Gambling Addiction Treatment
What is Gambling Addiction?
While addiction is most frequently associated with substance abuse, drugs and alcohol are only some of the many objects and behaviors with which people can develop unhealthy relationships. A wide variety of impulse control disorders exist, ranging from sex addiction to internet addiction. These behaviors are generally pursued for pleasure by the majority of people. However, in cases where people develop addictions, they may be unable to resist cravings or control the extent of their behavior. This can lead to severe negative consequences.
Gambling addiction is often defined as a process addiction, sometimes known as a behavioral addiction. Unlike substance addictions, which occur when a person feels obligated to stimulate themselves using a particular psychoactive substance, process addictions involve compulsive relationships with stimulating behaviors. These behaviors can range from passive behaviors (eg, watching television) to active behaviors (eg, playing video games, pathological working). Gambling is a particularly stimulating activity, given its potential for extreme ups and downs. The activity also leads to very profound consequences, ranging from the fortunate to the disastrous, which further increase its addictive potential.
In order to understand what gambling addiction is, it is necessary first to define healthy gambling. Gambling, in essence, involves wagering something of value (most commonly money). These wagers occur in the context of an event or game with an outcome that is uncertain to a greater or lesser degree. The objective of gambling is to win a prize that is greater in value than the object that was wagered. When an individual places a bet, they are exposing themselves to the whims of chance. Given the uncertainty of the outcome, they place themselves at risk of significant loss, but they also stand to gain. Healthy gambling is an activity that is pursued willingly; when an individual engages in healthy gambling, they are generally able to stop when they decide to do so. Addictive or compulsive gambling, however, is an activity that a person cannot control.
People may gamble for many reasons. Those who gamble for recreational reasons do so for the fun of it, because they enjoy the activity for its own sake. The vast majority of people gamble to pursue monetary gain. Professional gamblers make their living from gambling, and often utilize complex strategies to maximize the chances of a favorable outcome. Both recreational and professional gambling can be either healthy or unhealthy.
Individuals who suffer from gambling addiction are unable to manage or regulate their gambling. Whereas non-addicts can engage in the activity for a short period and then easily let go, people who suffer from gambling addiction may feel unable to stop once they begin. Gambling addicts frequently experience cravings or strong desires to gamble throughout the day. These cravings may interfere with their ability to function normally in their everyday lives, whether the cravings are acted upon or not. Further, the behavior of gambling itself can have extreme and inherently unpredictable consequences for their lives — and for the lives of their family members. Individuals suffering from gambling addiction may recognize these negative consequences, and they may exert effort to curb their gambling behaviors or stop entirely, but the nature of addiction itself prevents them from doing so successfully, at least for long. Without outside help, individuals suffering from gambling addiction generally continue to experience the destructive effects of their compulsive behaviors, with often devastating consequences.
Long-Term Risks of Gambling Addiction
Over time, what begins as a recreational hobby can rapidly turn into an activity that controls — and ruins — almost every aspect of a person’s life. The long term risks for professional gamblers are as serious as those for recreational gamblers. On the most basic personal level, anyone suffering from addiction, including gambling addiction, shares one common experience: a feeling of losing control of oneself and ones life. Gambling addiction can make people feel helpless, as they time and time again return to a behavior that they have promised themselves to stay away from. When the consequences of gambling addiction manifest themselves in more severe ways, repeatedly engaging in this self-destructive behavior against ones own will can make people feel despondent.
As an activity that requires wagering valuable items, most commonly money, gambling first and foremost poses extreme risks to a person’s financial well-being. It is common for people who suffer from gambling addiction to bet beyond their means. This can mean dipping into savings accounts, childrens’ college funds, or money allocated for rent payments. While gambling addicts can periodically win, the nature of the game entails that they will more frequently lose — and their impulsivity in gambling further increases the chances of a financial loss. As a result, people with gambling addictions generally suffer from acute financial distress. They may struggle to pay for rent, food, or other basic necessities. They may go into bankruptcy. It is also common for people with this condition to go into considerable debt. As financial crises pile up, a person suffering from gambling addiction may be all the more tempted to place a bet in the hopes that a lucky result will erase all their problems.
Few people experience financial problems alone. While individuals who suffer alone are in some ways the most vulnerable, exposing themselves to the risks of homelessness and starvation, among other ills of destitution, people with strong social support systems face a variety of other consequences. The debts and other financial problems that accumulate around gambling often drive gambling addicts to turn to friends, family members, or other more dubious individuals to borrow money. As the money is unlikely to be paid back, this habitual activity can put a significant strain on interpersonal relations. The situation is far worse when a gambling addict has people who depend on him or her. Suffering from a gambling addiction makes it all but impossible to support a family. When a person’s addictive gambling behavior puts their family at risk of poverty, homelessness, and general instability, family life can suffer considerably. Gambling addiction can destroy relationships with friends and family, end in divorce, and even result in loss of child custody.
The financial problems that result from gambling addiction can also drive people to pursue criminal means of funding their addiction. When family members and friends are unable or no longer willing to loan out money, it may be tempting to steal, engage in fraud, or borrow money from criminal organizations. These activities put a person and their family at considerable risk. Furthermore, they expose them to significant legal risks. Defending oneself in court and the necessity of hiring a lawyer to do so can add to financial stress. Should that go wrong, criminal consequences, such as imprisonment, are a very real possibility.
Gambling addiction can also lead to a wide variety of health complications. Research has shown that gambling addiction actually leads to long-lasting changes in the brain on a neurological level, altering how a person metabolizes dopamine, serotonin, and adrenaline. The gambling sessions themselves also affect health. Gambling sessions among addicts often last up to two or three days straight, often without food, water, or sleep. Ignoring the biological needs of the body during a gambling session can have deleterious effects on health, but the prolonged physical and emotional stress associated with such gambling sessions makes the impact even more severe. Gambling addiction can cause or exacerbate dangerous physical health conditions, including hypertension, peptic ulcer disease, and cardiovascular disease. It should come therefore as no surprise that deaths of “natural causes” inside casinos are commonplace.
The activities and consequences associated with gambling addiction also frequently lead to mental illness. The interpersonal, financial, and criminal consequences of gambling addiction naturally result in a great deal of stress, which can manifest itself via a variety of mental health conditions, including anxiety disorder, major depression, and other mood disorders. The accumulated guilt, shame, hopelessness, and despair that accompanies gambling addiction tends to worsen these symptoms. Substance use disorders are a particular risk. Gambling addiction is highly correlated with alcohol use disorder, especially among men (who constitute the majority of gambling addicts). Comorbid substance use disorders not only complicate the process of treating a gambling addiction, they significantly increase health problems, and they can even be fatal in the case of a drug or alcohol overdose.
The most life-threatening problem that long-term gambling addicts face is suicide. Individuals suffering from gambling addiction have high rates of suicidal ideation. In fact, one study found that among problem gamblers, 20% had attempted suicide and 77% regularly experienced sucidal thoughts. A follow-up study found that among suicide attempts, 12% to 24% could be attributed to pathological gambling. Given that only 8% of people with gambling addiction ever seek help for their disorder, these individuals are gambling with more than just their financial assets — they are putting their lives at stake.
Treating Gambling Addiction
Gambling addiction is a treatable medical condition. Unfortunately, the stigma and shame that many people associate with gambling, and especially compulsive gambling, makes many people reluctant to discuss their problems. Most gambling addicts recognize the problematic nature of their behavior, especially when consequences become severe, but very few reach out for help. While it may be tempting to try to control and manage ones gambling addiction on ones own, the nature of addiction makes this very difficult. Given that gambling addicts suffer from a disorder located in their brain’s motivation and decision-making centers, trying to treat gambling addiction using individual willpower is like trying to cure a broken leg by going for a jog. While gambling addiction can be treated and successfully managed, doing so is contingent upon seeking outside help. Most outpatient treatment centers utilize a variety of treatment methods to manage gambling addiction, including psychotherapy, support groups, and sometimes medication. The nature of a person’s treatment plan depends in large part on their individual circumstances and needs.
Treating Gambling Addiction Through Therapy
Most outpatient treatment centers for gambling addiction offer talk therapy, sometimes known as psychotherapy. Talk therapy can be highly beneficial for individuals suffering from gambling addiction. It allows them to deeply reflect on the underlying causes of their gambling addiction. By providing support during the course of such introspection, psychotherapists can help addicts address these underlying issues, which can range from early childhood trauma to untreated mental health disorders. Psychotherapy can also be a valuable tool for developing new coping strategies and tools for avoiding a gambling relapse. Certain therapeutic modalities are especially beneficial for gambling addiction.
- Cognitive-behavioral therapy (CBT) is generally the first type of psychotherapy recommended for gambling addicts. Cognitive-behavioral therapy involves recognizing maladaptive thought and behavior patterns and systematically working to replace them with more rational, beneficial thoughts and behaviors. Cognitive-behavioral therapy is a highly structured, goal-based therapy that often has a finite duration. Individuals with gambling addiction can use CBT to reduce their cravings and obsessions and gain the mental fortitude to avoid returning to old unhealthy behaviors.
- Couples therapy is a valuable tool for gambling addicts whose addictions have wreaked havoc on their family life. Spouses and significant others are often severely affected by the behavior of a gambling addict, which can drain shared financial resources and cause interpersonal conflict. While a gambling works to recover from their condition, addressing these interpersonal issues is an important part of the healing process.
- Group therapy is a great way of individuals suffering from gambling addiction to come together and share their experiences. By addressing personal challenges on a group level, individuals suffering from gambling addiction can feel less alone in their struggles.
Gambling Addiction Support Groups
Outpatient programs understand that an essential aspect of recovery from any addiction, from a substance use disorder to a gambling disorder, is developing a strong social support system. In fact, a large body of research exists backing up the idea that individuals with strong sober social support systems have better recovery outcomes. As such, one of the main benefits of enrolling in an outpatient treatment center is that a person gains access to a network of other like-minded individuals. Gambling addiction can be lonely and isolating, and being understood by other people with the same disorder can be a profoundly healing experience in and of itself. Furthermore, these support systems are likely to remain strong in the years subsequent to formal addiction treatment, providing recovering gambling addicts with a long-term resource that is likely to discourage relapse. Beyond merely discouraging relapse, however, involvement in a social support group is an inherently enriching experience that offers a source of joy in people’s newfound sober lives.
Other Support Groups
Many individuals who suffer from gambling addiction suffer from other comorbid mental health conditions. Since substance use disorders, especially alcohol use disorder, are by far the most common comorbid mental illness, it is often recommended that individuals with gambling problems make use of other kinds of support groups. By treating their other conditions, they can ensure that a relapse of their alcohol use disorder, for instance, doesn’t trigger a relapse of compulsive gambling as well. While individuals suffering from gambling addiction should primarily attend Gamblers Anonymous, a variety of other 12-step based programs are often recommended, depending on which additional conditions a person suffers from. These programs include:
- Alcoholics Anonymous
- Narcotics Anonymous
- Cocaine Anonymous
- Sex Addicts Anonymous
- Debtors Anonymous
Non 12-step-based programs and support groups are also popular options for people suffering from gambling addiction. The most prominent of these is SMART Recovery. SMART Recovery is a program that addresses all forms of addiction, ranging from substance use disorders to behavioral addictions like gambling. SMART Recovery, unlike 12-step programs, is entirely secular and is not rooted in spiritual principles. The program is designed with the concepts of cognitive-behavioral therapy (CBT) in mind. SMART Recovery helps members manage their cravings, emotions, obsessions, and compulsions. It does so by encouraging members to recognize and evaluate their maladaptive thought patterns and behaviors and then work to systematically replace them with healthier ones. SMART Recovery is convenient for people who live in remote areas, since the program is mostly online. However, while in-person SMART Recovery meetings do exist, they are less ubiquitous than 12-step meetings, and therefore 12-step-based programs are still recommended for individuals aiming to build a solid social support system in recovery.
Gamblers Anonymous (GA) is a program for individuals who are working to recover from gambling addiction. Gamblers Anonymous does not use the terms “problem gambling,” “gambling addiction,” or “gambling disorder,” preferring to address the issue in terms of “compulsive gambling” instead. At Gamblers Anonymous meetings, members who are trying to avoid a gambling relapse come together to share their experience, strength and hope. Gamblers Anonymous meetings are opportunities for people at varying stages of recovery to relate their experiences and challenges, receive advice and emotional support, and help others recover.
The program is 12-step-based and modeled after the principles of Alcoholics Anonymous (AA), the longest-running recovery group in the world. A large number of outpatient programs are also 12-step-based, and therefore many of them encourage individuals to attend GA meetings. The 12 steps of Gamblers Anonymous are spiritually-based, emphasizing the importance of developing a relationship with a “higher power.” This concept of a higher power is self-defined, meaning a person’s understanding of it can include anything from God to the community of GA itself. Ultimately, the 12 steps are about recovering from addiction by letting go of ones personal ego and self-will. Newer members are advised to work with a “sponsor,” who is a person who has completed the 12 steps and is amenable to guiding a newer member through them. Since GA’s program of recovery emphasizes helping others as a means to helping oneself, sponsors, as well as the rest of the GA community, are generally willing to bend over backwards to support newer members in their recovery efforts.
Gamblers Anonymous is available worldwide in almost every major city. The program has no costs for membership, and the only requirement for admittance is a desire to stop compulsively gambling.