Photo/Illutration A roulette wheel used at a school for training casino workers in Osaka in 2018 (Asahi Shimbun file photo)

With casinos coming to Japan, an advisory panel to the health minister is recommending that treatment for gambling addiction be covered by the national health insurance program starting from April.

The recommendation, by the Central Social Medical Insurance Council, on Jan. 10, comes as the government is moving ahead with allowing up to three casino-centered resort projects to open.

The government legalized casino gambling in Japan in 2018 and has been pushing the projects to bolster the economy.

However, concerns have been voiced over a likely spike in gambling addicts when casinos open in various locales in the first half of the 2020s.

About 700,000 people are suspected of having a gambling addiction, according to an estimate by the Ministry of Health, Labor and Welfare.

Under the law, gambling addiction is a disorder that is disruptive and destructive to a person’s daily and social life.

Treatments expected to be covered by national health insurance include group therapy, in which problem gamblers collectively share their experiences to help them overcome the disorder.

But critics are opposed to the use of the public insurance program or public funds for such therapies, saying addicts started gambling at their own discretion.

Even if group therapy becomes more accessible due to coverage by national health insurance, data showed that such treatment is effective only for a limited period.

A survey by the government-affiliated Japan Agency for Medical Research and Development found that nearly 60 percent of gamblers who underwent group therapy started gambling again within six months.

The study involved 187 patients from 35 medical institutions across Japan. A research team with the agency developed a program to treat problem gamblers based on various remedies conducted at several medical institutions.

Of the 187 patients, 95 signed up for the program. The study found that 42.6 percent stayed away from gambling for six months after going through the program. The rest returned to gambling some time during that period.

As for the 92 people who did not participate in the program, only 2.2 percent could stop gambling.

The study also showed that addicts who resumed gambling spent about 50,000 yen ($458) while gambling 2.4 times in the most recent month six months after finishing the program.

Those who did not join the program spent about 118,000 yen while gambling nine times a month.

It is difficult for early detection of gambling addiction unless there are telltale signs such as a person incurring ballooning debts, according to Susumu Higuchi, director of the Kurihama Medical and Addiction Center with the National Hospital Organization.

He said many addicts tend to resume gambling since pachinko parlors, where a pinball game can be played for money, are everywhere in the country. In addition, horse racing and motorboat races were easily accessible on the internet.

“Gambling addicts need to submit to a follow-up program on a long-term basis,” Higuchi said. “There are many people who have not sought treatment. It is important to have them undergo therapy and rein in the number of patients.”

The government plans to set up key facilities and specialized clinics to treat patients with gambling problems in all 47 prefectures by the end of March 2021.

But only 35 local governments had done so as of August 2019.

Experts warned that there is a shortage of medical practitioners specializing in the field.

(This article was written by Kohei Tomida and Ryuichi Hisanaga.)