We’ve all seen the Ambien CR commercials, right? After pronouncing the therapeutic benefits of this dual-layered sleepytime capsule, the announcer quickly reads though the drug’s disclaimer, which can also be found on its print advertisements: “Sleepwalking and eating or driving while not fully awake, with memory loss of the event, as well as abnormal behaviors such as being more outgoing or aggressive than normal, confusion, agitation and hallucinations may occur. Don’t take with alcohol as it may increase these behaviors.”
Also: “Some people using this medicine have engaged in activity such as driving, eating, or making phone calls and later having no memory of the activity.”
Gambling could easily be included in that list of activities as well, and it may be a warning that casino managers, not just Ambien poppers, would be well advised to heed. While the gaming industry has many dirty little “open” secrets among its members, including that in a 24/7/365¼ industry, many individuals turn to uppers and downers (including sleeping pills) to dovetail their biological clock with the clockless casino lifestyle, I’m going to focus now on the consequences of our patrons gambling while under the influence of seemingly innocuous drugs like Ambien. (Since we live in a litigious society, I must clarify that this article is not meant to be definitive—it is merely a conversation starter.)
First, consider this example from “The Hollywood Insider” website, which quotes James Edstrom of “Times Square Gossip”:
“Hollywood star Steve Martin is vowing to stop taking prescription drugs to help him sleep, after discovering he developed an online poker habit after dozing off. The comic sought medical help to cope with his restless nights when doctors suggested he take prescription drug Ambien, typically used as a short-term treatment of insomnia. But its hypnotic effects were too much for Martin, who quit the drug after a lucky night of gambling, because he was so stunned he didn’t remember playing the game at all. He says, ‘For a while I played Internet poker when it was legal, until I had one of those Ambien experiences. It was late at night and I was playing poker… I took an Ambien to go to sleep and I had $500 in my account, I quit, and I went to bed. I woke up the next morning … and I had $1,500 in my account, and I said, ‘Oh, they made a mistake …’ So I called the guy in Pakistan, and he said, ‘No we have your I.P. (Internet Protocol) address. We have you playing between 4 and 5 in the morning …’ I never took an Ambien again.’ ”1
There have been numerous cases brought by gamblers who have claimed alcohol inebriation caused them to take out line of credits that they should not have, but from my limited legal research, I have not found a case where an “altered state” caused by prescribed drugs has been isolated as the impetus for problem gambling and/or credit line acceptance.
The prototypical case may have some of the characteristics of gambler/drinker/busted tycoon Leonard Tose’s countersuit against a casino trying to claim a $1.2 million debt that he owed, which led to a judge ruling that “casinos that allow patrons to gamble while ‘visibly and obviously’ intoxicated are strictly liable for betting losses.”2
Attorney I. Nelson Rose commented on a similar case being decided in Indiana: “That approach may not satisfy a jury. Casinos are in the same position today that bars were in 40 years ago … No bar owner today would allow a drunk to be served alcohol. Yet some casino owners allow gamblers who are obviously out of control to continue to bet.”3
Rose makes this related observation in a CasinoCityTimes.com article: “An old maxim states, ‘For every wrong, there is a remedy.’ That may be true. But it does not say that, ‘For every harm, there is a remedy.’ Sometimes bad things happen. But another person is not liable for damages suffered by a victim unless he has somehow ‘wronged’ that victim. If you trip while walking and reading this article, you will have been injured, but I do not owe you a duty to warn you not to walk while reading.”4
But with no Ambien-specific legal precedent for fog-fueled gambling, I can only offer my own experience and advice to the industry.
A couple years back, I went on a casino junket trip. After the charter flight landed and the bus transported us from the remote town’s airfield, I moseyed (its was an Old West kind of town) down to the casino floor to play nickel-stakes blackjack. After losing my predetermined gaming stake for the day, I savored a traditional prime rib dinner with heartburn-inducing horseradish and went back to my room for a little shut-eye. (Notice me exhibiting responsible gambling behavior by setting and sticking to a loss limit.)
Maybe it was the strange bed, the horseradish or the “wide open”-ness of the town, but I could not sleep. My private, non-HMO physician had prescribed Ambien for just this sort of scenario, so I ingested one little round blue pill and slipped under the covers.
This is where the story gets weird and, as it turns out, all too familiar for Ambien-takers. In the morning, I woke up a little groggy, went downstairs and ordered breakfast. When the bill came, I reached for my wallet and, to my great surprise, found just over one thousand dollars taking refuge in the billfold. Behind the Benjamins was a $500 marker receipt. Huh?!
Between hitting the sack the night before and lumbering down to the coffee shop that morning, I must have made a midnight detour through the casino. And I had absolutely no recollection of anything after drifting off to what should have been dreamland.
After breakfast, I crossed the casino floor and approached the cashier at the marker window, produced my marker receipt, and gingerly handed over five crisp c-notes. The cashier stamped the debt note as “PAID,” and I went to search for a casino manager, glad I hadn’t woken up in arrears.
Upon finding the manager, I asked if he could tell me when I was at the casino. He looked up my player’s card, and sure enough, I had hit the tables between 3 and 5 a.m. Also, according to the system notes, I was betting green, two spots. Then the casino manager told me that, according to the log book, I was really fired up and acting a bit loopy—nodding off during shuffles and zoning in and out while the cards were in play. The question now is should my inattentiveness and occasional nodding off have been a clear sign that I was not performing at full capacity or, to borrow a gambling euphemism, that I was a deck with a few cards missing? Should a casino manager have backed me off the game?
In some jurisdictions, like Colorado, it is actually illegal to place a wager while intoxicated, but the onus is on the player. The sticking point here is that I had not been privately or publicly (observably) imbibing, which would have provided a clear cause for my “loopy” behavior, but my activity was still such that I was noticeably incapacitated to some degree. So what should the casino have done? What should casinos in general do in this sort of situation?
One possible solution is using tracking systems to prevent incidents like this. Some tracking systems can limit players’ gaming options (e.g., during a 24-hour period, the carded player can set a loss of X dollars or allow for Y amount of hours); a machine, with the card inserted, will not operate for the recognized player once those limits have been met. Likewise, these systems could be used to create a voluntary temporary disassociation.
For example, if a player is going to take a sleeping pill and realizes that his ability to take cognizant action will be hindered, then he might ask to be temporarily disassociated from 10 p.m. to 10 a.m. the next morning. Then, if he attempts to play while under the Ambien influence, the machine would disengage just as it would for excluded patrons (i.e., the bill validator would not accept currency or TITO slips); live table games dealers could back the player off. Of course, this proposed solution is not an end-all. As with any system where carded use is voluntary, a player could simply not use his card.
The universal certainty is that personal responsibility lies squarely with the player. Gaming is a voluntary activity and all participants should be cognizant adults. Yet, knowing that one side effect of Ambien, as well as other sleeping pills and certain other prescription medications, is a decreased ability to make logical decisions, implementing a system like this would increase the gaming facility’s presence as a steward, protecting the gamer from himself and the property from unwanted litigation.
Footnotes
1 www.theinsider.com/news/1624273_Steve_Martin_Sleepwalked_On_Ambian
2 www.nytimes.com/1993/03/01/nyregion/gambler-bets-drinks-loses-and-then-s…
3 www.casinoman.net/gambling-news/article/bankrupt-gambler-sues-casino.333…
4 http://rose.casinocitytimes.com/articles/6064.html