Gambling Addiction: Diagnosis & Treatment
by Rynae Golke
Healthcare providers, specifically those in primary care or family practice, are charged with caring for the whole patient, including screening for mental health issues and addiction. While patients may not readily offer up information that assists in uncovering addiction, providers can learn more by asking questions that uncover behaviors, concerns, and underlying troubles. One important addiction to screen patients for is compulsive gambling, which is also referred to as gambling addiction or gambling disorder.
Compulsive gambling is a very serious addiction with extensive consequences when left untreated. Although initiating the discussion with a patient can feel invasive or uncomfortable, early diagnosis and treatment are key to successful rehabilitation and recovery. Early diagnosis can also limit the impact of gambling on the patient’s life.
Signs and Symptoms of Compulsive Gambling
Every patient experiences addiction differently. Patients suffering from gambling disorders may experience some or all of these symptoms:
- A desire to gamble to alleviate guilt, depression, or anxiety
- The need to increase the bet each time to achieve the same euphoria
- Inability to stop gambling or control spending while gambling; feelings of nervousness or restlessness when trying to quit gambling
- Putting important jobs, relationships, or responsibilities at risk in order to continue gambling
- Obtaining gambling money through unethical means like embezzlement, fraud, or theft
It can also be a sign of an addiction if friends and family members are concerned about the patient’s gambling habits.
Uncovering Addiction in Primary Care
Providers can screen for gambling addiction by asking questions. For example:
- How often do you gamble? Daily, weekly, quarterly, annually, or not at all?
- Have your friends or family members ever expressed a concern about your gambling habits?
- Have you ever tried to stop gambling?
- Would you like to talk about this more? Can we talk about the types of help available to you?
Healthcare providers are tasked with finding a balance between uncovering underlying issues and respecting patient privacy and wishes.
In many cases, patients are not ready to talk about their addiction. They may experience feelings of shame, defensiveness, or denial. If the healthcare provider suspects gambling addiction but the patient is not ready to discuss his or her symptoms or desired outcome, the provider should simply let the patient know that addiction is a disease and that he or she is ready to create a treatment plan together whenever the patient is ready.
Causes and Risk Factors
Most people can gamble on occasion without ever becoming addicted or developing an unhealthy habit. However, certain people are at higher risk of addiction, including:
- Those who suffer from mental health disorders like bipolar disorder, attention deficit hyperactivity disorder, depression, drug or alcohol addiction, and anxiety
- Those who are young to middle-aged
- Men, who are more likely to become addicted than women
- People who are lacking positive peer or family support; those with problems or instability at home
- Those who take dopamine agonists (usually for RLS or Parkinson’s disease), which on rare occasions cause compulsive behaviors
Studies show that serotonin, endogenous opioids, dopamine, and hormone imbalances in the brain contribute to both behavioral (gambling, sex) and substance (drugs, alcohol) addictions.
By taking special care to screen at-risk patients, healthcare providers may improve the chances of recovery for patients suffering from gambling disorders.
According to the National Center for Responsible Gaming, 1% of all adults in the United States suffer from a severe addiction to gambling, while an increased 6 – 9% of young people and young adults are plagued with the addiction. Rates are also higher among minority groups than the general population. Additionally, 96.3% of those suffering from gambling addiction long-term also suffer from another psychiatric disorder. Around a third of gamblers recover without treatment.
Risks Associated with Gambling Disorder
Gambling disorders can result in significant, severe consequences for patients. Gambling addiction can result in financial problems, legal problems, imprisonment, relationship strain or divorce, job loss, health problems, and suicide or thoughts of suicide. Early diagnosis and treatment are key in preventing long-term or irreversible complications.
Screening and Diagnosis
Screening and diagnosis can take place during an appointment scheduled to discuss gambling addiction or during a regular physical or mental health checkup. Gambling addiction is most often diagnosed following a review of patient medical history and a patient interview.
In many cases, patients may not be ready to talk about addiction. Providers can encourage patients to complete the Brief Biosocial Gambling Screen (BBGS) online privately, which is based on the American Psychiatric Association’s DSM-IV gambling addiction criteria. This test can help patients learn more about the risk associated with their gambling habits and take the first step toward change.
Compulsive gambling is treated by one or a combination of the following techniques:
- Group therapy. One of the most common group-therapy options is Gamblers Anonymous, which is based on the 12 Steps used by Alcoholics Anonymous.
- Cognitive Behavioral Therapy, which focuses on redirecting unhealthy thoughts and behaviors to positive, healthy ones
- Medications, which can treat underlying mental health disorders that contribute to addiction
Some patients recover without formal treatment, but an admission of addiction and desire to recover are vital.
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