According to those close to Tobey Maguire, friends of the Spiderman star are worried that he's a gambling addict.

These rumors come in the wake of the $80,000 settlement that Maguire paid toward the victims of Ponzi-schemer Bradley Ruderman, an ex-hedge funder who’s now serving a decade-long term for defrauding his clients. The back story is this: Maguire, who is evidently very skilled at Texas Hold'Em, supposedly won around $300,000 at secret poker games in New York and Los Angeles, while Ruderman lost five million in all. Maguire hasn’t broken any laws; the payment is his way out of a lawsuit that also targeted Gabe Kaplan of Welcome Back Kotter, The Notebook director Nick Cassavetes and 19 others. The actor was apparently unaware that Ruderman didn’t have the funds to cover his debts.

Maguire certainly isn’t the only bold-faced name to be accused of gambling too much. Ben Affleck, Michael Jordan, Bill Bennett, Charles Barkley, A-Rod, Gladys Knight, Artie Lange, Pamela Anderson, Paris Hilton, and Brandon Davis, among many others, have also gathered ink for the same affliction.

Yet 36-year-old Maguire is the rare star who has done much of his gambling in public. After learning poker from professional player Daniel Negreanu, Maguire competed in and won the World Series of Poker. And professional poker player Phil Hellmuth once said on Poker After Dark that Maguire has won as much $10 million through poker alone.

“I’ve never treated anyone who didn’t have a dual addiction,” reveals Dr. Paul Hokemeyer, a marriage and family therapist who specializes in relationships and addiction.

But Dr. Timothy Fong, Associate Professor of Psychiatry at UCLA and Co-Director of the UCLA Gambling Studies Program, cautions that the way the media treats celebrity gamblers confuses an extremely serious issue. “Just because someone loses $100,000 doesn’t mean that person is a gambling addict,” says Fong (who has never treated Maguire). “If you can afford to lose the money and it doesn’t damage your life, it is considered a hobby—or, at worst, a bad habit. The problem is when people continue to gamble despite horrible consequences.”

Still, Maguire has been public about the fact that he's been sober since the age of 19 and cross-addiction—which often means getting sober and then acting out addictively in other ways—is extremely common. “I’ve never treated anyone who didn’t have a dual addiction,” reveals Dr. Paul Hokemeyer, a marriage and family therapist who specializes in relationships and addiction. “And the primary disease has to be treated before the secondary disease can even be revealed.” Adds Fong, “A solid treatment program will address all addictions but oftentimes therapists will say things like, ‘Glad you stopped smoking crack’ and recommend that a patient take up something like poker, believing it’s benign.”

Yet gambling addiction is the furthest thing from benign. “It’s a disease that kills,” says Fong. “’Died of gambling addiction’ isn’t listed a death certificate when someone commits suicide and 25% of gamblers who have entered treatment have tried to kill themselves.” (The percentage of drug addicts and alcoholics who have attempted suicide, Fong says, is much lower: roughly 10-15%). Also, Fong adds, “Gambling addicts don’t just die from suicide: they also have heart attacks and strokes as a result of not taking care of themselves because of their obsession.”

While California—where Maguire lives—has a higher population of problem gamblers than the rest of the country (roughly four percent compared to a national average of one to two percent, according to Fong), Fong attributes that primarily to the fact that the state offers so many gambling opportunities (horse tracks, Indian casinos, et. Al) and not to any sort of wacky ideas about how if you put the country on its side and shook it, all the loose pieces would fall to California (full disclosure: that's my own theory). But where there's a problem, there's oftentimes a solution and since July, 2009, California has offered free state-funded treatment for gambling addiction. “We have five million dollars a year dedicated to it,” Fong explains. “That includes over 200 licensed therapists and eight free sessions for anyone suffering.” While roughly 32 states have state-funded treatment for gambling addiction—see this map for specific information—California's budget is the largest in total (though not the largest per capita).

The 12-step program Gamblers Anonymous—which is in every major city in the United States—has also come to the aid of many sufferers. “I hear it’s actually an even more supportive program than AA,” Hokemeyer offers. “It’s supposed to be a very tightly knit community.” People who are concerned about their relationship with gambling should consider taking the GA test. As for Maguire, more—as they say—will be revealed.

Anna David is the Executive Editor of The Fix and the author of the books Party Girl, Bought, Reality Matters and Falling For Me. She's written about Tom Sizemore and Steve-O, among others, for The Fix.

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The number of people showing up in emergency rooms for "adverse reactions" to nonalcoholic energy drinks like Amp and Red Bull has shot up tenfold over a four-year period, according to data from the Drug Abuse Warning Network (DAWN) of the federal Substance Abuse and Mental Health Services Administration (SAMHSA). In 2005, DAWN logged just 1,128 emergency department visits involving nonalcoholic energy drinks like Monster, Full Throttle and Rockstar; by 2008 that number shot up to more than 16,000, and in 2009, the most recent year for which DAWN has data, it was 13,114. The problem? Caffeine—a lot of it. The average can or bottle contains up to 500 mg, compared with about 100 mg in a five-ounce cup of coffee or 50 mg in a 12-ounce cola. “There are no safe levels of caffeine,” Dr. Albert Woodward, DAWN's director, tells The Fix. DAWN’s data also found that men are more likely to mix these drinks with alcohol or illegal drugs, while women are more likely to combine prescription drugs with highly caffeinated drinks. And Woodward said younger people have greater access to “central nervous system medications” such as Adderall and other stimulants whose risks are exacerbated when combined with excess caffeine.

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• Secondhand Smoke Tied to Bad Heart Failure Outcomes [Reuters]
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George Harrison, the “quiet Beatle” known as the soul of the band, died 10 years ago today, aged 58. Among the tributes to his brilliant career, it’s worth noting that while the cause of his death is generally reported as cancer, what really killed the Beatles’ lead guitarist—as he freely admitted—was nicotine addiction. He smoked an average of three packs a day for three decades, starting when he was in his teens.

"I got it purely from smoking,” he said when he was diagnosed with throat cancer in 1997. “I gave up cigarettes many years ago, but had started again for a while and then stopped this year.” In 2001 he had surgery for lung cancer, but within months the tumors had metastasized in his brain. Told he might only have weeks to live, he desperately underwent a controversial—and very costly—experimental treatment to bombard the brain tumor with radiation. (The doctor involved, Gilbert Lederman, spent the next ten years promoting himself as “George Harrison’s doctor” and was eventually found guilty of malpractice in a sweeping lawsuit covering 20 wrongful death claims.) Harrison died a few months later. 

In the decade since Harrison’s death, tobacco control and bans have cut US rates of cigarette smoking and lung cancer—but only by 2 or 3 percent, according to the CDC. Not surprisingly, the incidence of the disease mirrors rates of smoking state-by-state—which in turn closely shadow anti-smoking regs. Since the recession, however, funding to implement these laws has fallen to near zero in many states. The biggest change may be measured less in terms of public health than public attitudes. When George Harrison was dying of lung cancer, it was his smoking "habit” that was blamed. Now we understand smoking as an addiction—and nicotine as the hardest substance of all to quit.

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Conrad Murray, most famously Michael Jackson’s "Dr. Feelgood," was sentenced today to four years in prison for the involuntary manslaughter of the late King of Pop. The four-year term is the maximum allowed under state law and could be seen as a warning shot to scrip-happy docs. But some speculate the term may be cut in half due to California's prison overcrowding. Murray’s lawyers requested a probationary sentence, but were denied by the judge. The disgraced doctor said he prescribed Michael Jackson the powerful anesthetic Propofol to help him sleep, and was charged with causing his death. Defense attorneys were unable to convince jurors of their client’s innocence in the six-week trial. “The defendant has displayed a complete lack of remorse for causing Michael Jackson's death," prosecutors stated. Murray’s lawyers countered, "There is no question that the death of his patient, Mr. Jackson, was unintentional and an enormous tragedy for everyone affected." Jackson family members, who claimed Michael was not an addict and pressed for the maximum sentence, wrote, "We are not here to seek revenge. There is nothing you can do today that will bring Michael back."

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Ecstasy—or something posing as it—has been blamed for the deaths of two young British club-goers, with at least 20 more party-goers hospitalized after an all-night dance marathon in London. The exact cause isn't yet established, and reports are vague: the British press variously blames heat stroke, dehydration, and heart failure. "Death by Ecstasy" has been tabloid fodder for so long now that we tend to either take it for granted, or assume they got it wrong: the UK's most famous example was in 1995 with the hugely publicized case of Leah Betts, an 18-year old who fell into a coma and died after taking Ecstasy. X was also blamed for 6 deaths due to excessive body temperature in Florida recently. The Florida X turned out to be PMA (paramethoxyamphetamine) or a similar derivative. Some of these knock-off drugs mimic the chemical composition of X, but the effects can be vastly different. Science has claimed both that X harms your brain—and that those tests were wrong, and it's relatively harmless. Then there's the question of what’s really in the stuff sold. All kinds of alternative chemicals show up in studies of purported MDMA. Professor David Nutt, a former UK drug policy adviser who was fired for his controversial views, calls for a program allowing club-goers to test their ecstasy without fear of arrest. Predictably, this is yet to be adopted. Drug policy experts tell Addiction Inbox that surveys show young club drug users to be remarkably undeterred by this chemical lottery—even given prior knowledge that what they’re taking isn’t MDMA. And if you don’t care what drug you take, then all the educational campaigns in the world won't save your heedless butt.

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