Gambling Addiction Treatment
With Co-occurring Substance Abuse
Compulsive gamblers can lose and win thousands of dollars within a matter of days, or even hours, because they are unable to stop. The euphoric rush that accompanies a win can be so exhilarating that gamblers begin to crave that euphoria. When gamblers lose, the emotional crash of a loss requires a quick fix to regain that high. The inability to stop gambling, in spite of the negative consequences to one’s life, is known as gambling addiction, problem gambling, or compulsive gambling.
Warning Signs of Gambling Addiction
Unfortunately, it is not always easy to detect these red flags, especially if the gambler is in denial about the problem. For many families, the first sign that a member of the household has a gambling problem is the sudden loss of a large sum of money. However, there are other signs to watch for that may help prevent serious damage to a family’s welfare.
- Giving up favorite hobbies, recreational activities, or family events in order to gamble
- Opening up a new checking account or applying for new credit cards without any apparent need for more money
- Possessing large amounts of cash, which then disappear
- Acting secretive or defensive about one’s gambling activities
- Having difficulties at work or conflicts in relationships because of gambling wins or losses
- Loss of control over how much money is wagered in any given gambling session
- Attempting to stop gambling without success
- Placing increasingly large bets or taking increasingly dangerous risks (such as borrowing money from illegal sources or stealing from others)
- Expressing guilt, shame, or remorse about gambling yet being unable to stop
- Asking to borrow money from friends or family members, with no obvious need for extra cash
- Lying about activities or spending habits
- Spending a lot of time online and refusing to talk about activities on the computer
- Substance abuse
- Stomach problems
- Heart problems
The loss of large amounts of money can be devastating to problem gamblers. They may fall into a severe depression, which may lead to suicidal thoughts, self-destructive behavior, or attempted suicide. In order to alleviate feelings of depression and despair, gamblers may use this addictive process as a way to escape or to fix their problems. Gambling thus becomes a cycle in which the elation or depression that follow an episode lead to greater risk-taking and higher bets.
Causes and Risk Factors
- Neurochemistry: Compulsive gambling, also known as pathologic gambling, triggers physical and emotional reactions that are similar to the responses to drug or alcohol use. A big win can trigger the release of naturally occurring chemicals such as dopamine and norepinephrine, creating a rush of pleasure and energy, as well as feelings of power and invincibility. The Indian Journal of Psychological Medicine points to research stating that individuals with a gambling problem may have lower than average levels of norepinephrine, a chemical that generates feelings of energy. The high of a gambling win may help to create sensations of elation or power that their natural chemistry does not provide.
- Family history: If one of more close relatives has a history of compulsive behavior or addiction, the risk of developing an addiction to gambling or another substance or process is increased. According to Alcohol Research & Health, the risk of developing alcoholism is up to 60 percent greater in males or females who have a family history of alcohol abuse. This genetic predisposition appears to apply to other forms of substance abuse, as well as to process addictions like compulsive gambling.
- Social and environmental factors: Living in an environment where gambling is widely practiced and accepted can increase one’s chances of becoming a compulsive gambler. Other social factors, such as isolation from others, peer pressure to gamble, or the frequent abuse of drugs or alcohol may contribute to problem gambling. Some individuals gamble out of loneliness and a need for distraction, while others may gamble out of a need to relieve stress or to gain approval from peers.
- Co-occurring mental illness or substance use disorders: Mayo Clinic notes that compulsive gambling is more common among people who have a co-occurring mental health diagnosis — such as depression, bipolar disorder, or anxiety — or a substance use disorder. Impulse control disorders and attention deficit hyperactivity disorder (ADHD) also increase the risk of having a problem with gambling.
In order to engage in compulsive gambling, the individual must have the opportunity to participate in betting activities and at least minimal resources or borrowed money in order to place bets. The arrival of online gambling, which requires only access to a personal computer and an internet connection, has eliminated the need to leave one’s home in order to gamble. According to a report from Rubin Brown Consultants, US revenue from gaming increased to $68.7 billion between 2013 and 2015, largely as a result of the popularity of online gaming and limited stakes gaming, or the slot machines available in public venues.
Gambling Addiction and Substance Abuse
Pathologic gambling frequently co-occurs with alcoholism or drug abuse. Free alcoholic beverages are often available at casinos, where drinking is encouraged in order to release inhibitions against spending money. Alcohol or drugs may be used to celebrate a win, to console oneself for a loss, or to mentally escape from the shame and guilt associated with gambling. In addition, the same neurochemical factors that make some individuals vulnerable to gambling addiction may predispose them to substance abuse.Having a predisposition toward compulsive gambling seems to go hand in hand with a tendency toward other forms of addictive behavior, including drug addiction or alcoholism. Problem gambling also coexists frequently with forms of mental illness, such as personality disorders, anxiety, or depression.
- 62 percent of the gamblers in the study suffered from a co-occurring psychiatric disorder
- 42 percent met the diagnostic criteria for a personality disorder
- 33 percent met the criteria for alcohol abuse or dependence
- Study participants with dual diagnoses suffered more negative consequences as a result of their gambling than those who did not have a co-occurring mental illness or substance use disorder
Alcohol and illicit drugs can worsen the impact of gambling addiction by impairing the individual’s judgment and encouraging the kind of risk-taking behavior that leads to significant financial losses and negative effects on the individual’s health. Substance abuse also exacerbates the physical and psychological effects of gambling, increasing the severity of conditions such as heart disease, digestive problems, anxiety disorders, depression, and the risk of heart attack or stroke. The longer substance abuse and pathologic gambling go untreated, the greater the risk of serious health consequences as a result of both addictions.
The Gambling Rehab Process
Although gambling addiction is a serious, potentially dangerous disorder, it can be treated with a combination of therapeutic modalities, recovery resources, and supportive psychosocial services. These therapies and services are available through professional treatment programs that specialize in addressing compulsive gambling, with or without a co-occurring substance use disorder. Treatment may take place at an inpatient facility, where 24-hour supervision and support are provided, or at an outpatient rehab program, which offers greater autonomy and flexibility to clients.
- Individual therapy: Working one-on-one with a therapist, the compulsive gambler strengthens the motivation to stop gambling, identifies triggers and dysfunctional coping strategies, and learns how to deal with stresses and triggers in more effective, productive ways. Therapists utilize modalities such as Motivational Interviewing (MI), a collaborative approach that engages both the client and therapist in an effort to overcome addiction.
- Group therapy: Group therapy sessions help problem gamblers build a network of supportive peers who are working to overcome the same issues. In group therapy, members exchange personal experiences, coping strategies, and hopes for the future. Self-help support groups like Gamblers Anonymous and other 12-Step programs can be an important component of a comprehensive recovery plan.
- Cognitive Behavioral Therapy (CBT): CBT addresses the self-defeating thoughts and behaviors that lead to problem gambling. The Indian Journal of Psychological Medicine notes that CBT is especially helpful at correcting the delusional thinking that characterizes compulsive gambling, such as the belief that one can win in spite of repeated, devastating losses.
- Family or couples counseling: In contemporary therapeutic settings, addiction is viewed as a problem that affects entire families, not just isolated individuals. As a result, the family must be treated as a unit in order for rehab to be successful. Family and couples counseling helps to create a more supportive home environment that is conducive to sobriety and a life free from gambling or substance abuse. This form of counseling also strengthens the bonds among family members, defines boundaries, and reestablishes trust.
After establishing a foundation for recovery from gambling and/or substance abuse, individuals in a rehab program may be ready to move from inpatient care to outpatient treatment, or from outpatient treatment to an autonomous life in the community. Gambling addiction programs provide a network of support services that aid the individual throughout the phases of rehab and aftercare.
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