big ideas by jim leitzel

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1 big ideas by jim leitzel Samuel Taylor Coleridge,the early Romantic-era British poet, battled opium addiction throughout his adult life. Thomas De Quincey, the British essayist and another famous opium addict, relates one stratagem that Coleridge deployed in a largely vain attempt to control his habit. Coleridge, he explained: went so far as to hire men porters, hackney-coachmen, and others to oppose by force his entrance into any druggist s shop. But, as the authority for stopping him was derived simply from himself, naturally these poor men found themselves in a metaphysical fix, not provided for even by Thomas Aquinas or by the prince of Jesuitical casuists. According to De Quincey, Coleridge would renounce his prior contracts with his hirelings in these terms: An emergency, a shocking emergency, has arisen quite unlooked for. No matter what I told you in times long past. That which I now tell you, is that, if you don t remove that arm of yours from the doorway of this most respectable druggist, I shall have a good ground of action against you for assault and battery. Coleridge chose his vice and his timing poorly. Had he been a modern gambler, he could have signed up for what is now termed self-exclusion. Casino bouncers would have no metaphysical qualms about keeping their arms on the doorway. Gambling self-exclusion debuted at a Canadian casino in 1989, but caught on fast elsewhere. Provisions for self-exclusion are J IM LEITZEL is the director of public policy studies in the College at the University of Chicago now part of the licensing requirements for lotteries and gambling establishments in Australia, Britain and many American states. Moreover, self-exclusion options are frequently initiated by gambling establishments, even where they are not mandated by regulators. In Missouri, more than 10,000 people have signed up for lifetime bans from the state s riverboat casinos. Self-exclusion does not solve all problems with compulsive gambling, of course. Indeed, it is frequently initiated by a gambler only in the wake of personal catastrophe. Nevertheless, self-exclusion does help to bolster the self-control of some problem gamblers. Or potential problem gamblers: many of those who volunteer for exclusion do so preemptively, taking the step before signs of pathological gambling are evident. Self-exclusion programs are particularly appealing because they are voluntary, though sometimes the gamblers do get a little help: 76 The Milken Institute Review

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3 big ideas In the Netherlands, casino employees monitor betting to identify potential problem gamblers, many of whom then agree to selfexclude. Proactive self-exclusion programs are part of the new casino regulations in the United Kingdom, too. The rules for self-exclusion vary from jurisdiction to jurisdiction and among types of gambling. Features that the rules tend to share, however, are the imposition of physical inaccessibility and reward diminution. For bricks-and-mortar casinos, physical inaccessibility means that gamblers on the excluded list are, Coleridge-like, barred from the premises. For online wagering, inaccessibility (more virtual than physical) consists of closing the account under which gambling is undertaken for the duration of the exclusion. The reward diminution element of self-exclusion comes about by preventing excluded gamblers from collecting large wins. To receive a sizable jackpot at a casino, a gambler not only needs to hit the jackpot, but also must provide personal identification to the casino officials. In the United States, federal tax law neatly dovetails with reward diminution because the IRS requires documentation for payouts exceeding $1,200. Bettors who have self-excluded, therefore, are unable to collect appreciable jackpots. So, in addition to rendering gambling inaccessible, self-exclusion takes away much of the potential monetary reward and eliminating the potential for a big hit significantly diminishes the excitement of gambling. It s as if the Coleridge tactic became enforceable, while rendering any opium procured despite the exclusion to be unpalatable. Neither the physical inaccessibility nor the reward diminution brought about by self-exclusion programs are beyond circumvention. Some self-excluded gamblers return to their favorite betting locales and manage to avoid detection. Nevertheless, many gamblers abide by the exclusion rules. Just the knowledge that you are on the self-exclusion list apparently helps to reduce cravings to gamble. Individuals don t have to be opium-addicted transcendental philosophers to employ physical unavailability and reward diminution to help manage their own temptations. You might opt not to keep any alcohol, cigarettes or ice cream at home. You might stick with a slow dial-up Internet connection or go without the Internet service entirely at all to raise barriers to the consumption of Web pornography or cyberbetting. You might 78 The Milken Institute Review

4 miguel gandert/corbis make a public abstinence pledge to lower the reward to vice consumption, as future transgression would trigger the anger and disappointment of family and friends. An alcoholic might take the drug disulfiram, which induces nausea with the first drink. Stomach reduction surgery can reduce the urge to eat, while also raising a physical barrier to bingeing. But couldn t the equivalent of gambling self-exclusion be employed more broadly for public policy toward vice? Why not allow individuals to be self-excluded from alcohol or tobacco purchases? We already check IDs for age verification, so checking IDs against a self-excluded database shouldn t be that much more costly. We could even go further, and require legal purchasers of vice goods to acquire a special license precisely the recommendation that drug policy expert Mark Kleiman, director of the Drug Policy Analysis Program at UCLA, has offered for deterring alcohol abuse. A decision not to acquire the license then becomes a self-exclusion device. Today s default setting for legal vices is that adults automatically qualify for as much as they care to consume. A license requirement would alter the default, so that people would have to take positive steps to legally engage in vice, and licensed consumers could set their own purchase limits. A system of First Quarter

5 big ideas fines for those who engage in the vice in the absence of a license would add the reward diminution element to the barrier to availability facing unlicensed consumers. Note, too, that the licensing regime could itself be supplemented with a meta-self-exclusion option, whereby people could put themselves on a list denying them the possibility of receiving a license in the future. So, with little imposition upon adults who make a considered choice to drink or smoke or gamble, a self-exclusion system or a broader licensing regime could be provided to those Drug prohibition already sets up a sort of exclusion regime for would-be drug consumers, one that includes both physical unavailability and through the prospect of arrest along with the uncertain purity and danger of black market supply reward diminution. The exclusion program implemented through prohibition is not well targeted, however, since it applies just as much to those with criminogenic addictions as to those whose drug use generates little or no social consequence. In some respects, drug prohibition is perversely targeted, as physical availability of illicit drugs often is greatest for those whose With little imposition upon adults who make a considered choice to drink or smoke or gamble, a self-exclusion system or a broader licensing regime could be provided to those who fear that such habits might get the best of them. who fear that such habits might get the best of them. There are many tricky issues here, such as the duration of exclusion and what to do about people whose original decision to selfexclude is made in unthinking haste. But the existing gambling programs already are pointing to methods of dealing with these sorts of details. Self-exclusion or buyer licensing that requires an opt-in might sound heavy-handed for legal vices, though I think that a case can be made for either approach. But the advantages of licensing or self-exclusion seem most pronounced when applied to currently illegal substances such as cocaine and heroin. Heavy consumers of some illegal drugs know they are exercising bad judgment, so they might welcome programs (short of incarceration) that limit their consumption. consumption is most problematic. The collateral effects of prohibition everything from the loss of civil liberties to violent crime induced by competition among dealers for turf make this sort of poor targeting even more objectionable. Buyer- and seller-licensing that includes a self-exclusion mechanism, by contrast, is compatible with the ideal of minimizing government interference in peoples lives. Under such a system, adult users would have to apply for a license, and demonstrate knowledge of the potential dangers of the drug to qualify. They would have to choose the maximum amount of the drug that they could purchase over a period of time a requirement that itself might encourage temperance. To this end, Swedish Internet poker patrons are required to choose gambling thresholds. 80 The Milken Institute Review

6 robb hill/ibid In the case of drugs, the maximum amount allowed by law would presumably be large enough to sustain the most ardent addict, but small enough to limit diversion into black markets. Sellers would be licensed or the government would operate monopoly outlets. And licensed buyers might have to order their drugs in advance, with the opportunity to revoke the order during the ensuing waiting period. Drug sales might be taxed to discourage use though not to the extent to create a black market and purity would be regulated. Advertising would be prohibited or at least controlled, as with some state lotteries today. (A standard element of gambling selfexclusion is that providers must remove excluded individuals from promotional mailing lists and inducements such as frequent-player programs.) Individuals who misbehave under the influence of the drug would have their licenses revoked, or be involuntarily placed on the excluded list. One could even imagine a requirement of annual evaluations for drug-license holders to determine how they are coping with the drug, and to counsel lower limits, complete self-exclusion or treatment admission for those whose drug use appears to be getting the better of them. That is, self-exclusion could be active, like at Dutch casinos, and drug sellers could be drafted into the activity of barring their best customers a far cry from their current behavior. Among the advantages of the licensing/exclusion approach outlined above are that it allows resources to be targeted at problematic drug use not at the majority of use, which is benign. The black market would be undermined, so that for many people, the availability of drugs would decrease. Those concerned with their own self-control would have options available to limit drug availability more and better options than those generally available to alcoholics today, or available to opiate addicts like Coleridge in the 18th century. And the inequities and the negative collateral consequences of drug criminalization could largely be dispensed with. M First Quarter