Gambling Addiction

What Is It, Causes, Signs, Prevention, Support, and More

Author: Ahaana Singh

Editors: Kishan Patel, Antonella Melani, MD

Illustrator: Jillian Dunbar

What is gambling addiction?

Gambling addiction, also known as compulsive gambling or ludopathy, is an addictive disorder that refers to the compulsive urge to gamble. Gambling is when something of value is risked in the hope of gaining something of greater value. This often involves the wagering of money, but can include material goods or property as well. Gambling can occur in the form of online or casino games (e.g. poker or roulette), lottery tickets, scratchcards, slot machines, and betting (e.g. sports, fixed-odds, virtual, spread). It can take place in all kinds of settings, though it is most often associated with casinos or online gambling.

How does the gambling industry enable addictive behaviors?

Gambling behavior and addiction are often enabled and perpetuated by the gambling industry itself. Gambling advertising, for instance, is used as a tool to attract both new and consistent gamblers across a wide range of platforms, such as online marketing, social media, television, newspaper ads, billboards, and sponsorship. Online advertising is particularly effective, since it can be tailored and targeted based on demographics and interests. Consequently, the ad-viewer can be encouraged to engage in online gambling at the click of a few buttons. 

Another common tactic used by the industry is known as “welcome incentives” or incentives to draw in first-time gamblers, typically online. These include free or risk-free bets. These offers, however, often have hidden terms and conditions that require the individual to continue engaging in gambling behavior. 

Additionally, online gambling sites make it very easy to register and deposit funds, while making it much more difficult to withdraw winnings. This, in turn, can discourage individuals from withdrawing, and instead leads to continued gambling

Finally, casinos often enable gamblers through excessive stimulation and distraction, such as enticing ambience, loud music, and lack of windows. These factors can also lure individuals in and often make them lose track of time while gambling.

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Why is gambling addictive?

Gambling addiction can act very similarly to drug addiction. In both cases, the reward pathway in the brain can be stimulated, creating a sense of satisfaction. More specifically, the stimulation of this reward pathway triggers the release of a chemical messenger called dopamine, which leads to an euphoric feeling. Gambling products that enable easy and fast play, seen in particular with fixed-odds betting, can also be addictive, as ‘near wins’, which are losses disguised as a win, also excite the reward pathway in the brain. 

In order to regenerate this feeling, some individuals may repetitively engage in gambling behavior. Eventually, gamblers can build up a tolerance, causing their brain’s neurons to adapt and produce less dopamine in response to that behavior. In order to overcome this, compulsive gamblers will often engage in riskier ventures to create the same sense of satisfaction and may find it difficult to stop gambling. This cycle of behavior can lead to addiction and gambling disorder. However, it is important to note that not all individuals who gamble will develop a gambling addiction.

What are the risk factors for gambling addiction?

Concurrent problems associated with an individual’s health, mental health, and general well-being are some of the strongest risk-factors for gambling addiction. Certain factors may increase the risk of gambling addiction, including biological, genetic, and environmental factors. Certain personality characteristics such as competitiveness, impulsivity, and restlessness may also contribute to an increased risk of gambling addiction. Individuals with a family member who has a gambling problem are also more likely to engage in such behavior. Moreover, compulsive gambling may be associated with certain mental health disorders, such as substance abuse, depression, anxiety, and personality disorders. In some rare cases, certain medications for Parkinson’s Disease and restless leg syndrome may lead to compulsive behaviors such as gambling

What are the signs of gambling addiction?

Gambling addiction is often described as being a silent addiction. However, it can cause a wide variety of signs and symptoms that primarily manifest as behavioral changes. Problem gamblers often appear preoccupied with gambling by reliving past gambling experiences or planning future ones. Increased risk-taking, such as larger bets or wagers, can also be a sign of addiction. A compulsive gambler may also resort to gambling in order to cope with personal problems or stresses. Additionally, individuals may lie in an effort to hide the extent of their problem and often jeopardize important relationships and opportunities because of gambling. In some cases, individuals may have an increased likelihood of committing crimes such as theft—typically, in an effort to generate more money to gamble. When attempting to cut back on gambling, individuals may experience signs of withdrawal, such as depression, insomnia, cravings, anxiety, and irritability. 

Most signs of gambling addiction are difficult for the individual themselves to recognize, and they may often display increased denial. It is important that family and friends keep a watchful eye on such signs if gambling addiction is suspected.

How is gambling addiction diagnosed?

Gambling addiction can be diagnosed by a physician or another mental health professional by assessing gambling habits, medical history, and mental health status. Reviewing medical history can reveal certain medications or health concerns that may contribute to increased compulsive behaviors. A psychiatric assessment is also often performed to evaluate mental health status and determine if any mental health disorders may be contributing to excessive gambling. Finally, gambling addiction is formally diagnosed in the United States using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association. Other questionnaires, such as the Problem Gambling Severity Index (PGSI), are also used around the world.

How is gambling addiction treated?

Treatment for gambling addiction begins with the individual acknowledging their disorder. This can be one of the most challenging parts of treating compulsive gambling, as it is often very difficult for compulsive gamblers to admit they have a problem. 

In some cases, medications that treat mental disorders, such as antidepressants or mood stabilizers, can aid in reducing gambling behaviors. Long term treatment to overcome gambling addiction often focuses on behavioral changes and support. Oftentimes, behavior therapy or cognitive behavioral therapy may be beneficial. Behavior therapy employs systematic exposure to gambling behaviors in an effort to reduce urges. Cognitive behavioral therapy focuses on replacing unhealthy behaviors and beliefs with healthy and positive ones. Support groups, such as Gamblers Anonymous, can also be helpful. Through these interventions, individuals should aim to create barriers between themself and gambling, change how they view gambling, and develop new hobbies. Another suggested tool is self-exclusion, which refers to blocking oneself from gambling temptation. This can be done through certain software used to block online gambling (e.g. Gamban or BetBlocker), or can be arranged with gambling operators and personal banks to prevent gambling in other forms.

Depending on the individual’s needs and resources, treatment may involve inpatient programs, outpatient programs, or in some cases a residential treatment facility. It is important to note that despite treatment, one can still be at risk of relapse, especially if exposed to other gamblers or gambling environments. It is recommended to reach out to a physician or mental health provider if one feels particularly at risk of relapse.

How do you help someone with a gambling addiction?

It can be hard if a loved one is struggling with gambling addiction. In order to help, it is important to look out for signs of the problem, such as excessive gambling, preoccupation, lying, and often lifestyle changes. The first recommended step is to talk to the individual. Although you cannot force one to confront their addiction, you can certainly offer your support if it feels safe to do so. You can also encourage the individual to seek professional help in dealing with their addiction when they feel ready. 

If your loved one’s addiction is causing problems for yourself, such as anxiety, it is recommended to also seek out mental health support for yourself.

What are the most important facts to know about gambling addiction?

Gambling addiction refers to the compulsive urge to gamble. It can occur in individuals participating in casino games, online gambling, betting, and lotteries and if often enabled and encouraged by the gambling industry. Gambling can become addictive because it stimulates the reward pathway in the brain, which can then encourage and reinforce gambling behavior. Several biological, genetic, and environmental factors can lead to an increased risk of gambling addiction, such as certain mental health disorders, personality characteristics, medications, and exposure to gambling. Signs of gambling addiction include excessive gambling, preoccupation, lying, and lifestyle changes. Diagnosis is typically determined through medical and psychiatric assessments with the help of the DSM-5 and PGSI classifications. Treatment requires the individual to acknowledge their existing problem and can consist of therapy, support groups, behavioral modifications, and sometimes medication. If a loved one is coping with gambling addiction, it is suggested that you encourage and support them in their recovery journey. If, however, their addiction or recovery process is taking a toll on you, it’s recommended to seek out the support you need.

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Related links

All Bets are Off podcast, co-hosted by Kishan
Clinical Reasoning: Substance-related addiction disorders

Resources for research and reference

Gardner, E. L. (2011). Addiction and Brain Reward and Antireward Pathways. Chronic Pain and Addiction Advances in Psychosomatic Medicine, 30: 22-60. DOI:10.1159/000324065

Moreyra, P., Ibáñez, A., Liebowitz, M. R., Sáiz-Ruiz, J., & Blanco, C. (2002). Pathological Gambling: Addiction or Obsession? Psychiatric Annals, 32(3): 161-166. DOI: 10.3928/0048-5713-20020301-05

Murch, W. S. & Clark, L. (2016). Games in the Brain: Neural Substrates of Gambling Addiction. The Neuroscientist, 22(5): 534-545. DOI: 10.1177/1073858415591474

Nower, L., Caler, K. R., Pickering, D., & Blaszczynski, A. (2018). Daily Fantasy Sports Players: Gambling, Addiction, and Mental Health Problems. Journal of Gambling Studies, 34(3): 727-737. DOI: 10.1007/s10899-018-9744-4