The Patient Gambler

The Patient Gambler

Parkinson's may have driven him to gamble, but authorities were slow to stop him

Tom Blackwell, National Post, Saturday, October 30, 2004

Joe Treyes must have cut quite a figure at Toronto's Woodbine racetrack. Not long into slot-machine sessions that stretched from dawn to dusk, the 58-year-old's medication would wear off and Parkinson's disease would take hold of his slight body, causing it to shake and jerk almost as crazily as the spinning reels on the machines.

Sometimes he'd fall down, or spill someone's free drink.

Other patrons just thought he was happy, perhaps having hit the rare jackpot. "I was so popular there. Everybody knew me because I was the guy who danced and whooped a lot and went crazy at the machine," Treyes recalls of that period from late 2003 to this past March. "But at the same time, my Parkinson's was acting up. Some people thought I was just dancing. They didn't know."

Scientists now believe the debilitating disease, or the drugs used to treat it, may actually be encouraging gambling addiction in Parkinson's patients.

Regardless, the electrical engineer should never have even been inside those slot-machine halls. Three years earlier, he had signed a self-exclusion agreement at Woodbine: an indefinite contract that called on Ontario gaming authorities to try to keep him out of the province's casinos.

He stayed away of his own accord for two years, undergoing counselling and electro-shock therapy in a fruitless attempt to curb his addiction. But when he started gambling at Woodbine again last year, no one stopped him, and the one-armed bandits relieved him of his last $100,000 in savings.

His photograph would have been on file as part of the self-exclusion process, but Treyes' identity was no secret to casino staff. He says he frequently collapsed when the drugs to control his Parkinson's wore off and he had to be helped into Woodbine's back office by security personnel, who usually took his name and other particulars. They let him rest until the next dose of medication started kicking in, then he'd head back to the gaming floor.

"They let me play and play," says Treyes. "I was out of control."

This is hardly surprising, says an Alberta-based expert who has studied casino exclusion systems. Most provinces offer the service as a key plank of their anti-addiction efforts, says Dr. Robert Williams of the University of Lethbridge's school of health science, but in his view the orders are rarely enforced with any vigour, making them little more than public relations gestures.

Authorities in the Netherlands and other European countries, on the other hand, have made exclusion work, partly by requiring gamblers to show identification at the door.

"It seems very odd to me that the [provincial] government would drag its feet in assuming some responsibility for a contract it has signed," Williams says. He mentions what may be a possible explanation: problem gamblers account for a major chunk of casino revenues.

The Ontario Lottery and Gaming Corp. says it cannot comment on Treyes' case for privacy reasons, but says generally that catching excluded gamblers as they enter their premises is all but impossible. About 12,000 patrons a day walk into Woodbine, for instance, noted Theresa Roncon, a corporation spokeswoman.

As it turns out, Treyes' strange combined affliction of Parkinson's and pathological gambling is no more unique than his experience with exclusion. Mounting evidence suggests sufferers from the debilitating disease are particularly susceptible to gaming problems, perhaps because of medication they take that pumps the brain chemical dopamine into their bodies. Dopamine helps alleviate the tremours, shuffling gait and stiffened facial muscles associated with Parkinson's, but also has been linked to compulsive gambling behaviour.

"The normal little voice in your head that tells you, 'Don't do this any more,' doesn't work," says Dr. Mark Guttman, a leading Canadian Parkinson's physician.

"I've had doctors, lawyers, very educated people get involved in this kind of activity." One of his patients lost $500,000 gambling.

Just this past week, a session of a major conference on Parkinson's in Austria focused on gambling, sex and other addictions among patients with the disease. "It's a hot topic," says Guttman, who is Treyes' doctor.

He has 20 Parkinson's patients with gambling problems, out of a caseload of 1,200. While this percentage is not high, he notes most started gambling obsessively after being put on the medication and stopped as soon as they were taken off. And it would seem unusual that anyone coping with a life-altering, degenerative medical condition would become a compulsive gambler if something powerful was not driving them, Guttman says.

Indeed, a study presented at the conference suggests a much larger proportion of Parkinson's patients may be in trouble with gambling. The paper by Drs. Abraham Lieberman and Ali Rezai, top U.S. experts on the disease, note 20% of patients in an on-line survey indicated they had gambling addictions, several times the rate in the general population. The higher number could partly stem from the survey's methodology, but is likely also explained by anonymous participants feeling freer to admit an embarrassing problem, the authors say.

Treyes, a native of the Philippines, was working as an engineer at Delphax Systems, a maker of high-speed printers in Brampton, Ont., when he was diagnosed with Parkinson's in 1993. Three years later, he left to go on long-term disability. He says he started playing the slots at Mohawk Raceway west of Toronto and then at Woodbine. He celebrated Christmas Day, 1999, by playing the machines at Mohawk, near Guelph, Ont. "I left my wife and daughter to gamble."

Finally, after losing about $20,000, he decided on his own to sign the exclusion order in September, 2000. He saw a psychiatrist who prescribed electro-convulsive therapy, which Treyes believes only made his addiction worse. He spent three months at Homewood counselling centre in Kitchener, still making little progress.

He was also taken off the type of drug suspected in Parkinson's patients' gambling problems, but his behaviour apparently chang-ed little.

Then in October, 2003, he went back to Woodbine, this time bankrolled by his share of proceeds from the family home, sold after he separated from his wife. His bank statements from the period tell a sad story, the balance of about $100,000 shrinking away relentlessly, with withdrawals of several hundred dollars almost every day.

Eventually, he dipped into his disability cheques and had nothing left to pay his rent. This summer, he was evicted from the nursing home where he was living. Meanwhile, his wife and 27-year-old daughter, fed up with the spiralling addiction, have abandoned him.

As he hit rock bottom, it seems, the Ontario Lottery and Gaming Corporation finally decided it had had enough of its disruptive, time-consuming customer. On Jan. 2 this year, when Treyes' bank balance stood at minus-$28, the agency took out a trespassing order on Treyes, indicating they would have police charge him if he tried to come back. But he did anyway, seemingly unimpeded, and raced through another $30,000 by March.

He says staff at Woodbine told him the trespass order was signed out because he had "abused the system," but never mentioned the exclusion order.

It is a pattern Williams is familiar with. Studies in Quebec and Connecticut showed that those who signed a self-exclusion agreement and wanted to return encountered no obstacles. In the Netherlands, not only is more done to enforce the orders, but the idea of signing them is promoted heavily. If gamblers visit a casino frequently, a staff member will approach them and ask if they want to sign an exclusion order, Williams says.

Roncon says about 1,000 gamblers a year have signed self-exclusion applications since they became available in 1999. A number of gamblers have been discovered and ordered to leave, but no statistics are available on exactly how many, she said.

But Williams says casinos tend to be very effective in keeping out those it really does not want as customers, such as "card counters" and other cheats and people who unduly disrupt the facility.

Treyes says he is looking for some kind of help, at least to oversee his disability cheques, and keep them out of the slot machines. He is clearly still hooked.

After a recent interview ended, Treyes shuffled up to a reporter's car as it was about to pull away.

"I hate to do this," he says, "but I'm broke. Can you give me $5?"

CanWest Interactive Inc. is an affiliate of CanWest Global Communications Corp.



	The Patient Gambler Parkinson's may have driven him to gamble, but authorities were slow to stop him Tom Blackwell, National Post, Saturday, October 30, 2004 Joe Treyes must have cut quite a figure at Toronto's Woodbine racetrack. Not long into slot-machine sessions that stretched from dawn to dusk, the 58-year-old's medication would wear off and Parkinson's disease would take hold of his slight body, causing it to shake and jerk almost as crazily as the spinning reels on the machines. Sometimes he'd fall down, or spill someone's free drink. Other patrons just thought he was happy, perhaps having hit the rare jackpot. "I was so popular there. Everybody knew me because I was the guy who danced and whooped a lot and went crazy at the machine," Treyes recalls of that period from late 2003 to this past March. "But at the same time, my Parkinson's was acting up. Some people thought I was just dancing. They didn't know." Scientists now believe the debilitating disease, or the drugs used to treat it, may actually be encouraging gambling addiction in Parkinson's patients. Regardless, the electrical engineer should never have even been inside those slot-machine halls. Three years earlier, he had signed a self-exclusion agreement at Woodbine: an indefinite contract that called on Ontario gaming authorities to try to keep him out of the province's casinos. He stayed away of his own accord for two years, undergoing counselling and electro-shock therapy in a fruitless attempt to curb his addiction. But when he started gambling at Woodbine again last year, no one stopped him, and the one-armed bandits relieved him of his last $100,000 in savings. His photograph would have been on file as part of the self-exclusion process, but Treyes' identity was no secret to casino staff. He says he frequently collapsed when the drugs to control his Parkinson's wore off and he had to be helped into Woodbine's back office by security personnel, who usually took his name and other particulars. They let him rest until the next dose of medication started kicking in, then he'd head back to the gaming floor. "They let me play and play," says Treyes. "I was out of control." This is hardly surprising, says an Alberta-based expert who has studied casino exclusion systems. Most provinces offer the service as a key plank of their anti-addiction efforts, says Dr. Robert Williams of the University of Lethbridge's school of health science, but in his view the orders are rarely enforced with any vigour, making them little more than public relations gestures. Authorities in the Netherlands and other European countries, on the other hand, have made exclusion work, partly by requiring gamblers to show identification at the door. "It seems very odd to me that the [provincial] government would drag its feet in assuming some responsibility for a contract it has signed," Williams says. He mentions what may be a possible explanation: problem gamblers account for a major chunk of casino revenues. The Ontario Lottery and Gaming Corp. says it cannot comment on Treyes' case for privacy reasons, but says generally that catching excluded gamblers as they enter their premises is all but impossible. About 12,000 patrons a day walk into Woodbine, for instance, noted Theresa Roncon, a corporation spokeswoman. As it turns out, Treyes' strange combined affliction of Parkinson's and pathological gambling is no more unique than his experience with exclusion. Mounting evidence suggests sufferers from the debilitating disease are particularly susceptible to gaming problems, perhaps because of medication they take that pumps the brain chemical dopamine into their bodies. Dopamine helps alleviate the tremours, shuffling gait and stiffened facial muscles associated with Parkinson's, but also has been linked to compulsive gambling behaviour. "The normal little voice in your head that tells you, 'Don't do this any more,' doesn't work," says Dr. Mark Guttman, a leading Canadian Parkinson's physician. "I've had doctors, lawyers, very educated people get involved in this kind of activity." One of his patients lost $500,000 gambling. Just this past week, a session of a major conference on Parkinson's in Austria focused on gambling, sex and other addictions among patients with the disease. "It's a hot topic," says Guttman, who is Treyes' doctor. He has 20 Parkinson's patients with gambling problems, out of a caseload of 1,200. While this percentage is not high, he notes most started gambling obsessively after being put on the medication and stopped as soon as they were taken off. And it would seem unusual that anyone coping with a life-altering, degenerative medical condition would become a compulsive gambler if something powerful was not driving them, Guttman says. Indeed, a study presented at the conference suggests a much larger proportion of Parkinson's patients may be in trouble with gambling. The paper by Drs. Abraham Lieberman and Ali Rezai, top U.S. experts on the disease, note 20% of patients in an on-line survey indicated they had gambling addictions, several times the rate in the general population. The higher number could partly stem from the survey's methodology, but is likely also explained by anonymous participants feeling freer to admit an embarrassing problem, the authors say. Treyes, a native of the Philippines, was working as an engineer at Delphax Systems, a maker of high-speed printers in Brampton, Ont., when he was diagnosed with Parkinson's in 1993. Three years later, he left to go on long-term disability. He says he started playing the slots at Mohawk Raceway west of Toronto and then at Woodbine. He celebrated Christmas Day, 1999, by playing the machines at Mohawk, near Guelph, Ont. "I left my wife and daughter to gamble." Finally, after losing about $20,000, he decided on his own to sign the exclusion order in September, 2000. He saw a psychiatrist who prescribed electro-convulsive therapy, which Treyes believes only made his addiction worse. He spent three months at Homewood counselling centre in Kitchener, still making little progress. He was also taken off the type of drug suspected in Parkinson's patients' gambling problems, but his behaviour apparently chang-ed little. Then in October, 2003, he went back to Woodbine, this time bankrolled by his share of proceeds from the family home, sold after he separated from his wife. His bank statements from the period tell a sad story, the balance of about $100,000 shrinking away relentlessly, with withdrawals of several hundred dollars almost every day. Eventually, he dipped into his disability cheques and had nothing left to pay his rent. This summer, he was evicted from the nursing home where he was living. Meanwhile, his wife and 27-year-old daughter, fed up with the spiralling addiction, have abandoned him. As he hit rock bottom, it seems, the Ontario Lottery and Gaming Corporation finally decided it had had enough of its disruptive, time-consuming customer. On Jan. 2 this year, when Treyes' bank balance stood at minus-$28, the agency took out a trespassing order on Treyes, indicating they would have police charge him if he tried to come back. But he did anyway, seemingly unimpeded, and raced through another $30,000 by March. He says staff at Woodbine told him the trespass order was signed out because he had "abused the system," but never mentioned the exclusion order. It is a pattern Williams is familiar with. Studies in Quebec and Connecticut showed that those who signed a self-exclusion agreement and wanted to return encountered no obstacles. In the Netherlands, not only is more done to enforce the orders, but the idea of signing them is promoted heavily. If gamblers visit a casino frequently, a staff member will approach them and ask if they want to sign an exclusion order, Williams says. Roncon says about 1,000 gamblers a year have signed self-exclusion applications since they became available in 1999. A number of gamblers have been discovered and ordered to leave, but no statistics are available on exactly how many, she said. But Williams says casinos tend to be very effective in keeping out those it really does not want as customers, such as "card counters" and other cheats and people who unduly disrupt the facility. Treyes says he is looking for some kind of help, at least to oversee his disability cheques, and keep them out of the slot machines. He is clearly still hooked. After a recent interview ended, Treyes shuffled up to a reporter's car as it was about to pull away. "I hate to do this," he says, "but I'm broke. Can you give me $5?" © National Post 2004 Copyright © 2004 CanWest Interactive Inc. All rights reserved. CanWest Interactive Inc. is an affiliate of CanWest Global Communications Corp.

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