The Las Vegas center is the VA's second inpatient treatment facility for veterans, who are at higher risk of gambling addiction.
Army veteran Ronnie Reyes said the time he spent in the military is a big part of the reason why he became a gambling addict.
Reyes spent twelve years in the Army. Though he didn't see combat, he was a victim of military sexual trauma. After he left the service in 1991, he became a frequent gambler in Las Vegas casinos.
"I think it has a numbing effect," Reyes said. "When I'm in the heat of the moment, at the tables or a slot machine, I just get tunnel vision. And nothing else seems to matter."
Reyes got a job in a casino as a blackjack dealer, even as his gambling addiction worsened. He said it was hard for him to admit he had a problem until he was thousands of dollars in debt.
"There is not a substance attached to it," Reyes said. "There is no drug, there is no bottle. It's a behavior that can be easily hid."
Reyes now is seeking treatment through the Department of Veteran Affairs Southern Nevada Healthcare System. Late last year, the system opened an inpatient gambling treatment program - only the second such program in the VA. The first opened at a VA center in Ohio in 1974.
In the Las Vegas program, veterans spend up to 45 days in therapy and group activities that attempt to treat their addiction.
Roxanne Untal, who runs the 20-bed Las Vegas clinic, said she has patients with more than $100,000 in debt. Researchers say that's one reason veterans with gambling addiction have a higher suicide rate.
"You can treat the gambling, and once you treat the gambling, you're still facing that debt," Untal said. "And how do you go about living a life that is meaningful with that? I think it's just very different consequences and very different pathways."
VA research concluded that among people who have tried gambling, about five percent are addicted. But the number among veterans is eight percent. Vets with PTSD have a 60 percent higher rate of gambling addiction than the general population.
And the VA statistics may be low, because the agency doesn't screen for gambling addiction the way it does for drugs and alcohol, Untal said.
Gambling also hasn't attracted nearly as much funding as drug and alcohol addiction.
"Drugs and alcohol have public voices, public faces, and a much longer history of those voices advocating in this field," said Bo Bernhard, executive director of the International Gaming Institute at University of Nevada, Las Vegas. "Gambling addiction is really a newer field."
For the VA, Las Vegas was an obvious choice
The history of seeing gambling as an addiction actually starts with one pioneering VA doctor - Robert Custer in Ohio.
Custer opened the first inpatient treatment center for problem gambling in 1974 near Cleveland, after he saw symptoms among his drug and alcohol patients.
"Many of them were 'swapping seats on the Titanic,' as he used to put it," Bernhard said. "We're switching from a drug and alcohol addiction to what he thought of, first, as a gambling addiction."
Custer left the VA shortly after creating the first treatment program. In 1980, the American Psychiatric Association formally recognized gambling as an addiction, largely because of Custer's work.
There are outpatient gambling programs throughout the VA system. But for decades, Custer's Cleveland-area VA remained the only inpatient treatment clinic. With its high concentration of gambling and a growing veteran population, Las Vegas seemed the obvious choice for a second.
One thing that makes gambling addiction different from drugs or alcohol is "the chase." The feeling that no matter how deep the hole, a gambler can somehow win everything back.
"I get paid one day, the next day I'm broke," said Las Vegas patient Jim Romero, who was a mechanic in the Air Force in the early 2000s.
Romero was homeless by the time he entered the VA program. He's been battling one addiction or another for 20 years.
"I thought I had it under control, but I'll never have this disease under control," he said. "It's something I'll have to fight every single day."
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting.
