Western Pennsylvania’s first legal casino opened at The Meadows 10 years ago this June amid warnings from some opponents that a surge in the region’s level of compulsive gambling was inevitable, leading to increased bankruptcy, divorce, crime and other societal ills.

If such an increase has taken place in the course of the decade, it’s hidden under the radar, just as is typically the case with gambling addiction itself.

The private, nonprofit Council on Compulsive Gambling of Pennsylvania held its annual Pittsburgh conference Thursday — coincidentally one of the biggest gambling days of the year, the first full day of the NCAA basketball tournament — with nothing to indicate the clinicians attending it had been bombarded with gambling addicts in the past decade.

Gamblers Anonymous meetings and attendance in the region are down from what they were 10 years ago, according to the group’s spokesman. The number of callers seeking help from the state compulsive gambling council’s hotline dropped in 2016 from the year before. Individuals admitting their addiction keep adding themselves to the Pennsylvania Gaming Control Board’s self-exclusion list that bars them from casinos, but at a steady annual pace rather than surging.

For therapists in the region who have been in the gambling treatment field since casinos opened, there are patients to see — some of them treated with state funds — but no sharp increase occurred as casinos became more accessible, including the opening of the Rivers Casino on the North Shore two years after The Meadows.

Sabrina Heller, a licensed social worker with a Squirrel Hill practice who attended Thursday’s conference, said eight of her current treatment clients have gambling problems, with just two of those tied to casino gambling.

“I definitely did not see an onslaught” from opening of casinos, she said. “I don’t know the reason why.”

Norm B., a spokesman for the Western Pennsylvania-West Virginia region of Gamblers Anonymous, said that based on experience among GA chapters nationally, there had been a presumption that opening of local casinos would increase attendees. Instead, the 24 weekly meetings in the region currently are a few less than a decade ago, and their rolls of active attendees show about 20 fewer Pennsylvanians.

“I expected a deluge of new people, and that has not happened,” said Norm B., who abides by GA’s policy of keeping his full name confidential.

That’s not to say there aren’t gambling addicts with serious problems, as the following numbers attest:

• The state council’s gambling hotline, reached by several numbers but primarily 1-800-GAMBLER, received 1,422 calls last year from either individuals with a serious problem or someone who knows a compulsive gambler and sought advice on obtaining help.

• The Gaming Control Board adds about 1,500 new people each year to its voluntary self-exclusion list, meaning they are willing to be arrested for trespass if they are found within a casino by security personnel. The list has nearly 7,800 people on it.

• The state Department of Drug and Alcohol Programs used a portion of gaming funds from casinos to pay for compulsive gambling treatment for 261 Pennsylvanians in the 2014-15 fiscal year, the most recent year it made a figure available. An untold number of additional individuals had private insurance to cover treatment or paid for it with their own funds. Gambling addiction often overlaps with drug and alcohol problems and is treated in combination with them.

And there continue to be occasional news stories in which criminal activities are identified in court as connected to a gambling addiction, such as last week’s guilty plea by a former Matthews International Corp. cashier who admitted embezzling nearly $13 million from the company.

“In explaining it to the public, I like to say gambling addiction is a huge, enormous problem for a very small percentage of people,” said Elizabeth Lanza, the state gaming board’s director of compulsive and problem gambling.

Surveys generally show about 5 percent of adults are susceptible to gambling problems, with 1 to 2 percent in the category of pathological gamblers who cannot help themselves. National studies have suggested that easier access to casinos by opening new ones creates more problem gamblers who may have been able to avoid the disorder and its effects previously. As there was no baseline study done of gambling problems in Pennsylvania before casinos were legalized, Ms. Lanza said, it’s difficult to make a true estimate of the extent of any change.

If problems have not grown locally in any visible way, those in the field offered several possible explanations:

• The longtime exposure to other forms of gambling that became ingrained in Western Pennsylvania culture.

• The access to casinos in nearby states that made people familiar with that form of gambling and any problems from it before the local openings.

• The effectiveness of programs such as the exclusion list, state-funded treatment and the casinos’ required promotion of problem gambling awareness.

• Compulsive gambling itself being a disease that is well-hidden until it reaches a crisis stage, so it may be more of a problem right now than anyone can see.

“It may come down to a counselor [treating a client for other issues] just not asking the right question, not doing a thorough screening,” said Josh Ercole, chief operating officer of the state compulsive gambling council.

Gary Rotstein: This e-mail address is being protected from spambots. You need JavaScript enabled to view it  or 412-263-1255.