Understanding Gambling Addiction, Symptoms, Statistics, and Treatments
Written by: Brian Clark, BSN, MSNA
Last Updated: September 28, 2016
Gambling is a popular pastime here in Australia and is a deep part of the Aussie culture. From sports betting to playing pokies in the grand halls of a casino most everyone has taken a chance on lady luck. However, some local Australians can over indulge in the bright lights of the casino world. This can lead to serious financial problems, stress, and even loss of control. To understand why this occurs extensive research has been done to better navigate the human brain and how it can become addicted to gambling. Through this knowledge, advanced steps can be taken to better treat those who suffer from perpetual gambling addiction.
Compulsive gambling is the inability to control ones desire to gamble regardless of serious personal consequences and harm. Besides sending individuals into a spiral of depression, it can also damage interpersonal relationships and lead to serious financial troubles.
Gambling As A Behavioral Addiction
It wasn’t until 2013 that compulsive gambling was labeled as a behavioral addiction. This placed gambling addiction in the same category of disorders as substance abuse. The reason for this was due to recent neuroscience research that better outlined the underlying cause. This research showed those addicted to gambling shared remarkable similarities to those with drug addiction with relation to changes in their brain function and behavior.
Just as with drug addiction, gambling addicts show features of tolerance and withdrawal. They also present with having gambling become a major interference in their life even after multiple attempts to reduce their gambling frequency or stop all together. Those who try to stop will often suffer from insomnia, irritability, agitation, and uneasiness. Some of the most unambiguous similarities between drug addiction and gambling addiction comes with constant cravings, blunted response to certain stimuli, and accentuated highs. Problem gamblers will become dull to small bets or winnings and will eventually progress to where they require bigger bets and riskier options to feel the same “high” or satisfaction when playing. This is when the addiction can become consuming.
What should also be recognized is compulsive gambling is hereditary just like other behavioral addictions. There is substantial cross over from one behavioral addition to another. For example, if a parent had an addiction to alcohol their child is at an increased risk for developing a gambling addiction.
Brain Imaging & Neurochemical Testing
One of the most influencial reasons as to why gambling was designated a behavioral addiction is through the results of brain imaging and neurochemical testing. Gambling has shown to activate the ventral striatum, a reward system in the brain, by flooding its receptors with dopamine. If the practice of gambling is continued on a regular basis the reward system adjusts to the high level of dopamine produced by downregulating the dopamine receptors, meaning players must make higher bets, take on more risk, and play more often to achieve the same “high.”
This disruption of the reward system can take a relatively permanent effect if not appropriately addressed and treated, meaning problem gamblers can often relapse even after years of abstinence. The behavior can alter the circuitry of the brain related to memory and learning, resulting in a strong association between the pleasure zone and the circumstances in which it was stimulated. Because of these breakthroughs in understanding gambling addiction many of the current treatments for gambling addiction focus on training the brain to unlearn these memories and associations.
Other studies have also shown that gambling has a profound effect on impulse control located in the prefrontal cortex. This particularly makes it more difficult for gamblers to resist the urge even against their better judgment. If there are already deficiencies in the function of the prefrontal cortex then the player is at even greater risk for developing an addiction. This is in large part why adolescents are more likely to become addicted to gambling. Generally the prefrontal cortex of humans does not become fully developed until their late twenties.
While there is no specific gene marker recognized as making someone more susceptible to gambling addiction there is evidence that risk for addiction is hereditary. Research has shown that up to 60% of someone’s risk for addiction is due to a variety of genetic factors derived from the parents. Through the compounding of at risk genes an individual can be highly vulnerable to gambling addiction.
Other brain imaging studies have revealed that when a person who is already addicted to gambling, as with other behavioral addictions, is shown brief images or videos related to gambling there is a significant change of blood to certain parts of the brain. The abrupt increase and then drop off of dopamine in the ventral striatum is what makes a behavior addictive. The more diminished the general homeostasis of the ventral striatum and the faster and more brief its spikes in dopamine play a large role in someone’s risk for addiction and progress of the disease.
Other variables that increase an individual’s likelihood of gambling addition include environmental factors such as stress. These have the ability to disrupt brain circuitry even more making an individual more likely to develop an addiction. The withdrawal of gambling online is much attributed to a neurotransmitter that is associated with stress called corticotropin-release factor. This neurotransmitter heavily affects the amygdala region of the brain, which is associated with feelings of fear, anxiety, and depression.
Fortunately, there is the possibility of recovery. The brain has the ability to heal itself and regain a homestatic balance without the need to gamble. With the correct behavioral conditional, counseling, and treatment problem gamblers can keep their desire to gamble at bay.
Symptoms of Gambling Addiction
- Those with an addiction spend an unusual amount of time thinking about gambling.
- Problem gamblers will slowly need to increase their betting amounts in order to continually feel the “high” associated with the game.
- Problem gamblers will often chase their losses with larger and larger bets even when they know the odds to win are not in their favor.
- Refraining from gambling will often cause addicts feelings of restlessness or irritability.
- Those with an addiction will often use gambling as a way to escape anxiety or depression.
- Problem gamblers will often lie about the quantity of time and money they spend gambling.
- Those with an addiction often will let gambling interfere with the rest of their life. This includes the loss of relationships, jobs, and education.
- Problem gamblers sometimes performing crimes in order to obtain money for gambling.
- Problem gamblers will often make several attempts to limit their time gambling or quit completely but later find themselves playing in excess just as before.
Australian Gambling Addiction Statistics
- Approximately 2% or 500,000 Australians are in the at risk or problem gambler category. Out of these individuals 115,000 are in the problem gambler category and another 280,000 in the ‘moderate risk’ category.
- The average Australian loses around $1,279 a year gambling. Problem gamblers on the other hand lose approximately $21,000 a year. This means problem gamblers contribute approximately 40% of all revenue generated through gambling in Australia.
- The gambling addiction of 1 person negatively affects between 5 to 10 other individuals yet only 15% of problem gamblers seek any form of help.
- The social cost of problem gambling is estimated to be around 4.7 billion AUD a year.
- Around 600,000 Australians play pokies at least once a week and out of those 95,000 qualify as problem gamblers. That means one in six Australians who play pokies regularly has a serious addiction.
- Young adults between the ages of 18 to 24 spend more time playing pokies than any other age group and are at the most risk for developing an addiction.
- Three quarters of all problem gamblers in Australia prefer to play pokies as their games of choice. It is even higher for women. 9 out 10 women who have an addiction to gambling prefer playing pokies.
- Problem gamblers in Australia are six times more likely to be divorced and are four times more likely to have a problem with smoking and/or drinking alcohol.
- Problem gambler’s children are ten times more likely to become problem gamblers themselves later in life compared to the average Australian.
Treatments for Problem Gamblers
The treatment for gambling addiction starts with an individual recognizing they have a problem. For an individual to recognize they have a problem with gambling and to seek help they often require the assistance of friends or family. Once this occurs there are a few treatment options available that can help an individual control their habit.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is the most commonly implemented form of psychotherapy used to treat mental disorder. It is a type of talk therapy that primarily focuses on helping the patient develop personal coping strategies. Because CBT is a “problem focused” and “action oriented” type of treatment, it helps identify specific problems related to the patient’s disorder followed by helping to identify effective goals and strategies to decrease the symptoms and behaviors of the disorder.
The therapist will generally begin by exploring the relationships between a person’s feelings, thoughts, and behaviors. CBT allows the therapist to explore what thought patterns have been developed by the patient that cause unhealthy emotions and ultimately self-destructive behaviors.
After recognizing these negative thought patterns and how they hinder constructive behavior by the patient, the therapist can then map out a plan to condition the brain and reward it for healthy behaviors. This often results in changing the patient’s basic outlook on how to approach challenges or obstacles in life and make better decisions.
Cognitive behavioral therapy allows the patient to replace negative or inaccurate thoughts with more realistic and confident thoughts based upon prior experience. This helps patients face daily tasks and challenges more confidently and to respond in an effective manner. During this form of treatment patients are also regularly requested to keep a journal. CBT has been shown to be effective for the treatment of a variety of mental illnesses and has even shown to improve brain function.
The basis for cognitive behavior therapy is that maladaptive behaviors and thought distortions largely contribute to the development and the sustaining of psychological disorders. The symptoms of a psychological disorder can then be reduced by teaching new skills related to information-processing and other coping mechanisms.
Cognitive behavioral therapy has been proven to be successful on it’s own in treating less severe forms of mental disorder without the need of psychotropic medications. It is also the first line treatment for children and adolescence when treating psychological disorders.
Traditional cognitive behavioral therapy is based on the idea that changing maladaptive thinking leads to change in a patient’s affect and behavior. Now it is understood that CBT is better defined as changing a patient’s relationship to the maladaptive thinking rather than the changing the thinking itself. CBT fundamentally looks at an individual as a whole and then decides what needs to be fixed rather than focusing on diagnosing a patient with a specific disease.
Cognitive behavioral therapy using the Kanfer and Saslow steps:
First: Identifying critical behaviors (addiction to specific games such as pokies, keno, or lotto)
Second: Evaluate and decide if the critical behaviors are either deficits or excesses
Third: Evaluate the regularity, duration, and intensity of each critical behavior
Fourth: If a deficit exists, try and increase the behavior. If an excess exists, try and reduce the behavior.
There is another set of steps that outlines the six phases of cognitive behavioral therapy:
- patient assessment
- skills acquisition
- skills consolidation and applied training
- generalization and maintencance
- post-treatment assessment and treatment follow-up
Not surprisingly successful treatment often includes widely available resources such as gambling addiction hotlines, Gamblers Anonymous, self-help programs, and peer support groups. For friends and family of problem gamblers there is also a support group called Gam-Anon.
Gamblers Anonymous (GA)
Gamblers Anonymous is a safe and confidential support group led by an experienced gambling counselor. They are a self-help program that focuses on gambling abstinence using a 12 step program similar to Alcoholics Anonymous. Their group meetings can be found throughout Australia at different times during the week. Generally meetings are held at church halls, public buildings, or local community centers. Each group meeting lasts approximately 1.5 hours.
Many people have had success using the techniques and companionship found at Gamblers Anonymous. The program helps those suffering from gambling addiction to find and identify with others who struggle with the same vices. It also lets people discuss what techniques have worked for them in gaining control of their gambling addiction. Gamblers Anonymous does not require any payment.
Gamblers Anonymous helps those with an addiction realize that they don’t need to hide their gambling habit. That there are others who have the same tendencies to play that they do. This is an important step in being honest with oneself and making progress in the resolution of the behavior. Sharing experiences with others who have been through similar circumstances and seeing success by their peers can also give a sense of hope. It helps modify the individual’s thinking in how they view their potential to control their behavior.
While Gamblers Anonymous is a great support group for those who are problem gamblers it is still not for everyone. There is an expectation from group members to maintain complete abstinence from participating in any form of gambling or playing for chance. This also includes refraining from playing raffles, bingo, or even flipping coins.
Perspective of Gamblers Anonymous
The organization of Gamblers Anonymous views problem gambling as a progressive illness that can be controlled but not cured. Individuals with compulsory gambling create a mental image of a mountain of insolvable problems. Out of all the problems associated with problem gambling, the financial loss is usually one of the easiest to fix. Once an individual has control of their gambling and is able to start paying back debts the financial stress in regularly diminished. However, some problems that come with compulsory gambling are often much longer lasting. These include the loss of relationships, employment, and even legal troubles. The most difficult problem generally faced by problem gamblers is recovering from character changes within themselves. This is one of the aspects Gamblers Anonymous attempts to have its members tackle immediately and continue to work on throughout their lives.
Things To Consider When Joining Gamblers Anonymous
As mentioned before Gamblers Anonymous expects its members to maintain complete abstinence from any form of gambling or playing any game of chance. If a person has a compulsive gambling habit to one type of game or bets but participates in other forms of gambling without issue, they must still be willing to give them all up. As a result this support group is not for everyone looking for help.
In the past most of the addiction materials written for Gamblers Anonymous participants was written by men for men. This often left women feeling discouraged that participated within the group. Today the group has become much more sensitive to the needs of their female participants and has worked heavily to make sure they receive the same quality of attention and care. Achieving the goal of serving both the female and male community members as best as possible has been a priority of Gamblers Anonymous for close to two decades.
If an individual has other concurrent psychiatric disorders they should first be evaluated by a medical specialist who understands their condition and can best lay out a treatment plan. This is generally a concern if a psychiatric disorder preceded the development of a compulsive gambling problem.
Meetings generally have anywhere between 5 to 30 participants. Those coming for the first time should be there somewhere between 15 to 20 minutes early before the meeting begins. This will allow new people joining the group to meet a couple of the other participants before everyone has arrived and the meeting has begun. Also the meeting secretary is often there early and will have a chance to orient new members. During this time a new member will likely received a brief orientation regarding the meeting format and the associated literature. New members are able to listen in the group and are will be given an opportunity speak or share with the group if they so desire. The new member will be given 20 questions, and following their response they are welcome to join the group. Don’t worry if you answer yes to some of the questions. Most problem gamblers answer yes to seven or more questions upon arrival.
Casino and Bookmaker Help
If an individual doesn’t want to completely stop gambling as is required with Gamblers Anonymous there are other options. These options generally require some oversight by a family member, loved one, or councilor. Casinos and bookmakers will offer different options for problem gamblers to gain a greater level of control over their spending and time spent at the casino. These are limits that the gamblers can place on themselves during a time when they feel that they are in control.
One of the ways problem gamblers can gain control over their spending is by setting deposit limits at the casinos or with the bookmakers. This will ensure that the specific casino does not allow the gambler to spend more than a predetermined amount of money at their establishment in a given period of time.
Self exclusion is another way to gain a certain level of control over gambling addiction. This is where a player can opt to have a cooling off period where they are not allowed to participate at the casino and they will not send you promotional materials.
While these options can be helpful they are not true solutions to problem gambling. These can only help if the individual’s gambling options are limited, otherwise multiple casinos and online operators will have to be notified. Considering the fact that there are hundreds of online casinos, setting limits at each one would be a monumental task.