This article has been updated to reflect the percent increase in people seeking treatment from the Center For Problem Gambling.
Talk to most people, and they'll tell you that the main problem with upstate's new casinos is that they're not generating enough revenue — that not enough people are visiting these casinos and gambling away their money.
Talk to Philip Rainer, and he'll tell you that the shortfall in gaming revenue and gamblers doesn't trouble him one bit.
Rainer is the chief clinical officer at Capital Counseling, the non-profit agency that runs The Center for Problem Gambling in Albany.
In the 11 months since Rivers Casino in Schenectady opened, Rainer has seen a steady uptick in the number of people seeking treatment for a gambling addiction from his organization.
It's something he anticipated, and that he spoke of at length when I interviewed him shortly before Rivers went live.
When I caught up with Rainer last week, he spoke about the casino's impact in the same matter-of-fact tone he did last year, only this time he was armed with hard numbers that suggest the new casinos have led to an increase in problem gambling.
In February 2017, there were 34 people enrolled in the Center's gambling-treatment program. By December, that number had risen to 54 — a 60 percent increase.
Those numbers might not sound huge.
But they represent a significant increase for a program that has been pretty stable, in terms of the number of individuals served, over the years.
The surge in people seeking treatment has prompted The Center for Problem Gambling to submit a budget increase request to the state Office of Alcoholism and Substance Abuse Services to increase staffing by two full-time positions.
When I spoke with Rainer last year, I wondered whether the big increase in problem gambling that he was predicting would come to pass.
Certainly, there was reason to believe that it might.
At least one study, from the University at Buffalo's Research Institute on Addictions, has shown that having a casino within 10 minutes of your home is associated with a 90 percent increase in the odds of being a problem gambler.
But a more recent University at Buffalo study, from 2014, appeared to contradict this finding.
According to this newer study, there has not been a significant increase in problem gambling in the U.S., despite a nationwide increase in gaming opportunities.
I suspect that the truth lies somewhere in the middle — that problem gambling does increase as gambling opportunities increase, though perhaps not to the extent we've been led to believe.
Regardless, one thing is clear: The Center for Problem Gambling has been treating more people since the upstate casinos opened.
And with a fourth casino set to open in the Catskills this year, Rainer expects that demand for the organization's services will continue to increase.
"We anticipate that we're going to see more growth once the fourth casino opens," Rainer said.
He added, "It's a concern for us that the state is trying to increase revenue using an approach that has been known to be detrimental to the health of the community," Rainer told me.
One place that hasn't seen an increase in problem gamblers — but is more prepared for one, should one occur — is New Choices Recovery Center in Schenectady.
Over the summer, the non-profit organization received a waiver from the state that will allow it to serve people whose sole addiction is gambling. New Choices had treated problem gamblers prior to receiving this waiver -- but only if they sought treatment for a substance abuse problem.
"We have not seen more requests [for gambling-only treatment], but it's something the state is anticipating," said Laura Combs, who serves as New Choices' clinical director and is certified to treat problem gambling.
I'm sure I'll be checking in with New Choices sometime this year or next to see whether the organization has seen an uptick in problem gamblers.
I hope not, but it's nice to know the organization is prepared to treat those who seek help.
In the meantime, I'm with Rainer: There is an upside to lower-than-projected gaming revenues, and it's that there are likely to be fewer people battling gambling addictions.
Which is a good thing, even if it hurts the casinos' bottom lines.
Reach Gazette columnist Sara Foss at firstname.lastname@example.org. Opinions expressed here are her own and not necessarily the newspaper's.