reward centers of the brain.
There is also the paper gaming tickets of varying values in casinos for kids. Youth and adult players buy these at a gazebo located at the very center of the well of machines so there is never far to walk to convert paper money for valueless paper that lets you play. The tickets are paper versions of gambling chips, of course. There is a store at the rear where wads of tickets can be exchanged for stuffed toys of every color in the rainbow. The machines are programmed to let some win, some of the time, just like in any casino. But make no mistake: The house always wins.
Brilliant, I thought. The gaming (gambling) industry has developed and propagated youth gaming centers, gambling prep schools if you will, which can serve as gateways to adult casinos and breeding grounds for compulsive gambling. I'll bet that the rates of compulsive gambling and video game addiction will increase in the years to come. In fact, I'll give you odds.
The opinions expressed here are solely mine as a psychiatrist and public health advocate. I receive no support from any pharmaceutical or device company.
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