LAS VEGAS – As darkness swallowed the sky over Las Vegas, the neon glow of the Strip only grew. The bustle of the city’s nightlife began to take an obvious shape.

Crowds gathered outside to see the line of dazzling lights along the roadway, watch the quarter-hourly water show at the Fountains of Bellagio, take photos, pose with Vegas Strip showgirls, and peruse along the street to some of the bars and nightclubs.

Many wouldn’t make the trip without hitting the slots at a casino at least once.

Yet that sound of the slot machine’s lever cranking and clicking of the reels as they rotate are too familiar of a sound for some residents.

Only 20 minutes northeast of the flashy Last Vegas Strip, the lights fade and become nothing more than a skyline, only visible between single- and double-story stucco buildings, each with security gates over their windows and connected to chipped sidewalks.

In a sunbeat parking lot, a dozen people parked their cars and trucks near the sign that read “Alcohólicos Anónimos” and “Jugadores Anónimos” – Alcoholics Anonymous and Gamblers Anonymous – before they filed into the latter.

Inside, two rows of chairs filled the room, all facing a podium and desk covered with Spanish pamphlets and problem gambling support information.

These people hardly knew each other, but all had at least two things in common: they spoke Spanish, and they struggled with compulsive gambling.

A man in dark sunglasses sat in one of those chairs. The black lenses matched his dark hair – with a healthy amount of grey – and the shirt he wore with a pair of contrasting bright red pants.

He said his gambling addiction started when he moved to Las Vegas and began visiting its casinos soon after. Cronkite News agreed to withhold the attendees’ identities for this story.

“I began by gambling small amounts of money. Twenty dollars here and there, sometimes winning a little, sometimes $40 and $50 from the machine, and I would take it out and start feeling very happy,” he said in Spanish. “Two or three days later I gambled again, and I lost my money. Over time, I couldn’t stop. I’d put everything I had in my wallet into the machines. I was addicted, I admit it, and I couldn’t stop.”

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A woman in a red shirt that read “Positive Attitudes makes for good times” rolled up her sleeves over her forearms and rested her hands on her lap.

She said she lost relationships and her house to her gambling addiction. Both attendees agreed it was hard to realize that they had started a snowball effect.

“We never say how much we lose; we count the victories but not the defeats.” …. “We are gradually getting into addiction and this is self-destructing. We lose people, family, houses, losses, and work only to support our addiction.”

Aside from this group, which offers Spanish-speaking members an opportunity to attend whenever they are available, gambling addiction help for Nevada’s largest minority population is slim, and the group meetings are not a substitute for therapy or clinical care.

“We do have Gamblers Anonymous available at least one meeting every day in Spanish, but it’s not the same as professional treatment, and people who need that higher level of care, it’s going to be a little bit difficult for them to find those resources,” said William “Ted” Hartwell, the director of storytelling and development for the Nevada Council on Problem Gambling.

Gambling disorder is the uncontrollable urge to keep gambling or betting despite the toll it takes on a person’s life.

While casino gaming is legal in 43 states, Nevada has electronic gambling machines inside retail and convenience stores, which means everyone in Las Vegas has a machine within just a short drive.

Gambling disorder contributes to a high suicide rate for people who have it. Problem gambling-related suicide in Nevada is roughly nine times greater than the national average and these cases have distinct patterns compared to other suicides, such as alcohol use, financial problems, family relationship and job-related issues.

Yet the true public health burden of compulsive gambling is still underestimated, according to the researchers.

People develop gambling problems for a variety of reasons. Some see gambling as a way to cope with stress and make quick money, while cultural beliefs shape how people perceive luck, said Alan Feldman, director of strategic initiatives at the International Gaming Institute at the University of Nevada Las Vegas and Chair of the Advisory Committee on Problem Gambling.

“The bigger positive impacts do relate to the excitement, the fun, the thrill and the ability to socialize,” Feldman said. Yet without a “healthy balance,” the “downsides are pretty clear.”

The high of winning is similar to drug-related highs but is not guaranteed every time one gambles, according to Dr. Rory Reid, the clinical director for the Gambling Addiction Treatment Center in Las Vegas.

Reid also described the disorder as “hidden” compared to obvious physical changes that accompany many substance use disorders, such as losing weight, skin rash or missing teeth.

“(People) don’t realize that all of those brain parts are operating and functioning in a person with a gambling problem the exact same way as they are functioning with somebody with a substance use disorder,” Reid said.

The path to recovery works step-by-step and not all at once, similar to the gradual slope into compulsive gambling, Hartwell said, calling recovery journeys “often chronic and progressive as well.”

A fairly wide array of service providers can treat gambling addiction, according to Nevada State Law NRS 458A.

The list includes marriage therapists, nurses and social workers, but the requirements differ, with the most stringent assigned to certified problem gambling counselors, who “must complete 2,000 supervised clinical hours, prove the completion of a 60-hour training specific to problem gambling, successfully pass a written exam and have their application approved by the Board of Examiners for Alcohol, Drug & Gambling Counselors,” said Jesse Stone, a spokesperson for the Nevada Department of Health and Human Services’ Division of Public and Behavioral Health.

The exact number of Spanish-speaking professionals that work with compulsive gamblers in the state is not known, but the sources interviewed for this story agreed there is a lack of problem gambling counselors who speak languages other than English, including Spanish.

The Problem Gambling Treatment Services Provider Manual, which outlines requirements for agencies and individuals seeking state funding to treat problem gambling, highlights the needs for non-English speaking patients, including Spanish speakers.

“Obviously, one of the most critical things is having services in Spanish, although that is not the entirety of it,” said Andrea “Andi” Dassopoulos, the project manager for the Nevada Problem Gambling Project at the University of Nevada, Las Vegas International Gaming Institute, which works with Spanish-speaking population to address and develop data-driven solutions to gambling addiction for the state.

Dassopoulos referred to a slew of other reasons that contribute to care access barriers, such as transportation or scheduling conflicts, “but that’s not as big as making that step and feeling safe to access health.”

“There are also cultural norms that create barriers to getting treatment,” Reid said. “The phenomenon of ‘machoism.’ And sometimes it’s culturally discouraged to go outside of your community to get help, and that can create a lot of shame and isolation for someone within the community that’s struggling with a gambling problem.”

Gambling addiction is often interrelated with other addictions and disorders, such as substance use disorder or anxiety which further impairs judgement, Reid said, pointing to the need to address the issues holistically.

“If we don’t work with smoking cessation at the same time as a gambling addiction, they’re 2.8 times more likely to relapse gambling,” Reid said.

Dr. Shane Kraus, an associate professor of psychology at UNLV and a member of the state’s Advisory Committee on Problem Gambling, argues that preventative measures are more effective.

“Before you have a gambling problem… if I can tell you about some risk factors, some good strategies to maybe regulate your gambling, we know that people generally do well,” Kraus said. “The issue is we’re not really doing a good job of that, and we’re waiting to someone actually has a problem, saying, ‘hey, come get treatment.’”

Advertising responsible gambling in over a dozen languages at casinos is another goal that is in progress: “We’ve approved those. So I think those will be going out for print soon,” Kraus said, adding that one of the goals is to have the brochures in smaller casinos around Las Vegas, where most local problem gamblers bet.

Cronkite News could not independently confirm the advertisements were approved after reviewing the state’s Advisory Committee on Problem Gambling meeting minutes this year.

“We are mirrors. We have all made the same mistakes,” said another attendee after the Jugadores Anónimos meeting. She wore a white, partially lace dress with embroidered yellow and pink flowers on her chest and above her knees.

She said that while at one point she did consider suicide, attending meetings and connecting with people with similar experiences has helped her get back on track.

“I was very afraid to join the group, thinking they would start judging me, but fortunately, instead of judging me, they gave me warm hugs.”

If you or someone you know is struggling with compulsive gambling the National Problem Gambling Helpline provides caller translation services in more than 200 languages. Call 1-800-GAMBLER.

Cronkite News Reporter Nicole Macias Garibay contributed to the story.