Epigraph:

They ask thee concerning wine and the game of hazard (gambling). Say: ‘In both there is great sin and also some advantages for men; but their sin is greater than their advantage.’ (Al Quran 2:220)

Please make well referenced contributions in the comment section to make it an international repository, to demonstrate the truth of this verse of the Holy Quran.

I have put here an article that in its earlier form, was published in Journal of the Islamic Medical Association of North America: http://jima.imana.org/

Gambling: A Correlation between the Holy Quran and Science

Written and collected by Zia H Shah MD, Chief Editor of the Muslim Times

Abstract

There is increasing awareness in the medical community about the prob­lems caused by gambling. Similarities between gambling and drug addictions also are being recognized. The Glorious Quran has informed us about the similarities of the harmful effects of gambling and alcohol. Two verses in the Holy Quran warn about the effects of gambling and contain warnings about alcohol. Though there are minor beneficial effects of gambling, the harmful consequences far outweigh these. Pathologic gambling is an addiction characterized by an irresistible de­sire to gamble frequently with larger amounts of money in spite of repeated losses and mounting debts. The normal social obligations frequently are ignored, and the repeated efforts to stop gambling are not successful. The prevalence of pathologic gambling varies between 2 to 3% in the general population and is increasing with the legalization of gambling and the increasing availability of gambling machines to younger people. There is evidence that gambling is a factor in crime. Counseling is being used as therapy for pathologic gamblers, but this is only a partial solution to the problem. Unless the practice is banned, as is implied by the Quranic verses, the problems associated with gambling are likely to continue.

Key words: Gambling, alcohol, addiction, Islam, Quran, crime.

Discussion

John Daly the number II golf player in USA, in the first decade of 21st century, says he has lost between $50 million and $60 million during 12 years of heavy gambling, and that it has become a problem that could “flat-out ruin him” if he doesn’t bring it under control.

The two-time major champion wrote that he has spent the last 10 years paying off gambling debts with his sponsorship income, hustling appearance money and “running myself ragged doing corporate outings instead of spending time with my family and working on my game.”

“Hour after hour, the blackjack cards flipped past, and still she played. Friday afternoon blurred into Saturday. Through the ringing of slot machines and chatter­ing of coins dropping into tin trays, Catherine Avina heard her name paged. ‘Are you coming home tonight?’ It was her 21-year-old son, Joaquin, on the phone. ‘Probably not,’ she answered. Avina didn’t go to Mystic Lake Casino in Prior Lake, Minn., as much as she escaped to it. That weekend in May 1994, the de­pressed 48-year-old mother of three was escaping the worst news yet she was in danger of being fired after al­most 11 years as an assistant state attor­ney general. On Monday – her fourth straight day at the casino – she dragged herself back to her St. Paul home, broke and more depressed than ever. Two days later, Joaquin confronted his mother about her gambling, and they argued. The next morning, when she didn’t come out of her bedroom, he peeked in. Two empty bottles of antidepressants and a suicide note were near her body. Later the family found debts of more than $7000, and Avina was still making payments for gambling-ad­diction therapy received a year earlier.”[1]

While the details of the story may belong to Catherine Avina, the biography is that of many a gambler. The prob­lems caused by gambling are numerous and pervasive. The Holy Quran drew our attention to the deleterious results of gam­bling 1,400 years ago, at a time when scientific inquiry was absent and human wisdom nebulous. The Holy Quran says in Sura Al-Baqarah in verse number 220:

They ask thee concerning wine and games of chance. Say, ‘In both there is great sin and harm and also some advantages for men; but their sin and harm are greater than their advantage,’ And they ask thee what they should spend. Say, ‘Spend what you can spare.’ Thus does Allah makes His commandments clear to you that you may reflect.

Again in Sura Al-Ma’idah, in verses 91 and 92 it is said:

O ye who believe! wine and the game of chance and idols and divining arrows are only the abomination of Satan’s handiwork. So shun each one of them that you may prosper. Satan seeks only to create enmity and hatred among you by means of wine and the game of chance, and to keep you back from the remembrance of Allah and from Prayer. Then will you keep back?

In the past, gambling was illegal in most western coun­tries. However, in recent years many governments have le­galized gambling for the possible short-term economic gains. In this article, the increasing body of scientific literature about gambling will be discussed in relation to the Quranic teachings in the above-mentioned verses. The correlation between these verses and the scientific literature will be em­phasized in four different aspects, namely:

1. The Holy Quran categorically and explicitly condemns gam­bling and does not leave any room for negotiation. This is due to severe and frequent problems caused by gambling.

2. The Holy Quran draws a parallel between gambling and al­cohol by mentioning them in the same verses.

3. The Holy Quran recognizes the possible advantages of gam­bling, as well as their insignificance compared to the disad­vantages.

4. Gambling leads to an increase in crime rates. This is implied in the verse, “Satan desires only to create enmity and hatred among you by means of alcohol and gambling.”

Definitions and nomenclature

The American Psychiatric Association has classified gamblers into three categories: social, professional, and pathologic gamblers.[2] Characteristic behaviors of gamblers are given below, and the individuals exhibiting four or more of these traits are called pathologic gamblers.

1. Frequent preoccupation with gambling or with obtain­ing money to gamble.

2. Frequent gambling of larger amounts of money or over longer periods of time than intended.

3. The need to increase size or frequency of bets to achieve desired excitement.

4. Restlessness or irritability if unable to gamble.

5. Repeated loss of money through gambling and returning to win back losses (i.e., chasing).

6. Repeated efforts to reduce or stop gambling.

7. Frequent gambling when expected to meet social or oc­cupational obligations.

8. Sacrifice of important social, occupational, or recreational activities in order to gamble.

9. Continuation of gambling despite the inability to pay mounting debts or despite other significant social, occupa­tional, or legal problems exacerbated by gambling.

Social gamblers typically gamble with friends and col­leagues. They gamble for a limited period of time and losses are predetermined. They generally do not suffer signifi­cant consequences from it.

Professional gamblers are those who are well adjusted to the profession of gambling. They take only limited risks, and their discipline is central to their style of gambling. They, however, are a small minority of people who indulge in gambling.[3] People who suffer negative consequences from gambling but not to the degree of pathologic gamblers are sometimes referred to as regular gamblers. It is important to realize that pathologic gamblers are one extreme of a continuum of people who suffer negative consequences.

Prevalence

In the United States, between 84 to 92% of adults gamble socially.  Some of these go onto become pathological gamblers, just like approximately 10% of social alcohol consumers go onto become alcoholics.   In an extensive review, Murray pointed out in 1993 that the number of pathologic gamblers in the U.S. is between 1.1 to 6 million.[4] It is estimated that in the U.S.A, 2-­3% of the general population are pathologic gamblers.[5]  Lifetime prevalence of pathologic gambling in the U.S. is even higher and is estimated to be 3.5 – 6.3% of the total population. The prevalence of pathologic gamblers in Canada is similar to the U.S. and it is predicted that in both the countries a social epidemic of gambling related prob­lems is looming in the next decade or two.[6]

The prevalence is increasing as more states legalize different types of gambling.[7]

Despite the laws against underage gambling, there is increasing prevalence of gambling in adolescents due to the increasing access to different gambling sites and internet based facilities. As lottery tickets are sold in ordinary retail outlets, often next to candy, the prohibitions on sales to children have been unenforceable. Sixty-two percent of retail shops in the United Kingdom reportedly sell lottery tickets to chil­dren younger than 16 years old.[8] Emanuel Moran reported that 61% of 11 1/2- to 15 1/2-year-olds had indulged in gambling.[9] Richard Buchta surveyed 200 adolescents be­tween the ages of 12 and 18 from California by an anony­mous questionnaire. He reported that more than 70% of the adolescents had gambled.[10] Lesieur et al also surveyed stu­dents from six colleges and universities in five states in the U.S.A (New York, New Jersey, Oklahoma, Texas, and Ne­vada) to evaluate their gambling behavior. They found that one third of all the male students and 15% of female stu­dents gambled once a week or more. Rates of pathologic gambling in the groups ranged from 4 to 8%.[11] This in­creasing prevalence in adolescents may translate into a fur­ther and dramatic increase in overall prevalence in coming decades.

If we take into account the impact of pathologic gam­blers on family members, the total number of individuals affected by gambling becomes very large.

Etiology

The exact etiology of pathologic gambling is not known. However, certain theories have been proposed, and certain associations have been appreciated.

A commonly shared etiologic hypothesis of pathologic gambling is that it is a drugless addiction resembling other substance abuse disorders. Pathologic gamblers are addicted to their own adrenaline surges. It is widely understood as an addiction to the altered psychological state experienced while gambling. This state is described as a “high” similar to the effect of a stimulant drug and also as a feeling of dissociation, which permits an escape from worries. The data supporting this theory comes from biological differ­ences that have been demonstrated in the sympathetic hor­monal system between pathologic gamblers and normal people.[12], [13] The video-gambling machines, which are more addicting and may prove to be more detrimental, are add­ing a new dimension to the menace of gambling.[14] For pathologic gamblers, video poker has been called “electronic morphine.”[15]

Impulse control problems have also been suggested as possible etiology for pathologic gambling.[16] The American Psychiatric Association, in its diagnostic and statistical manual of mental disorders has classified pathologic gam­bling as an impulse control disorder not elsewhere classi­fied. Pathologic gambling shares this category of diseases with conditions such as kleptomania and pyromania.2 The essential feature of impulse control disorder is an inability to resist an impulse or temptation to perform a certain act that is harmful to the individual doing it and to others in the society. Individuals with this disorder feel an increased sensation of tension or arousal before the act and experi­ence relief, fulfillment, and pleasure during the act.2

The reason people continue to bet even though it is not in their best interest is similar to why people indulge in smoking, alcohol, and dangerous driving, etc. The underlying cause is an inability to reason statistically and appreciate prob­ability and risk outcomes. Availability and easy access to gambling is a possible factor in the causation of the prob­lem. Legalizing gambling has led to an increase in the preva­lence of pathologic gamblers. Volberg et al have shown that the prevalence of pathologic gamblers is three times higher in states where gambling has been available for more than 10 years, compared to those states where It has been legal for less than 10 years.[17] This implies that a certain population may be predisposed to pathologic gambling and once they indulge in this, because of easy availability, their predisposition comes to surface.

Gambling at an early age is also a contributing factor to the pathogenesis of pathologic gambling. Volberg et aI’s questionnaire showed that about 8% of the respondents who gambled began wagering before the age of 15. This figure was much higher in pathologic gamblers, in whom 25-30% began betting before the age of 15.[18] Their data and the high prevalence of gambling in adolescents in states where gambling is legal and the increasing prevalence of gam­bling over time strengthens the notion that extensive child­hood involvement in gambling is predictive of later gam­bling problems. It seems that children and young adults like to do what they see older adults doing rather than what the older adults are telling them to do.

Pathology and clinical features

In pathologic or regular gamblers, the constant need for money to be able to place bets with interferes with other activities. They lie and fabricate to cover up losses and steal money from family members and employers. Their time is wasted in detrimental and negative pursuits rather than being spent in positive activities. They end up with difficulties in personal relationships and at work. As the process progresses, they develop numerous physical and psychological problems.

Pathologic gamblers have been shown to have a higher prevalence of depression,[19] [20] [21] stomach ulcers, alcoholism, and divorce compared to general population. Many psy­chiatric and behavioral problems are common in gamblers. For example, Miller et al reported that in a general psychi­atric unit in Minnesota 28% of the patients were classified as regular gamblers and 12% were classified as pathologic gamblers. They also reported that the prevalence of gam­bling was several times more in their patients compared to the general population.[22]

Like any other addiction, the negative consequences from gambling are numerous. Here is a confession quoted in a Gamblers Anonymous leaflet, which talks about sev­eral negative results:

“To reach our ‘rock bottom,’ many of us had to fail school, lose jobs, commit crimes or end up in jail. While gambling we found that our lives had become to­tally unmanageable. We told lies to hide our addiction. Not only were we hurting ourselves, but also those around us, in­cluding girlfriends, boyfriends and fam­ily. We were all alone – no one could understand that nothing, or no one, came before a BET for us. No matter how hard we tried to stop, or how much we prom­ised, we kept going back.”[23]

Some pathologic gamblers are able to recover with help after reaching “rock bottom.” However, all are not so lucky. According to Gil Kezwer, suicide remains a gambler’s last card; about 20% try to play that card at least once in their lifetime.[24] One gambler in Liverpool, England committed suicide after forgetting to renew his weekly stake. Tim O’Brien had picked the same number in the lottery for a long time. The week he forgot to renew the stake, however, the same number won a prize of 13 million dollars. Out of desperation he resorted to suicide.6 In another report more than 90% of pathologic gamblers who called a toll-free tele­phone hotline for help reported suicidal ideation.15

Like other addicts, pathologic gamblers have an inability to control their gambling behavior. The compulsive gam­bler has an inability to accept reality and lives in his dream world of denial of the consequences of his actions. He con­tinues to believe that even after sustaining heavy losses, his luck will change any minute and he will recuperate the losses. Unlike other addictions, where there is nothing real to support the denial, gamblers’ denial is reinforced and worsened with occasional wins and escape from desperate situations. Because of this heightened denial, it is more difficult to get the pathologic gamblers away from their ad­diction compared to other addicts. Pathologic gamblers believe that they can afford to gamble and cover bets, they fail to recognize that the stakes may include losing employ­ment, home, family, and self-respect.

The damage caused by gambling crosses all economic and social classes. Millions of taxpayer dollars that are meant to provide food, clothes, and housing for the poor are gambled and lost. The destitute created by gambling con­tinue to bet their welfare money in slot machines.

Association of gambling and crime

Gambling is associated with increased crime rates. In a recent study in a medium security prison in Nevada, Templer et al noted that 26% of the inmates were pathologic gamblers.[25] Rosenthal et al describing the high prevalence of crime in gamblers write, “A review of the nature and course of the disorder, including the studies of criminal behavior, leads one to conclude that the majority of pathologic gamblers (at least 70% to 80%) commit offenses late in the disorder and that these offenses are strictly gam­bling related.”[26] Asserting the fact that gambling makes these people criminals, the authors go on to write, “This is a population which is essentially nonviolent and which turns to property crimes out of desperation over gambling losses.”

Recently, Blaszczynski et al have reviewed all the scientific literature on the subject of association of crime and gambling.[27] One of their conclusions was: “Evidence sup­ports the contention that pathologic gamblers are at high risk for committing criminal offenses in order to maintain their habitual gambling behavior.” They continue their tes­timony and add: “An antisocial personality while acting to increase the risk factor is in itself an insufficient explana­tion for the observed link.”

As the prevalence of gambling increases in the coming years, more data are likely to be published to establish the relation of gambling and crime.

Advantages of gambling

To enhance revenues, many states have gone into the gambling business. Most states have an officially sanctioned or state-sponsored lottery. Gambling is big business in the United States, with about $330 billion wagered in 1992.[28] [29]Some of the taxes collected from this business go to support positive causes.

In the United Kingdom in 1995, the lottery was gener­ating up to 60 million pounds a week. Some of the money generated, as in the US., goes to charities and supports vari­ous honorable causes. In the United Kingdom’s lottery, 50% of revenues go to prize money, 12% to government taxes, 5% to the parent company that runs the lottery, 5% to the retailer, 23% to the arts, sports, national heritage and Mil­lennium Fund, and 5% to charities.[30]

The Holy Quran has alluded to some of these possible ad­vantages of gambling.[31] However, some of these economic gains are perceived and not real gains. Why are these un­real? No products are generated in gambling, and nothing constructive occurs. The money changes hands without truly turning the wheel of economy.

Some good does come out of the gambling industry. The key question is at what cost? Is there any end to put­ting a dollar figure to all aspects and affairs of human life?

Close relation to alcoholism and other addictions

There are several similarities between gambling and drug addiction, especially alcohol abuse. Many studies have shown that alcoholism and gambling coexist. About 50% of pathologic gamblers have a history of alcoholism or other substance abuse.[32] [33] [34] The converse, that there is increased prevalence of gambling in drug abusers, is also true. Lesieur et al investigated patients in an alcoholism and drug dependency treatment facility and found that of the 458 pa­tients, 9% were pathologic gamblers and another 10% had some signs of problematic gambling. Like substance abus­ers, gamblers have a limitless capacity of self-deception and denial. Pathologic gambling, like alcoholism, is also more common in children of alcoholics. The common etio­logic issues between gambling and other addictions have been discussed above. In short, there are several similari­ties between gambling and drug addiction in general and alcoholism in particular. Centuries before science under­stood the similarities between alcoholism and gambling, the Holy Quran discussed the two in the same verses that are quoted above.

Treatment

One commonly recommended treatment for pathologic gambling is individual psychological education. Group and family counseling are also suggested. Gamblers Anonymous, a nationwide self-help group can be reached at 213-­386-8789. There is also a toll free information hotline run by the U.S. National Council on Problem Gambling. Its number is 800-522-4700.

In light of Quranic recommendations and the mount­ing scientific evidence of problems associated with gam­bling, the Islamic opinion is that the true solution to the problem is to ban gambling.

Conclusions

The above studies and surveys clearly indicate that gambling not only promotes crime but also causes many other physical and psychological illnesses. By legalizing gambling we are encouraging crime and suffering of the society and individuals.

One of the major concerns is the rising prevalence of gambling in the young. The best and surest means to regu­late teenagers’ access to gambling is to ban gambling com­pletely. The common sense teaching in this regard is that what is bad for children is bad for us. Adults often try to dissociate adolescent and adult behavior by giving youth advice that they themselves do not follow. Such techniques seldom succeed. Invariably, youngsters copy the shortcom­ings of the older generation. It is time for us to face reality and resist the temptation of short -term economic gains from gambling. Rather than small unsure steps, what is needed is a bold decision to ban gambling for good. For the present, our society is in partial denial of the negative consequences of both alcohol and gambling. Just as the pathologic gam­blers need to overcome denial and see the facts with an honest attitude, so does society need to reevaluate its condoning attitude toward gambling.

The Holy Quran’s warning about the menace of gambling dates back to the 7th century.  It has described its association with alcohol and crime. It has alluded to some possible advantages, with emphasis on the fact that the disadvantages outweigh the advantages. The Quranic description, is indeed, very accurate and precise. It is impressive that the Holy Quran described these facts at a time that is centuries removed from the modern time of scientific inquiry and knowledge.

References

——————————————————————————–

[1] Ison C, McGrath DJ: Reader’s Digest. April 1996:101-5.

[2] American Psychiatric Association: Diagnostic and sta­tistical manual of mental disorders. 4th edition. Washing­ton, DC: APA, 1994.

[3] American Psychiatric Association: Diagnostic and sta­tistical manual of mental disorders. 4th edition. Washing­ton, DC: APA, 1994.

[4] Murray JB: Review of research on pathological gam­bling. Psychological reports 1993;72:791-810.

[5] Cusack JR, Malaney KR, DePry DL: Insights about patho­logical gamblers. ‘Chasing losses’ in spite of the conse­quences. Postgrad Med 1993;93:169-79.

[6] Kezwer G: Physicians say government-approved love affair with gambling sure bet to cause problems. Can Med Assoc J 1996;154:84-8.

[7] Breo DL: In treating pathological gambler, Mds must overcome the attitude, ‘Why bother’?’ JAMA 1989;262:2599­606.

[8] Shopkeepers break ban on child gamblers. Indepen­dent 1995;25:3.

[9] Moran E: Gambling with nation’s health? Majority of secondary school children buy tickets. (Letters). BMJ 1995;311: 1225-6.

[10] Buchta R: Gambling among adolescents. Clin Pediatr 1995;34;346-8.

[11] Lesieur HR, Cross J, Frank M, et al: Gambling and pathological gambling among university students. Addic Behav 1991;16:517-27.

[12] Roy A, AdinoffB, Roehrich L, et al: Pathological gam­bling: a psychological study. Arch Gen Psychiatry 1988;45:369-73.

[13] Roy A, De Jong J, Linnoila M: Extroversion in patho­logical gamblers: correlates with indexes of noradrenergic function. Arch Gen Psychiatry 1989;46:679-81.

[14] Sullivan P: PEl’s video-gambling machines creating an addiction problem, island MDs warn. Can Med Assoc J 1993; 148:257-9.

[15] Sullivan S, Abbott M, McAvoy B, et al: Pathological gamblers: will they use a new telephone hotline? New Zealand Med J 1994;107:313-5.

[16] Blaszczynski A, Steel Z, McConaghy N: Impulsivity in pathological gambling: the antisocial impulsivist. Addic­tion 1997;92:75-87.

[17] Volberg RA, Abbott MW: Lifetime prevalence estimates of pathological gambling in New Zealand. International J Epidemiol 1994;23 :976-83.

[18] Volberg RA, Abbott MW: Lifetime prevalence estimates of pathological gambling in New Zealand. International J Epidemiol 1994;23 :976-83.

[19] Thorson JA, Powell FC, Hilt M: Epidemiology of gam­bling and depression in an adult sample. Psychological Reports 1994;74:987-94.

[20] Kofoed L, Morgan TJ, Buchkoski J, et al: Dissociative experiences scale and MMPI-2 scores in video poker gam­blers, other gamblers, and alcoholic controls. J Ner Ment Dis 1997;185:58-60.

[21] Becona E, Del Carmen Lorenzo M, Fuentes MJ: Patho­logical gambling and depression. Psychological Reports 1996;78:635-40.

[22] Miller MA, Westermeyer J: Gambling in Minnesota. Letter. Am J Psychiatry 1996;153:845.

[23] Gamblers Anonymous: Young gamblers in recovery. Leaflet. International Services office.

[24] Lesieur HR, Blume SB: Characteristics of pathological gamblers identified among patients on psychiatric admis­sion service. Hosp Commun Psychiatry 1990;41:1009-12.

[25] Templer DI, Kaiser G, Siscoe K: Correlates of patho­logical gambling propensity in prison inmates. Compre­hensive Psychiatry 1993;34:347-51.

[26] Rosenthal RJ, Lorenz VC: The pathological gambler as criminal offender. Comments on evaluation and treat­ment. Psychiatric Clin North Am 1992;15:647-60.

[27] Blaszczynski A, SHove D: Pathological gambling: fo­rensic issues. Australian and New Zealand J Psychiatry 1996;30:358-69.

[28] Christiansen EM: The 1992 gross annual wagering of the United States: Part I and II, International Gaming and Wagering Business, 1993;7:12-33.

[29] Christiansen EM: The 1992 gross annual wagering of the United States: Part I and II, International Gaming and Wagering Business, 1993;8: 12-30.

[30] Dean M: London perspective: Medical research chari­ties squeezed. Lancet 1995;345:1228.

[31] The Glorious Quran, Al Baqarah 2:220.

[32] Smart RG, Ferris J: Alcohol, drugs and gambling in the Ontario adult population, 1994. Can J Psychiatry – Re­vue Canadienne de Psychiatrie 1996;41:36-45.

[33] Lesieur HR. Blume SB, Zoppa RM: Alcoholism, drug abuse, and gambling. Alcoholism: clinical and experimen­tal research 1986;10:33-8.

[34] Ramirez LF, McCormick RA, Russo AM: Patterns of substance abuse in pathological gamblers undergoing treat­ment. Addict Behav 1983;8:425-8.