The Connection Between Gambling and Substance Abuse

Many people enjoy gambling without having a problem. However, some people lose control of their gambling—at which point it does become a problem and can turn into an addiction. Many people who develop gambling addictions also develop problems with drugs and alcohol. Neither addiction is easy to manage without professional help.

What Is Gambling Addiction?

Gambling involves risking something of value in the hopes of winning something of greater value in return. In many cultures, people gamble on various things. Generally, this type of behavior does not become a problem. However, some people develop a gambling addiction or gambling disorder.²

A gambling disorder or pathological gambling is a pattern of behavior that severely impacts a person’s family, job, or personal life. One of the signs that gambling has become a concern is when a person feels an urgent need to keep gambling or to take even greater risks to reverse a loss. This behavior is sometimes called “chasing one’s losses.”²

It is estimated that gambling addiction affects between 0.2% and 0.3% of the general population. While the problems associated with gambling often begin during adolescence or young adulthood, they can also begin during adulthood. Gambling disorder tends to develop over the span of years. As such, most people who develop a gambling disorder gradually increase both the amount and the frequency of their wagers.²

People who develop gambling disorders earlier in life also tend to have problems with substance abuse or impulsivity disorders. Women who develop gambling disorders are more likely than men to also have problems with anxiety, depression, or bipolar disorder.²

Signs of a Problem

Signs of problem gambling include:²

• Recurrent gambling behavior that leads to distress.
• A persistent need to wager larger amounts of money or take bigger risks.
• Restlessness or irritability when attempting to cut down on gambling.
• Taking bigger risks to attempt to win back money after a loss.
• Lying to family members and friends to try to hide how much one is gambling.
• Numerous unsuccessful attempts to stop or cut down on gambling.
• Losing one’s job because of gambling.
• Borrowing money from others to relieve desperate financial situations caused by gambling.
• Endangering or losing a job, relationship, or other opportunity due to gambling.

Risk Factors

Several risk factors are related to gambling addiction, including:²

• Sex – Males are more likely to develop gambling disorder than females. Males are also more likely to develop the disorder at a younger age.
• Age – Young and middle-aged adults are more likely to develop a gambling disorder than older adults.
• Psychiatric history – Gambling disorders are more common in people who have anxiety, impulse control, depressive, and certain personality disorders.
• Substance abuse history – People with a substance abuse disorder are more likely to have a gambling disorder. Alcohol use disorders are particularly common in people who are diagnosed with a gambling addiction.
• Genetics – Gambling disorders are more common among first degree-relatives of people diagnosed with a moderate or severe alcohol use disorder than in the general population.
• Ethnic minorities – African Americans and indigenous populations have higher rates of gambling disorders than European Americans.
• Socioeconomic status – Gambling disorders are more common among people who live in lower socioeconomic areas.³

Co-Occurring Substance Abuse

A link between gambling disorder and other addictive disorders has been well-established.

Research suggests that there are high rates of comorbidity between substance use disorders and gambling addiction. Data from a large study in the United States found that alcohol addiction is the most frequently reported co-occurring condition among people with a gambling disorder. Just over 73% of people in the study that were diagnosed with gambling addiction also had an alcohol use disorder.⁴

Environmental Factors

Gambling and drug use may be related because of environmental factors. For example, alcohol disorders have been found to have the greatest link to gambling addiction, and alcohol is served at most casinos.⁴

On the flip side, one pattern that is commonly seen among people with a history of alcohol dependence is the development of a gambling problem—even after being in recovery for many years.⁵

Additionally, gamblers may use drugs and alcohol to celebrate a win or to cope with depression after a loss. Some also use it to deal with the guilt and shame associated with gambling.⁵

Gambling and cocaine abuse may occur together as part of a broader antisocial lifestyle. A person who uses cocaine may view gambling as an acceptable method to acquire money to support their drug habit. They might also have increased energy as well as an inflated sense of their gambling skill because of cocaine use and believe that they can’t lose.⁵

Genetic/Physiological Factors

Psychology, genetics, and neuroscience research over the last 2 decades indicate that drug addiction and gambling act in similar ways on the brain.

Pathological gamblers and people addicted to drugs share some of the same genetic risks for impulsivity and reward-seeking. Research suggests that people are vulnerable to compulsive gambling and drug addiction because the circuits of their brain that deal with rewards are underactive. Therefore, they tend to take bigger risks in terms of both substance use and gambling. Similar to how people addicted to drugs must take more of the substance to get the same high, people with gambling addictions must bet more money or take more risks.⁶

Psychiatric Factors

Research has found that people who have co-occurring substance abuse disorders and gambling disorders also tend to have higher rates of attention-deficit hyperactivity disorder (ADHD), risky sexual behaviors, and antisocial personality disorder.⁵

Signs of Drug Abuse

The signs of drug addiction are often similar to a gambling addiction. They include:²

• Taking the substance in larger amounts over longer periods of time than intended.
• Spending a great deal of time on activities necessary to support the drug or alcohol habit.
• Experiencing a strong desire to use the drug.
• Recurrent use of the substance in spite of social, occupational, or medical consequences.
• Giving up important social activities to use the drug.
• Repeated use of the substance in situations where it is dangerous.
• Tolerance, which is defined as the need to take larger amounts of the drug to achieve the same results.
• Withdrawal, or experiencing psychological or physiological symptoms that occur once the substance is taken in smaller amounts or stopped.

Program Options

A variety of program options are available to help people with gambling and substance addictions. Because every person is unique, there is no one program that will work for everyone. Each person will have to find the right fit. Here are some of the most common programs:⁷

• 12-step programs – An example of this kind of program is Gamblers Anonymous. This is a 12-step recovery program that is similar to Alcoholics Anonymous. A person in the program chooses a sponsor who is a former gambler that has remained free from a gambling addiction for some time. They provide guidance and support.⁷
• Outpatient programs – These programs may take place in a clinic, hospital, or other setting. They typically offer various types of therapy, including cognitive behavioral therapy and motivational interviewing. Outpatient programs are usually well-suited for people with strong social support at home.⁸
• Inpatient programs – Inpatient or residential programs offer a safe, supervised recovery environment. Treatment is highly structured and may consist of both individual and group therapy. For people addicted to drugs or alcohol, inpatient detoxification is often needed to prevent or ease dangerous and uncomfortable withdrawal symptoms.⁸

Getting Help

An integrated treatment that combines education, group therapy, cognitive behavioral therapy, and/or a 12-step program is usually the most effective for gambling addiction, according to the Substance Abuse and Mental Health Services Administration.⁵

Dealing With Triggers

One of the first steps to effectively managing a comorbid gambling and substance addiction is to learn to identify both internal and external triggers.⁵ One very effective treatment to help identify triggers and to modify how we react to them is cognitive behavioral therapy. Also called CBT, this method focuses on dealing with gambling urges, managing uncomfortable emotions, and examining unrealistic beliefs about gambling. CBT can also be used to treat substance abuse.⁷

After the initial treatment period, one strategy might be to remove things that trigger gambling at home. For example, this might mean closing credit cards, choosing a family member or friend to help you manage your finances, or limiting the amount of cash that you carry.⁵

Medications

Medications are sometimes used to help people with gambling addiction. Although selective serotonin reuptake inhibitor (SSRI) antidepressants are very effective at treating impulse control disorders, they have never been quite as effective for gambling disorders. However, medications that are used to treat substance addiction have been found to be useful in the treatment of gambling disorders. Naltrexone, which is used to manage both alcohol and opioid dependence, shows some promise for treatment of gambling disorders.⁶

Suicide Prevention

People with gambling disorders often have a high rate of suicide. They may have stolen or borrowed money from family members, run up huge debts on shared credit cards, or sold precious family heirlooms. These behaviors can cause huge drops in self-esteem and could be one reason for the high rate of suicide.⁷

Treatment can help manage such risk. Rehab program services may be used as part of treatment to help the person resolve some of these issues. For instance, it might help them identify ways to repair broken relationships and pay off debts. These services can also be used to help someone cope with the legal and financial issues surrounding gambling. For instance, they can be used for debt repayment or debt restructuring. Programs can also refer clients to legal counsel and help them find temporary housing if they’ve been evicted.^5,7

Continuing Care

Both substance abuse disorders and gambling disorders are recurring, chronic conditions. This means that there is a high potential for relapse without appropriate aftercare.⁵ Some aftercare options include:

• 12-step groups – This form of aftercare can include groups such as Gamblers Anonymous and Alcoholics Anonymous.⁵
• Sober living homes – These are safe alcohol and drug-free living environments that are focused on abstinence. They help a person recovering from substance abuse or gambling to find a foundation for lifelong recovery.⁹
• Individual and group therapy – Both individual and group therapy may be part of a continuing aftercare program.⁵

If you or a loved one has a problem with gambling and/or a substance addiction, get help right away. A drug and gambling rehab program can help you combat addiction and begin to make positive changes in your life.

Sources

1. Medline Plus. (2017). Compulsive Gambling.
2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
3. NIH News In Health. (2011). When the Stakes Turn Toxic: Learn About Problem Gambling.
4. Josephson, H; Carlbring, P; Forsberg, L; Rosendahl, I. (2016). People with gambling disorder and risky alcohol habits benefit more from motivational interviewing than from cognitive behavioral group therapy. PeerJ. 4, e1899.
5. SAMHSA: Center for Substance Abuse Treatment. (2005). Substance Abuse Treatment for Persons With Co Occurring Disorders (Problem Gambling).
6. Scientific American. (2017). How the Brain Gets Addicted to Gambling.
7. Jazaeri S, Habil MHB. (2012). Reviewing Two Types of Addiction – Pathological Gambling and Substance Use. Indian Journal of Psychological Medicine, 34(1), 5-11.
8. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
9. Indiana Affiliation of Recovery Residences. (2017). Recovery Housing in the State of Indiana: A Supportive, Affordable, and Effective Option.