What is Gambling Addiction?
While it may appear that addictions are solely pleasure-seeking behaviors, the roots of addiction can also be traced to a wish to suppress or avoid some kind of emotional pain.
In the broadest sense, addictive or pathological gambling is gambling behavior which causes disruptions in any major area of life: psychological, physical, social or vocational. Addictive gambling is sometimes referred to as the "hidden illness," because there are no visible physical symptoms. The American Psychological Association classifies compulsive gambling as a mental health disorder of impulse control. It is a chronic and progressive disease that is both diagnosable and treatable. About 2 to 4 percent of Americans have an active gambling problem.
Compulsive gambling can be categorized into two types: action gambling and escape gambling.
- In action gambling, the gambler is addicted to the thrill of risk-taking as his or her “substance of choice,” much in the same way that a cocaine addict is hooked on cocaine. The action itself becomes the drug. Action gamblers typically engage in games with other players, since part of the adrenaline rush is in the appearance or identity as a “winner.”
- Escape gambling occurs when the gambler seeks to blot out some discomforting feelings or emotional life crisis. The action of gambling is secondary to the numbing effect of the activity. Escape gamblers prefer more singular outlets such as slot machines, where they can avoid human contact. Men tend more towards action gambling, and women tend to become escape gamblers.
It is significant to note that teens are about three times more likely to become pathological gamblers than adults. This is the reverse of the case in most addictions, where the problem among adults is statistically more prevalent than among children and teens. For this reason, early education about the dangers of gambling addiction and information on how to get help for the problem is vital for preventing the disease. Problem and pathological gamblers across age groups also use tobacco, alcohol, marijuana, cocaine, and other drugs more often than do other groups.
What are the signs and symptoms of gambling addiction?
The American Psychological Association reports ten diagnostic criteria,for determining the extent of gambling addiction. These criteria are:
- Preoccupation – Preoccupied with gambling (e.g., preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money to gamble)
- Tolerance – Needs to gamble with increasing amounts of money in order to achieve the desired excitement
- Withdrawal – Is restless or irritable when attempting to cut down or stop gambling
- Escape – Gambles as a way of escaping from problems or relieving dysphoric mood (e.g., feelings of helplessness, guilt, anxiety or depression)
- Chasing – After losing money gambling, often returns another day in order to get even ("chasing one's losses"). Chasing is a classical behavior pattern characterizing pathological gambling.
- Lying – Lies to family members, therapists or others to conceal the extent of involvement with gambling
- Illegal acts – Has committed illegal acts (e.g., forgery, fraud, theft or embezzlement) in order to finance gambling
- Risked significant relationship – Has jeopardized or lost a significant relationship, job or educational or career opportunity because of gambling
- Bailout – Has relied on others to provide money to relieve a desperate financial situation caused by gambling
- Loss of control – Has made repeated unsuccessful efforts to control, cut back or stop gambling
* Five or more of these signs = pathological gambler
* Three or four = problem gambler
* One or two = “at risk” gambler
Another way of assessing whether or not you have an addiction to gambling is to ask yourself the following twenty questions, provided by the self-help organization Gamblers Anonymous:
- Did you ever lose time from work or school due to gambling?
- Has gambling ever made your home life unhappy?
- Did gambling affect your reputation?
- Have you ever felt remorse after gambling?
- Did you ever gamble to get money with which to pay debts or otherwise solve financial difficulties?
- Did gambling cause a decrease in your ambition or efficiency?
- After losing did you feel you must return as soon as possible and win back your losses?
- After a win did you have a strong urge to return and win more?
- Did you often gamble until your last dollar was gone?
- Did you ever borrow to finance your gambling?
- Have you ever sold anything to finance gambling?
- Were you reluctant to use "gambling money" for normal expenditures?
- Did gambling make you careless of the welfare of yourself or your family?
- Did you ever gamble longer than you had planned?
- Have you ever gambled to escape worry or trouble?
- Have you ever committed, or considered committing, an illegal act to finance gambling?
- Did gambling cause you to have difficulty in sleeping?
- Do arguments, disappointments or frustrations create within you an urge to gamble?
- Did you ever have an urge to celebrate any good fortune by a few hours of gambling?
- Have you ever considered self destruction or suicide as a result of your gambling?
According to Gamblers Anonymous, if you answer ‘yes’ to seven of more of these questions, you most likely have a compulsive gambling problem.
What are the “three phases” of gambling addiction?
The progressive, downward cycle of pathological gambling typically follows a pattern of increasing involvement in the addictive behavior. Robert L. Custer, M.D., identified the development of the disease as following three phases:
- During the winning phase, gamblers experience a big win—or a series of wins—that leaves them with unreasonable optimism that their winning will continue. This leads them to feel great excitement when gambling, and they begin increasing the amounts of their bets.
- During the losing phase, the gamblers often begin bragging about wins they have had, start gambling alone, think more about gambling and borrow money—legally or illegally. They start lying to family and friends and become more irritable, restless and withdrawn. Their home life becomes more unhappy, and they are unable to pay off debts. The gamblers begin to "chase" their losses, believing they must return as soon as possible to win back their losses.
- During the desperation phase, there is a marked increase in the time spent gambling. This is accompanied by remorse, blaming others and alienating family and friends. Eventually, the gamblers may engage in illegal acts to finance their gambling. They may experience hopelessness, suicidal thoughts and attempts, arrests, divorce, alcohol and/or other drug abuse, or an emotional breakdown.
Excerpted from: Pathological gambling: An addiction embracing the nation [Internet]. Illinois Institute for Addiction Recovery (Peoria, IL); 2005 [cited May 2006]. Available at: http://www.addictionrecov.org/aboutgam.htm.
A final phase can be categorized as the hopelessness phase, where gamblers cannot see a way out of their predicament. They have reached “the bottom,” and at this point almost all pathological gamblers consider suicide and about 20% will attempt it.
Two forms of gambling that can lead to full scale loss of control and life destruction relatively quickly are video poker and slot machines. These are sometimes called the "crack cocaine of gambling" because of their immediate and effective reinforcement schedules. A gambler addicted to slot or video-poker machines can progress into the desperation phase in two to three years.
What are the causes of addictive gambling?
Although the causes of pathological gambling are not known for certain, researchers have made many observations about the dynamics of the disease and the personality profiles of those who succumb to it. Gambling addiction expert Dr. Richard Rosenthal believes that three criteria are necessary for a person to become a pathological gambler:
- An intolerable feeling state, such as helplessness, depression, or guilt
- A highly developed capacity for self-deception, and
- Exposure to gambling under circumstances in which it is valued
Physical or hereditary predispositions are also thought to play a role, though these links have not been proven or disproven. One study conducted by Alec Roy, M.D., formerly of the National Institute on Alcohol Abuse and Alcoholism, showed that some pathological gamblers have lower levels of the brain chemical norepinephrine than normal gamblers. It has been hypothesized that pathological gamblers may engage in addictive gambling to increase their levels of norepinephrine, since it is excreted under stress and arousal.
What are the social and economic effects of gambling addiction?
In 1998 the National Gambling Impact Study Commission funded a study to determine the overall cost to society posed by problem and pathological gamblers in the United States. The results showed that approximately $5 billion was lost annually, with an additional $40 billion in lifetime costs for productivity reductions, social services and creditor losses. Studies have concluded that two out of three pathological gamblers commit illegal acts in order to pay gambling-related debts. This places a hardship on our legal systems, prison systems and public assistance programs.
The following consequences of problem gambling all result in economic costs for states, communities and individuals:
- Job loss, unemployment
- Debt, bankruptcy
- Embezzlement, fraud, check forgery
- Eviction, forced home sales
- Crime, arrest, incarceration
- Poor physical and mental health, suicide
Excerpted from: Effects of Problem Gambling [Internet]. California Council on Problem Gambling (Anaheim, CA); 2006 [cited May 2006].
Available at: http://www.calproblemgambling.org/gambling_effects.html.
The families of problem gamblers also suffer greatly from physical and psychological abuse; harassment and threats from bill collectors and creditors; increased stress stemming from neglect and divorce; and the extra financial burden placed on them to repay debts.
Sadly, children are negatively affected by gambling addiction in several ways. Physical and emotional abandonment is a very real phenomenon. “Casino kids” are left in cars or on the periphery of the gambling action while their parents gamble, or may spend hours with babysitters, thus missing the nurturing they need. Children of pathological gamblers are typically abused verbally, mentally and physically by the gambler, and often even more so by the co-dependent spouse. Finally, these children are much more likely to develop gambling addiction than their peers.
How can I identify gambling addiction in the workplace?
Henry Lesieur, Ph.D. observed the following behaviors in the workplace as being correlated with a gambling addiction:
- Excessive use of telephones (to call bookmakers, stockbrokers or to obtain credit)
- Taking the company vehicle to the race track, card room, casino, etc. (parking tickets near gambling locations are a "red flag")
- Absences from work, often for part of the day (typically after lunch)
- Arriving late for work (related to all-night card games, casino trips, anxiety-related sleep disturbances)
- Vacation days taken on isolated days rather than in weeks (or vacations taken to gambling locations on a regular basis)
- Failure to take days off (obsessed with getting money to pay gambling debts or afraid to take a day off because of a fear that embezzlement or fraud will be discovered in their absence)
- Changes in productivity (which seem to be related to mood swings)
- Organizing office pools and gambling junkets
- Borrowing money from co-workers or arguing with co-workers over failure to pay debts
- Embezzlement, defrauding customers or engaging in employee theft for resale
Excerpted from: Recognizing Internet Addiction [Internet]. Illinois Institute for Addiction Recovery (Peoria, IL); 2005 [cited May 2006]. Available at: http://www.addictionrecov.org/recoggam.htm.
How can I overcome my addiction to gambling?
If you are grappling with this addiction, seek professional treatment. Once you admit and address the problem, other pieces of your life will fall back into place. According to the Mayo Clinic, treatment for compulsive gambling is similar to therapies for other forms of addiction. Your doctor or mental health professional may use these approaches:
- Psychotherapy in the form of cognitive-behavioral therapy that focuses on identifying unhealthy, irrational and negative beliefs and having you replace them with healthy, positive ones.
- Group therapy that enables an addict to tap into the advice, feedback and support from other people on how to deal with a gambling addiction. Gamblers Anonymous provides self-help peer support and a 12-step program patterned after Alcoholics Anonymous. For people who are uncertain whether they have a gambling problem, Gamblers Anonymous publishes a list of 20 questions as a screening tool and provides a list of local chapters.
- Residential treatment programs organized and staffed to provide both general and specialized non-hospital-based interdisciplinary services 24 hours a day, 7 days a week. Residential treatment programs provide environments in which assistance is provided by personnel trained in the delivery of services for those with behavioral health disorders or related problems.
- Inpatient treatment programs providing coordinated and integrated services in hospital settings. Inpatient treatment is provided 24 hours, 7 days a week, and there are daily therapeutic activities in which patients participate. The goal of inpatient treatment is to provide a protective environment that includes medical stabilization, support, treatment for psychiatric or addictive disorders, and supervision.
- Counseling by a Certified Gambling Counselor who has completed a specific course of study in problem gambling treatment and has been certified by either:
- A national accreditation organization (National Gambling Counselor Certification Board-NCGC; American Gambling Counselor Certification Board-CCGC; or American Academy of Health Care Providers in the Addictive Disorders-CAS); OR
- A state certification organization that requires a minimum of 30 hours of problem gambling specific training and a period of direct (supervisor personal contact) supervision related to treating addicted gambler.
Crisis stabilization is very important at the beginning of treatment, because pathological gamblers have a much higher suicide rate than persons addicted to other substances or activities. Therefore, loved ones should be especially aware of the desperation phase of the disease, and monitor the gambler closely. Compulsive gamblers often have other addictions simultaneously, such as drug and alcohol abuse, compulsive shopping and bulimia. The addictive gambler may be harder to treat than someone with only one addiction, because he or she may “switch addictions” and therefore leave the addictive personality traits untreated. What should I look for in choosing a treatment program?
The National Council on Problem Gambling recommends selecting a treatment program that meets three criteria. The program should:
- Be licensed or accredited by a state or national authority to provide substance abuse and/or mental health treatment; AND
- Have a gambling specific track or protocol specifically designed for problem gambling clients, indicating a comprehensive view to gambling treatment, thorough assessment and adequate care of gambling specific treatment needs (family, educational, financial, legal etc.) ; AND
- Have at least one full time clinical staff member who is a Certified Gambling Counselor.
In addition, consider asking the following twelve questions when selecting a gambling treatment program:
- Are their counselors and staff experienced in treating problem gamblers? (How many problem gamblers are currently in their program; how many problem gamblers have they treated in the past year; what percentage of the patients are problem gamblers)?
- How many hours per day are dedicated to gambling specific treatment or education? What are the groups or educational topics that address the specific needs of problem gamblers and their families?
- Does the program accept your insurance? If not, will they work with you on a payment plan or find other means of support for you?
- Does the program encompass the full range of assessment and treatment needs of the individual/family (medical: including universal precautions for infectious diseases; psychological: including co-occurring substance abuse and mental health problems; financial: money management, budgeting and restitution; social; vocational; legal; spiritual; etc.)?
- Does the treatment program also address sexual orientation and physical disabilities as well as provide age, gender and culturally appropriate services?
- Is long-term continuing care support and/or guidance encouraged, provided and maintained?
- Is there ongoing assessment of an individual's treatment plan to ensure it meets changing needs?
- Does the program employ strategies to engage and keep individuals in treatment, increasing the likelihood of success?
- Does the program offer counseling (individual and group) and other behavioral therapies to enhance the individual's ability to function in the family/community?
- Does the program offer medication as part of the treatment regimen, if appropriate?
- Is there ongoing monitoring of possible relapse?
- Are services or referrals offered to family members to ensure they understand problem gambling, its impact on the family and the recovery process?
