blers in their early stages, do aim at reducing and controlling rather than stopping gambling (Lesieur, 1998).

It is important to consider that treatment for gambling is most likely to be provided by a combination of specialized and nonspecialized providers—that is, by a combination of those who treat gambling problems as the focus of their work and those who provide general counseling but occasionally work with gamblers. It may be that nonspecialized providers deliver the majority of addiction treatment services. As an adjunct or alternative to primary treatment, treatment providers often refer gamblers to Gamblers Anonymous and Gam-Anon (Lesieur, 1998; Stinchfield and Winters, 1996). In fact, Gamblers Anonymous appears to be the most readily available form of help for the problem gambler and its out-of-pocket costs are virtually nil. Based on a review of its international services, its Internet web site, and archival records (Svendsen, 1998), Gamblers Anonymous has meetings in all 50 states, with the average number of meetings annually per state being 26 and the median 14, an increase of 36 percent from 1995 to 1998 (see Appendix E).

As already noted, it is the consensus of state affiliates of the National Council on Problem Gambling that the majority of health insurers in the United States do not reimburse those receiving treatment for pathological gambling (Svendsen, 1998). There is nevertheless some funding for gambling treatment, although it is small. Many of the 34 state affiliates, as well as the national organization itself, receive some funding from state or gambling industry organizations (Letson, 1998; Svendsen, 1998). Approximately half of them report public funding specifically to support treatment for problem gambling (Svendsen, 1998); the revenues generated by gambling in the state are used to pay for these services. Amounts for problem gambling treatment services range considerably (from $100,000 to $1.5 million), although most state appropriations are at the low end. Not surprisingly, the affiliate councils see this level of funding as insufficient (Letson, 1998:53). Even in states that spend a good deal on pathological gambling, the amounts are small in comparison to what they take in from legalized gambling revenues. For example, the amount appropriated by the state of New York to its Council on Problem Gambling represents a mere one-tenth of 1 percent of the state's