How We’re Getting Gaming Addiction Wrong in the USA

Life has a funny way of turning out. Sometimes it is just going along when something happens that changes our trajectory. Maybe it is a big event that is clear the moment it happens like the birth of a child or meeting of your future spouse. Other times we can only see the pivotal moment with the passage of time. I remember most of my pivotal moments. The most recent one started with my phone ringing.

“I just don’t know what to do. I love him so much and he’s floundering, and I want to help but I am completely lost. He is so addicted and it’s destroying his life.” The voice on the other end of the phone was full of desperation. As someone who specializes in addiction I am used to these types of calls. But this one was different. It wasn’t a spouse calling me because of alcoholism. Nor was it a parent calling me because of their child’s drug use. This was a mother calling me because her adult son was addicted to video games. As a therapist I try to help everyone that contacts me. Sometimes it means that I see them professionally. Other times I try to link them to other therapists and resources that are more appropriate than me.

I took the mother’s information and assured her that I would call her back once I put together a list of resources for her. Immediately I did what I always do when I am searching for information. I googled it. I looked for therapists that specialize in video game addiction among college students in Morris County New Jersey. No results. I realized that my search was too specific. I expanded the geographical region to state-wide. No results. I removed the college student specifier. No results. I eventually ended up searching for video game addiction in the U.S. Nothing.

I never did end up working with that family. I spoke with the mother and her son was not willing to get help. I provided as much information as I could. I assured her that if he ever became willing to get help, I was happy to work with him. Life continued to move forward and I didn’t realize until later that a pivotal moment had occurred.

I eventually expanded my career to include public speaking. While I love working with clients individually, I realized that I could expand my impact by speaking to groups of parents, professionals, and community members. I focused on issues that youth and young adults face. The more I spoke, the more I was asked to speak. What started out as small events in church basements became large events at state-wide conferences. I went from speaking to five people at a time to hundreds. Then something interesting started to happen.

Somewhere along the way my discipline became a therapist for youth and young adults. I handled questions on alcohol, drugs, self-esteem, and social media with ease. But an old familiar topic started to come up; video games. Parents, teachers, and professionals started to ask me often about the impact of video games on youth.

I care about people. My belief is that if people are taking time from their day to see me speak then I need to honor that. One of the best ways I can do that is by giving them what they are looking for. With so many people asking about video games I decided to return to google. This time I searched for video game addiction globally. It made all of the difference.

It turns out that certain countries in Asia have treated video game addiction as a public health crisis since 2003. I read everything I could get. I went for long walks and let the information soak in. I formulated my thoughts. And then I wrote. I first started with a series of articles. Then I spoke with parents. Eventually I realized that I had so much information that articles and talks wasn’t going to cut it. I moved onto writing my first book focused on video game addiction.

A lot has happened since then. I have spoken to hundreds of therapists, parents, and teachers. My work and research have expanded dramatically. I am invited to speak at conferences all over the country. But as my profile has increased, I have very mixed feelings.

I have always loved poetry. The way the words dance play to me. In my therapy sessions I routinely weave in poetry. When I was reflecting on the source of my mixed feelings a poem came to mind. In Thomas Gray’s poem Ode on a Distant Prospect of Eton College he states “Where ignorance is bliss, tis folly to be wise.” This line perfectly captures the issue I run into.

I am an expert on video games and the impact they have on a neurological and emotional level. I understand how their design has changed to increase the rate and frequency at which people play. I know what percentage of youth struggle with video games domestically and internationally. I know the research on the link between loot boxes and gambling addiction. I even have a pretty good idea of how to treat it.

What I don’t have is a list of programs that can help people struggling with video game addiction. The best program in the United States is also one of the only programs. It is based in Washington state. With 8.5% of youth in the U.S. struggling with video games, one program is not enough to help them. If we had one hundred programs, we might make a small dent. If we had one thousand programs, we could actually make some headway. But we have just a handful of programs. My stomach twists when parents and professionals ask me what resources there are for video game addiction. There aren’t nearly enough. Which is why I am really pleased to see a service like Kindbridge getting built out. Kindbridge can rapidly expand coverage and access at the same time so that people all over the country will have a single source to reach out to and get help through. All with licensed, trained therapists. All interested in the future of gaming and gambling treatment.

Sometimes when I speak with other professionals they wonder if video game addiction is even a real thing. After all, in the United States we don’t recognize it as diagnosis. My counter is that even though we don’t recognize it here, the rest of the world does. It begs a question. What is more likely; the United States is right, and the rest of the world is wrong or vice versa?

My hunch is that the rest of the world is right. My concern is that my hunch is right. If it is, then we are not prepared for what has already happened. We are so far behind that we have a massive problem and do not even know it exists.

Another common question theme is on whether the adverse impact of video games is significant. Basically, is this really having a negative impact (i.e. is this even worth working on). There are two main arguments for why we need to treat this.

First, in extreme cases people can destroy their lives with video games. Now some believe that I am being dramatic when I say that. But a look at South Korea quickly illustrates my point. South Korea is the gaming capital of the world. Video games are wildly popular there. However, they have what they call the lost generation. It is comprised of youth and young adult males. They estimate that up to 50% of that population is struggling with video game addiction. Professionals will sometimes say “Yeah sure but that is South Korea.” They are correct. What they miss though is that South Korea is just further down the same road as the U.S. They started sooner than we did. If we want to see what is going to happen in the U.S., we just need to look at what’s already happened in Asia.

The second reason that I believe we need to treat video game addiction is not for the video game addiction itself necessarily, but rather what will come next. Recently I spoke at the state-wide gambling addiction conference in New Jersey. The topic of my presentation was on the link between video game loot boxes and gambling addiction. My work was based off of research in the U.K. which showed that gambling addiction quadrupled among their youth population in the past three years. The cause? Loot boxes which normalized gambling.

If you think about video game addiction as a warning light on your car’s dashboard, you need to think about gambling addiction as your car shouting that something catastrophic is about to happen. Gambling addiction has incredibly high rates of suicide. Up to 46% of people struggling with gambling addiction will contemplate suicide. Up to 20% will attempt it. To make matters even worse, up to 75% of individuals struggling with gambling addiction will also struggle with substance abuse.

Based on my research I feel like I can see around the bend of the road a bit. What I see is terrifying. We used to think of marijuana as a gateway drug. To various degrees this has been proven to be false. We need to think of video game addiction as a gateway drug. Kids play video games. They start to gamble in the video games with loot boxes. This normalizes gambling. They transition to other forms of gambling. They develop substance abuse issues. They contemplate suicide. They attempt suicide.

I have an incredibly strong argument about why we need to expand access to services immediately in the United States, which is why I’m a fan of what is being done at Kindbridge. All I need to do is look at the lost generation in South Korea to see that failure to do so will result in high rates of individuals who are unemployable and unable to sustain themselves. Even if I could accept high rates of unemployability, I cannot accept failing to act to weaken the tie between video game addiction and gambling addiction.

Interestingly enough, the entity who has the most to gain by increasing access to services is insurance providers. Their gain is not in decreased costs upfront but rather in the cost savings down the road. Substance abuse treatment is exceptionally expensive. An in-patient stay can cost tens of thousands of dollars a month. We have a pipeline of youth and young adults addicted to video games in the U.S. If we do not start to provide services to them, a significant amount will likely transition to gambling addiction. With gambling addiction comes substance abuse and, unfortunately, death. Financially insurance providers can pay a bit today to save a lot tomorrow. Failure to expand access to services will result in significant financially and emotional damage.

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