Although most adults and adolescents have gambled at some time in their lives, a small number develop gambling disorder—a condition defined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders as a persistent, recurrent, uncontrollable urge to place a bet that leads to significant distress or impairment. Despite its prevalence, the assessment and treatment of gambling disorders in primary care settings is not widely established, largely because of disagreement about whether gambling behavior should be considered an addictive disorder. In addition, some primary care clinicians are concerned about the possible impact of a diagnosis of gambling disorder on patients’ medical insurance coverage.
Gambling involves risking something of value (such as money) on an event that is determined at least in part by chance with the intent of winning a prize. It is a complex, multifaceted activity that encompasses many different games and activities. Some people use gambling as a recreation, while others have a serious problem with it that can cause family discord, job loss and legal issues. Those who are addicted to gambling exhibit many different symptoms, including compulsive and uncontrollable urges to gamble, lying about their gambling activity, hiding money from family members, using credit cards to fund their gambling, or even stealing in order to finance their addiction.
Most people think of casinos and slot machines when they hear the word gambling, but there are a wide variety of other activities that can be classified as gambling. For example, playing bingo, purchasing lottery or scratch tickets, or betting on office pools are all forms of gambling.
Whenever a person gambles, their brain releases dopamine, a neurotransmitter that makes them feel excited. This is why so many people enjoy the thrill of winning, but it also explains why they are able to keep gambling even after they have lost their money. For those who have trouble controlling their gambling, there are a number of options for treatment and rehabilitation.
If you are struggling with a gambling problem, talk to a counselor. There are also many self-help groups available, such as Gamblers Anonymous, a 12-step program modeled after Alcoholics Anonymous. These groups can help you find a sponsor—a former gambler who has experience remaining free from gambling and can offer invaluable guidance and support.
While it is not unusual for someone to develop a gambling problem, if you have other health problems or addictions, your risk of developing a gambling disorder increases significantly. For example, if you have a substance use disorder, your risk of gambling disorder is almost double that of people who do not have any other addictions or illnesses. Likewise, about 4% of people being treated for depression or other psychiatric conditions have gambling disorder. Understanding the causes of gambling disorders can help researchers and clinicians develop better prevention and treatment strategies. In the future, we hope to learn more about the underlying mechanisms of gambling disorders, and how they might be linked to other behavioral health and physical health problems.