Gambling Addiction

I was surprised to learn that gambling revenues are greater than revenues of film and recorded music and cruise ships and sports and live entertainment.

I heard Jon Grant, MD, speak at the 20th Annual Summer Institute on Addictions. He is a Professor of Psychiatry & Behavioral Neuroscience and is the author of ten books on impulsive and compulsive behaviors such as gambling. He made the point that gambling is a public health hazard. The outcome of problematic gambling are associated with high rates of divorce, poor general health, mental health problems, job loss and lost wages, bankruptcy, arrests and incarceration.

The profile of a problem gambler is 32% female and 68% male. It usually starts in early adulthood with men beginning earlier than women. Although there are more men in this population, men take 8-10 years of frequent gambling before they become addicted. Women take one to 1 ½ years of frequent gambling to become addicted. The average time spent on gambling is 16 hours per week and the amount of money lost is about 45% of one’s gross annual income.

Once addicted, the core features are repetitive or compulsive gambling despite negative consequences, loss of control over the behavior, and a craving to do it. It is marked by an increased tolerance – you may start to gamble with $20 and build to $200. There can be withdrawal symptoms if gambling is ceased abruptly such as personality changes, irritability, insomnia which can last 4-6 months. Typically a gambling addict will have unsuccessful attempts to cut back or stop.

Research shows that people who develop a gambling addiction are those people who experience stress, ADHD, depression, childhood trauma such as neglect, emotional abuse, sexual abuse, higher levels of suicide attempts, and smoking. It is interesting to note that the biggest predictor of a relapse to problematic gambling is the ongoing use of nicotine. Smoking and gambling goes hand in hand. Gamblers don’t tend to have cross addictions with alcohol or drugs. They don’t like to have their senses dulled.

Treatment for a gambling addiction varies greatly. One third of the population will stop their addiction on their own. Some people only need 1-2 sessions of cognitive behavioral therapy, some benefit from self-help workbooks, and some benefit from medication by lowering urges to gamble in combination with counseling.

Perhaps the first step to control gambling is to be excluded from a casino. Voluntary self-exclusion is a process that allows a person to request to be banned from all legalized gaming activities and to be prohibited from collecting any winnings at any licensed facility. In some cases, if you violate the program, you are subject to arrest for trespassing and must surrender any winnings.

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