When the Stakes Turn Toxic

Anyone who’s bought a lottery ticket or played bingo has gambled. Gambling is any game of chance in which money changes hands. It’s common in most cultures around the world. Many people enjoy gambling as recreation without causing harm to themselves or others. Yet some people can’t control their impulse to gamble, even when it takes a terrible toll on their lives.         

For these gamblers and their families, researchers have been making progress in several areas. Scientists are learning why people have problems with gambling: how common it is, what goes on inside the gambler’s brain, which is at risk and what kinds of treatment can help.

Problem gambling is defined by some researchers as gambling that causes harm to the gambler or someone else, in spite of a desire to stop. Between 2% and 4% of Americans struggle with this condition. Problem gambling can progress to a recognized psychiatric diagnosis called pathological gambling.

Pathological gambling may affect from 0.4% to 2% of Americans. “Pathological gambling comes with a constellation of problems that contribute to chaos,” says Dr. Donald Black of the University of Iowa. “It’s associated with worse physical health, excessive smoking, excessive drinking, not exercising, not seeing primary care doctors and worse dental care. It also fuels depression, family dysfunction, crime, bankruptcy and suicide.”

Together, pathological and problem gambling may affect up to 5% of Americans. That number may rise, though. Laws in many states are creating more options for legal gambling, and internet gambling is becoming more common.

Still, gambling is often done in family settings, condoned or encouraged by parents. And the younger you start, the more likely you are to get into trouble later on. From 3% to 8% of adolescents have a problem with gambling.

Dr. John Welte of the University of Buffalo has found that, across the lifespan, gambling problems are even more common than alcohol dependence. They are also much more common in males, in young people, and in people who live in relatively poor neighborhoods. “That’s not true of the prevalence of alcoholism,” says Welte. “Alcoholism is much more democratic. So think about motives for gambling. People are hoping that winning will improve their lot. That makes them more vulnerable to developing a gambling problem.”

In a study of mostly African-American inner-city youth, Dr. Silvia Martins of Johns Hopkins University has found that about 15% have some form of problem gambling. Most at-risk were adolescents and young adults who began showing symptoms of depression at age 12. They were highly impulsive, although not hyperactive or aggressive. As the African-American boys developed into their teens and early adulthood, gambling appeared to be a separate risk factor for early fatherhood and criminal arrest.

“We are following up with these inner-city kids every single year as they enter adulthood,” says Martins.

But why is gambling irresistible to some folks and not others? Using advanced imaging techniques, Dr. Alexander Neumeister of Mount Sinai School of Medicine looked at the brains of people with gambling problems and alcohol problems. He measured the number of special receptors involved in regulating impulse control and other factors.          

“A key feature of addiction is impaired impulse control,” says Neumeister. “Abnormal function of the forebrain leads to reduced tolerance to waiting.” The resulting impatience may cause people to act without considering the consequences. “Our imaging clearly points toward the importance of impaired forebrain function in addiction.”

Pinpointing areas in the brain’s reward center, Neumeister’s team found that people with alcohol addiction and gambling problems show different functioning of these special receptors compared to healthy people. The differences were related to the severity of addiction. Other researchers are trying to develop drugs that could treat the affected areas.

Talk therapy can also help. Dr. Nancy Petry at the University of Connecticut Health Center works with pathological gamblers and people seeking treatment for drug use disorders. Gambling problems arise in about 10% to 20% of substance abusers. Petry compared the use of different types of talk therapy, including very brief interventions and cognitive-behavioral therapy CBT. CBT teaches people how to think differently about problems and then act on that knowledge.

“We found very brief interventions and CBT were effective in reducing gambling and gambling-related problems,” Petry says. “There was a significant improvement relative to usual care or standard forms of treatment like Gamblers Anonymous [a 12-step program].”

Anybody can have a gambling problem, and no one should feel ashamed or be afraid to seek treatment. “Pathological gambling is a medical disorder, not a sin or a vice,” says Dr. Carlos Blanco of Columbia University and the New York State Psychiatric Institute. “There is no stereotype. The main predictor of outcome is really motivation.”

In other words, what counts most is a strong drive or desire to take action. Blanco offers gamblers motivational interviewing, which helps them explore their mixed feelings about trying to quit gambling. This primes them to be ready and willing to begin CBT. Using both therapies together can be very effective.

If you have concerns about your gambling, ask for help. Your health provider can work with you to find the treatment that’s best for you.

Caribbean Stud Poker

Caribbean Stud poker is a casino table game with rules similar to five-card stud poker. However, unlike standard poker games, Caribbean stud is played against the house rather than against other players. There is no bluffing or other deception.

As a result of the popularity of poker, casinos created a house banked game known as Caribbean Stud Poker in order to lure poker fans to play more table games. The birth of the game is not well referenced, which is unusual for a relatively new game. Gambling genius David Sklansky has laid claim to formulating the game on a well-known poker forum, positing that he invented the game in 1982 using the name “Casino Poker”. When he developed the game the rules had some differences like, the dealer having two hole cards revealed instead of only one hole card revealed as in Caribbean Stud today. Likewise there was no progressive jackpot in the game he allegedly founded. Sklansky was unable to patent Casino Poker due to patent laws, according to the story. A few years afterwards he was approached by a poker player who brought the game to Aruba and had it patented. The poker player and a casino owner changed the rules slightly to form what we experience nowadays as

Another story details that many people claim they played the game under a different name on a cruise ship going to Aruba, before it was known as Caribbean Stud. The proprietor of the now 'Excelsior Casino' is believed to have bought the game after it was discovered on the cruise ship. The casino at the time was known as 'The King International'. This new game has developed a tremendous interest from tourists in its short history. Fanatics of the game flock to Aruba yearly to play some Caribbean Stud at its home.

The true story of how the game as it is played today came into being goes back to 1987 when a gambler named James Suttle learned the game from a down on his luck poker player while playing Texas Holdem at Binion's Horseshoe on Fremont Street in Downtown Las Vegas. The Player offered to teach Suttle the game if he would lend him $5,000.00. James Suttle denies this. James who was a friend of casino owner and game developer Danny Jones, gave the man the loan because he knew that he could sell the game to Jones for a hefty profit. Jones owned the King International Casino in Aruba which latter became the Grand Holiday Casino. The casino was located in the Holiday Inn on Palm Beach in Aruba which was a favorite layover for many cruise lines. Danny began to market the game with minimal success to other casinos and cruise ships under the company D&D Gaming Patients. It wasn't until computer software engineer Michael Titus told Jones that his game needed a linked progressive Jackpot that the game took off. Titus was playing Poker with Jones at the Horseshoe when during a casual conversation about the game including discussion about the games strengths and weaknesses they determined that the game was too strong for the house and players needed an enticement to play in spite of the games favor for the house. It has been a long standing tradition in the gaming industry to add large or progressive jackpots to games that offer weaker returns to the player. The advantage of a progressive jackpot is that it almost always pays for itself through player contributions. In slot machine play this is easily accomplished as the gaming machine is such a key element to the game, on table games this had never been done in a real time environment. Poker games have had progressive Bad Beat jackpots for a long time, but these were calculated on a daily or weekly basis from a jackpot rake at a predetermined period of time. Jones and Titus roughed out the method by which the new game would be implemented and created the first live progressive linked jackpot on a table game which lead to the games rapid growth and popularity. Two days after the Horseshoe meeting Titus resigned from his job at the Las Vegas Hilton and went to work for newly formed Progressive Games, Inc.. Progressive Games started by sharing space with a Las Vegas Sign Company called City Lites which provided signage and jackpot meters for the game. Eventually the company split due to licensing issues in Nevada. Progressive Games moved to Florida and began Global Distribution of the game while Dane Jones, Danny's son, operated the Nevada company for about six months. Eventually, Dane made a deal for the Nevada distribution rights with a company called D.P. Stud. The million dollars that was to be paid to the Jones family for the rights to distribute the game was never paid in full and due to Jones licensing issues in Nevada he was never given just payment. The hardware that went into the Nevada version of the game was illegally knocked off by DP Stud for many years. This is part of the reason the history of the game became so clouded. Dane's fumbled deal ended the Jones family involvement with the game in Nevada. However, the Ft. Lauderdale based Progressive Games went on to distribute the game globally during the next two years. In a major consolidation move Mikhon Gaming bought out Progressive Games and the Nevada distribution company in 1995. The concept patent  for a progressive linked jackpot on a table game, that Titus brought to Caribbean Stud has stood many challenges. It is the Jackpot feature that has made the game a long time success among the new casino games.

The following rules are typical of U.S. casinos, but some of the details the payouts and limits vary from casino to casino.

To play, every player places his ante on a marked spot on the table playing surface the layout where indicated; all ante wagers must be placed prior to the dealer announcing No more bets. Each player also has the option to participate in the progressive jackpot feature of the game. This is also done before the dealer announces no more bets, by dropping a chip in the slot on the table which activates the progressive jackpot light for that seat and that particular hand of play. Each player and the dealer will then receive five cards, face down. The dealer will turn over one of his cards, then push the cards toward the players, after which the players may look at their cards. They may only look at their own cards, and may not discuss what they have with any other players at the table.

Players have the option to play or fold; if they choose to play, they place their bets twice the amount of their respective ante in the bet box. If they choose to fold, they forfeit their ante. After all the players have made their decisions, the dealer reveals his hole cards. The dealer only plays with an ace/king or higher; they then compare their cards to the other players' cards individually, right to left, and the players' hands that beat the dealer's qualifing hand wins.

There are some major rules in Caribbean Stud Poker that must be observed at all times while playing:

Only one hand per player. Players cannot hold or wager on multiple hands at the table.

Players choosing to play the Progressive Payout feature are responsible for ensuring their $1 wager has been inserted into slot and the Indicator Light is ON.

Players may not exchange or communicate information regarding their hands to other players or the dealer. Player violation will result in a dead hand and forfeiture of all wagers.

Incorrect amount of cards to the player constitutes a dead hand or push for that player only.

The decision of the table/casino supervisor is final.

If the dealer is dealt four cards of the five-card hand, the dealer shall deal an additional card to complete the hand. Any other misdeal to the dealer shall result in all hands being void and the cards shall be reshuffled.

Each player shall be required to keep the five cards in full view of the dealer at all times. Once each player has examined his or her cards and placed them face down on the layout, they may not touch the cards again.

If a hole card is exposed prior to the dealer announcing No More Bets, all hands shall be void.

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Dead Money

In poker, dead money is the amount of money in the pot other than the equal amounts bet by active remaining players in that pot. Examples of dead money include money contributed to the pot by players who have folded, a dead blind posted by a player returning to a game after missing blinds, or an odd chip left in the pot from a previous deal. For example, eight players each ante $1, one player opens for $2, and gets two callers, making the pot total $14. Three players are now in the pot having contributed $3 each, for $9 live money; the remaining $5 representing the antes of the players who folded is dead money. The amount of dead money in a pot affects the pot odds of plays or rules of thumb that are based on the number of players.

The term dead money is also used in a derogatory sense to refer to money put in the pot by players who are still legally eligible to win it, but who are unlikely to do so because they are unskilled, increasing the expected return of other players. This can also be applied to the player himself: Let's invite John every week; he's dead money. The term dead money also applies in tournaments, when many casual players enter events with virtually no chance of winning.