Gambling Addiction

This article provides a comprehensive overview of gambling addiction, including the main features, signs and symptoms, causes, risk factors, and treatment options.

Key Takeaways:

• Gambling addiction, or gambling disorder as it is officially known, is a behavioral addiction that causes people to continue to gamble despite negative consequences. Mental health conditions and high stress are common risk factors for gambling addiction. Other factors include early exposure to gambling, poor emotional regulation, and impulsivity.

• Professional treatment can help significantly with gambling addiction, especially when it’s started early. Psychotherapy, medication, and support groups are examples of treatments.

Understanding Gambling Addiction

Gambling addiction is a behavioral addiction characterized by an increased preoccupation with gambling, intense urges or cravings to gamble, and continued gambling despite significant negative consequences, among other features.

Individuals with a gambling addiction may seek out a variety of different ways to gamble and try to make money, such as through casino games, lotteries, horse races, and sports betting. Nowadays, there is a seemingly endless ability to gamble online as well, which has created many other avenues for gamblers. ^[1]

Is it a Recognized Condition?

Gambling addiction is officially referred to as gambling disorder in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. Text rev.; DSM-5-TR). It falls under the broader category of “Substance-Related and Addictive Disorders”. It is the only type of behavioral addiction recognized by the DSM-5-TR. ^[2]

Addiction, Disorder, or Compulsion?

While gambling disorder is the official term, it is also considered a behavioral addiction, so it can be seen as both a disorder and an addiction. Gambling disorder has many similar features to other more well-known addictions, including drug and alcohol addictions. For example, gambling addiction involves cravings, tolerance, withdrawal, compulsive engagement, and continued use despite negative consequences. ^{[1] [2]}

Prevalence of Gambling Addiction in the U.S.

Recent estimates show that roughly 0.5 to 3% of adults in the U.S. have a gambling addiction. This number rises to approximately 5% in adolescents and young adults. In addition, there are roughly twice as many men with gambling addiction compared to women. ^{[2] [3]}

Online Sports Betting and the Rapid Increase in Gambling Addiction

The legalization of sports betting has created a surge in gambling, with a similar rise in gambling addiction and gambling-related issues. A recent research article indicates that total sports wagers rapidly increased from $4.9 billion in 2017 to $121 billion in 2023. ^[4]

Online sports gambling is by far the greatest risk, with research indicating a surge in internet searches for gambling addiction help after the introduction of online sportsbooks. ^[4]

Signs of Gambling Addiction

There are several signs of gambling addiction. The primary signs and symptoms of gambling addiction are: ^{[1] [2] [5]}

• An increased preoccupation with gambling. For example:

• Thinking and planning gambling activities

• Using resources to get more gambling money

• Needing to gamble with greater amounts of money to get the same “rush” or effect

• Inability to stop gambling, despite efforts to do so

• Restlessness, irritability, and other withdrawal-like symptoms when trying to reduce or stop gambling

• Gambling to help relieve stress, anxiety, depression, or other mental health symptoms

• Trying to get back lost money by gambling more (“chasing losses”)

• Lying about and/or hiding gambling habits from family or other important individuals

• Significant interference in key life areas due to gambling, such as:

• Work

• School

• Relationships

• Asking others to help out with financial issues due to the loss of money from gambling

• Feelings of guilt or shame after gambling

The signs and symptoms of gambling addiction may fluctuate in severity. For example, some people may have periods of little to no signs of gambling disorder in between more severe episodes.

Causes of Gambling Addiction

The exact causes of gambling addiction aren’t definitively known. It is likely a combination of biological, genetic, environmental, and psychological factors.

Regarding biological factors, some research suggests that gambling disorders may at least be partially explained by variations in certain brain regions, such as the striatum, prefrontal cortex, amygdala, and hippocampus. These are involved in reward processing, emotional regulation, stress, impulsivity, and other important functions that could influence gambling behavior. Alterations in the functioning of dopamine, serotonin, and other neurotransmitters may also play a role. ^{[2] [3]}

The heritability rate for gambling disorder has been measured as high as 50 to 60% in some cases, suggesting a strong genetic basis. Having a family history of gambling disorder or other addictions increases risk. ^[2]

A variety of environmental and psychological factors may also play a role in the development of gambling addiction, such as early exposure, high stress or other negative emotions, higher baseline levels of impulsivity, and certain mental health conditions, such as anxiety disorders. ^{[2] [3]}

Who is at Risk of Developing a Problem with Gambling?

Many factors may increase the risk of developing a problem with gambling. Established risk factors for gambling addiction include: ^{[1] [2] [3]}

• Early exposure to gambling

• Mental health disorders, such as:

• Anxiety

• Depression

• Substance use disorders

• Impulse-control disorders

• Obsessive-compulsive disorder (OCD)

• Lower than average income

• Younger age (especially adolescents and young adults)

• Male gender

• Strong influence from family and friends

• Certain personality factors, such as:

• High competitiveness

• Impulsivity

• Restlessness or being easily bored

• Sensation seeking

Among these, the connection between mental health disorders and gambling disorder is particularly strong. Research has shown that 96% of individuals with gambling addiction meet the criteria for at least one lifetime mental health disorder. In addition, alcohol use disorder and other substance use disorders increase the risk for gambling addiction by three to fourfold, on average. ^{[2] [3]}

Symptoms and Effects of Gambling Addiction

Gambling addiction can lead to several negative consequences and effects that impact overall well-being and life functioning. Notably, gambling addiction greatly increases the risk of suicidality. Nearly 1 in 2 gamblers have thought about suicide, and 1 in 5 have made a suicide attempt. ^[6]

Individuals with a gambling addiction may experience significant difficulties at work, such as poorer job performance and an increased risk of unemployment. Gambling disorder can also cause significant issues at school, such as declining grades. ^{[1] [5]}

Problematic gambling can also strain relationships with family, friends, and other important individuals. Furthermore, gambling addiction can lead to significant financial issues, including bankruptcy, while also increasing the risk of legal issues or imprisonment in more severe cases. ^{[1] [5]}

How Gambling Affects the Brain

Gambling can cause several deleterious consequences to the brain, especially with long-term use. For example, gambling can disrupt the functioning of dopamine and serotonin, which are both implicated in reward pathways and addictive-like behaviors. Relatedly, problematic gamblers also often showed decreased activity in certain reward pathways in the brain (e.g., the mesolimbic pathway). ^{[2] [3]}

Gambling can also lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which is an important system involved in stress regulation. ^[2]

Gambling also seems to disrupt the functioning of the prefrontal cortex, which is important for many higher-level processes, such as decision-making, emotional regulation, and impulse control. Lastly, gambling may lead to decreased volume of the amygdala and hippocampus, which are important for stress regulation, emotional learning, and conditioned behaviors. ^[3]

Coping with Problematic Gambling

There are several things you can do to cope with problematic gambling. Joining a support group, such as Gamblers Anonymous, can connect you with others struggling with similar issues. This provides feelings of support while offering opportunities for key social connections. ^[6]

In addition, you can use several strategies and coping mechanisms to deal with gambling urges, such as: ^{[6] [7]}

• Reaching out to trusted family and friends

• Engaging in other activities:

• Exercise/physical activity may be particularly useful

• Avoid too much isolation

• Give yourself time to see if the urge will pass

• Write down or think specifically about the pros and cons of gambling

• Recognize your specific triggers, and work to avoid them

Gambling Addiction Hotlines

There are also gambling addiction hotlines for individuals wanting to get connected to more specific gambling addiction help.

In the United States, you can call the National Problem Gambling Helpline at 1-800-522-4700. This is operated by the National Council on Problem Gambling, which covers all 50 states and the U.S. territories.

It’s important to connect with a specialist if gambling is significantly interfering with key areas of your life, daily functioning, and overall well-being.

Gambling Addiction Help

Professional treatment can help individuals with a gambling addiction regain control of their lives and improve overall functioning. Yet, only 1 in 10 individuals with a gambling disorder seek help for gambling addiction. ^[5]

What is Gambling Addiction Treatment?

Gambling addiction treatment involves several different components, such as psychotherapy, medication, and self-help/support groups. A mental health professional will determine which components are most beneficial for your individual needs and circumstances. Treatment may consist of inpatient care, outpatient care, or a residential treatment program, depending on the severity, as well as your specific needs and resources. ^[7]

One of the most common forms of psychotherapy for gambling addiction is cognitive-behavioral therapy (CBT). CBT addresses the variety of emotions, thoughts, and behaviors contributing to the gambling disorder. It often helps individuals to recognize and control their impulses and urges, more effectively manage their emotions, and implement healthier, alternative behaviors. ^[2]

In addition to CBT, group therapy, family therapy, and psychodynamic therapy are potentially effective for gambling addiction as well.

There are no FDA-approved medications to treat gambling disorder specifically. However, certain medications may be useful, especially for individuals dealing with co-existing mental health conditions. Opioid-receptor antagonists, such as naltrexone, have the most evidence for treating gambling addiction. Selective-serotonin reuptake inhibitors (SSRIs) and glutamatergic medications have shown potential effectiveness, but with mixed results. ^{[2] [7]}

Knowing When to Get Professional Help

Some people can gamble occasionally without any issue, but many individuals go on to develop a gambling problem. You should seek professional help if your gambling is causing significant negative consequences in your daily life, ability to function, and overall well-being.

If gambling is resulting in financial issues, relationship problems, poor work performance, unemployment, or other major concerns, it’s time to seek help. Furthermore, you should seek professional gambling help if you’re experiencing negative emotions related to gambling, such as shame or guilt, or if you’re noticing withdrawal-like symptoms when you attempt to reduce or stop gambling.

Final Takeaway

Gambling addiction takes a toll not only on the gamblers themselves but also on the lives of others around them. Gambling disorders have increased in recent years due to the legalization of sports betting and the greater availability of gambling in general. Fortunately, professional treatment is available, which can help gamblers reduce or stop their problematic behaviors and help regain a sense of control and direction in their lives.