Understanding gambling addiction
Prior to joining the Addiction Treatment Programme team at Priory, Sam worked as a therapist with gambling addicts and their families at a local Gamcare-funded charity.
When we think about addiction, most often we think about addictions to substances such as alcohol or drugs. Behavioural addictions are a very real problem too, and as the internet continues to grow and flourish, addictions like gambling are becoming a more commonly acknowledged reality.
Addictions are complex disorders. The substance or behaviour becomes an obsession and compulsion. These, however, are merely the symptom of the addiction. Most people believe that by removing the obvious behaviour, i.e. the drinking, drug taking, gambling etc., the problem is solved. But for the addicted person this is merely the beginning. Bill W (Alcoholics Anonymous) describes alcoholism/addiction as a “hopeless state of mind and body” that can be recovered from, if the individual is prepared to change.
A need or urge to gamble compulsively
The fellowship of Gamblers Anonymous defines gambling as “any betting or wagering, for self or others, whether for money or not, no matter how slight or insignificant, where the outcome is uncertain or depends upon chance or skill”. Gambling addiction is a need or urge to gamble compulsively, despite the negative and harmful consequences that this has.
The gambling addict will typically find that they’re incapable of controlling their gambling behaviours, even when the gambling stops offering the same sense of satisfaction. The need to gamble will escalate, developing into riskier bets; gambling with more money and gambling more frequently. In the same way as a drug addict, a gambling addict may also start to experience mood swings, withdrawal symptoms, relapse, cravings, urges and a loss of control as the addiction progresses.
With the ongoing development of smart phones making the internet ever more accessible, gambling has become available 24-hours a day, with the ease of online betting and gambling applications (apps). The normalising of gambling and the ease of use has significantly increased the percentage of the population that gamble, and lowered the age of the average gambler.
The consequences of a gambling addiction
Addiction is a mental, emotional, progressive and chronic illness. The need to gamble dominates the thinking of the compulsive gambler; planning how, when and where to gamble becomes their priority. The compulsion to gamble becomes stronger than any desire to stop, the need to gamble becomes uncontrollable and the addict’s life becomes unmanageable. This unmanageability can range from strained relationships, especially due to the deception around gambling, to significant financial hardship and ultimately, the possibility of severe debt and the loss of possessions, the home, or family.
However, the consequences of gambling addiction aren’t just seen externally. A report by the National Council on Problem Gambling found that one in five compulsive gamblers attempt suicide. Further to this, it was stated that suicide rates in compulsive gamblers were higher than for any other addicts.
Addiction changes the brain, affecting judgement, decision making and moods. Like any addiction, gambling activates the brain’s pleasure and reward system in order to soothe and self-medicate. When we engage in an activity that engages the pleasure system in our brain, this results in the release of the brain’s ‘happy chemical’, dopamine, which gives us a wave of satisfaction. This encourages us to engage in this activity again and again to achieve the same feeling of happiness and pleasure. If we continue engaging in this behaviour, we start to create ‘shortcuts’ on the neural pathways connecting the reward circuit to the prefrontal cortex, and as we chase this feeling of happiness it becomes the natural instinct to turn to the activity. People find that they need to engage in increasingly risky gambling behaviour in order to feel the desired ‘rush’.
Information for GPs and medical professionals
If your patients are worried about their gambling habit, the following list of questions can be used in discussions during your consultations:
- Have you ever felt remorse after gambling?
- Have you ever gambled in order to try and pay off debts or ease a financial difficulty?
- Is gambling causing you problems at home, in your relationships, at work or at school?
- After winning, did you feel a strong urge to return and gamble more?
- After losing, did you feel that you must return to try and win back your losses?
- Have you ever borrowed money or sold something to fund your gambling?
- Have you ever gambled to try and escape feelings of sadness, grief, worry, stress, boredom or loneliness?
- Have you ever gambled for longer than you’d planned to?
- Are you finding that gambling is becoming more of a priority than your commitments, responsibilities, or the feelings of the people that you care about?