Gambling addiction has become increasingly recognized as an important issue affecting many Canadians. We examine its underlying causes and the available treatments.
It has become increasingly clear in recent years that gambling addiction is a severe issue that affects many Canadians. In the most recent edition of the authoritative Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association moved gambling disorder into the addictions section of the publication. This is a significant decision that demonstrates the recognition of a serious condition.
Definition of Gambling Disorder
The DSM-5 defines a gambling disorder as “Persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress.” It also provides twelve strong indicators of gambling disorder. The Centre for Addiction and Mental Health (CAMH) definition uses similar terminology, stating that gambling addiction is a gambling habit which “interferes with work, school or other activities, is harmful to mental or physical health, hurts a person financially, damages their reputation and causes problems with family and friends.” Fortunately, treatment options for people struggling with gambling addiction are constantly improving.
Underlying Causes and Recognition
We have significantly increased our understanding of gambling addiction in recent years. Research has substantially broadened our definition of the condition. As noted in Scientific American, “Whereas experts used to think of addiction as dependency on a chemical, they now define it as repeatedly pursuing a rewarding experience despite serious repercussions. That experience could be the high of cocaine or heroin or the thrill of doubling one’s money at the casino.”
This broader understanding has allowed professionals to treat the condition in a more progressive and evidence-based manner. Certain methods, such as cognitive behavioural therapy and cue-exposure therapy, have proven effective.
Studies on Gambling Disorder
Research has identified commonalities between gambling addiction and more traditionally recognized forms of addiction. As described in The Star, “Studies show gambling boosts dopamine in the brain – the neurotransmitter responsible for feelings of enjoyment – similar to stimulant drugs, such as crack cocaine.” Gambling addiction expert Professor David Nutt states that “Research to date shows that pathological gamblers and drug addicts share many of the same genetic predispositions for impulsivity and reward seeking.
Just as substance addicts require increasingly strong hits to get high, compulsive gamblers pursue ever riskier ventures. Likewise, both drug addicts and problem gamblers endure symptoms of withdrawal when separated from the chemical or thrill they desire.” Studies also indicate that people who become addicted to gambling often produce lower levels of serotonin, leading to anhedonia, a lack of enjoyment from ordinary pursuits. For these people, gambling serves as a stimulus to compensate for this lack of pleasure or excitement in ordinary life.
Gambling Addiction and the Human Brain
Gambling addiction has also been linked to other genetic factors, such as under-activity in the parts of the brain used to control inhibition and consider consequences. Alongside these genetic factors, psychologist Dr. David Hodgson of the University of Calgary notes that “environmental factors such as accessibility to gambling, location and type of establishment” are also influential. Experts have also established strong links between gambling disorder and other forms of addiction. Pathological gamblers are four times more likely to also struggle with alcoholism, six times more likely to abuse drugs, and four times more likely to have a mood disorder.
Accessibility of Gambling
The prevalence and accessibility of gambling in Canada has substantially increased in recent decades. This is partially due to changes in legislation, but primarily because of the internet. Dr. Hodgson states that “Even those who have never been to a casino and likely never will can still become addicted gamblers because of the proliferation of gambling websites.” Many people may also engage in online games that they do not consider to be gambling, despite the involvement of money, because they do not align with traditional ideas of gambling.
Statistics on Gambling Disorder
As gambling addiction has gradually become recognized as a serious issue, pressure has increased on the Canadian government to improve measures for preventing addiction. However, the government has little incentive to decrease gambling revenue. A 2017 CBC report captures the scale of Canada’s gambling habit: “Last year, we spent about $13 billion on legal, government-run gambling. That’s more than we spend on movies, hockey tickets, and Tim Horton’s- combined.”
A substantial proportion of this revenue is generated through problem gambling. As noted in CBC’s report, “Experts say that as much as 50% of that gambling revenue comes from problem gamblers.”
Gambling Advertising and Addiction
Promotion of gambling often targets vulnerable groups. Measures taken to prevent problem gambling have so far proven relatively ineffective. In Ontario, for example, the Ontario Lottery and Gaming Commission’s operates a mandatory self-exclusion policy. This allows problem gamblers to identify themselves and agree to restrictions preventing them from entering Ontario’s seventy casinos. However, the policy is poorly enforced. Most of those who sign up for self-exclusion are apparently allowed to return and continue gambling unperturbed.
Natasha Dow Schull, an addiction expert with New York University, is critical of the theory behind the policy as well as its execution. “It puts the responsibility on the person,” she says. “I’m not going to alter the algorithms in this machine; I’m not going to alter its accessibility to you, the times of day at which you can play it, I’m not going to put limits on how much money you can spend.”
Vulnerable Groups
There is also a growing body of evidence to suggest that gambling promotion targets vulnerable groups, such as older people. Casinos often run bus tours for older people, taking them from one gambling venue to the next. According to a study carried out by CAMH, 30% of the people on these tours have moderate to severe problems. Dr. Mark van der Mass was lead author of the study. He states that the promotional deals “have negative effects on older people, who can be more vulnerable to harm because of shrinking social networks and decreased financial resources.”
Dr. Nigel Turner, who co-authored the study, stated that “Problem gambling prevention information efforts should be directed towards this population,” and called for increased regulation of casino marketing and promotion. These developing patterns make evidence-based treatment for gambling addiction vital. Studies such as these also demonstrate the need for treatment focused specifically around gambling disorder and its underlying causes.
Remaining Stigma Around Gambling Addiction
Despite our improved understanding of gambling addiction, and its increased prevalence in society, there remains a stigma around the issue. Flora Matheson, a scientist at the Centre for Urban Health Solutions at St. Michael’s Hospital, even goes so far as to say there is “even more stigma related to problem gambling than there is substance use.” This adds further difficulty for people struggling with gambling addiction in communicating with loved ones or seeking professional help. Dr. Hodgins estimates that “shame and denial mean only one in ten problem gamblers actually seek treatment.” This makes it essential for problem gamblers to find professional help that treats them with compassion and understanding of their condition.
The American Psychiatric Association’s recent decision to move pathological gambling to the addictions chapter in the latest edition of the DSM is a significant progression. It is a recognition of the severity and legitimacy of the issue. The decision, which followed fifteen years of deliberation, reflects a new understanding of the biology underlying addiction. It has already changed the way psychiatrists help people who cannot stop gambling. Gambling addiction is not a failure of will but rather a brain disorder that the gambling industry preys upon.
Gambling Addiction Treatment
There is substantial proof of the efficacy of certain treatments for gambling addiction. Cognitive Behavioural Therapy is one of the most common methods, with many studies confirming its impact. This treatment teaches people to resist unwanted thoughts and habits. Gambling addicts can learn to confront and resist unhealthy impulses and irrational thought patterns. Overestimating probabilities of winning, illusions of control over the outcome of a gamble, the belief that a win is due after a series of losses (the gambler’s fallacy), and memory biases in favour of remembering wins. Once these beliefs have been confronted and methods for dealing with them have been established, resisting the impulse to gamble becomes far more manageable for an addict. Trafalgar Addiction Treatment Centres offers expert cognitive behavioural support, provided by experienced, dedicated professionals.
Options for Gambling Addiction Treatment
Medical options are also now available for people struggling with gambling addiction. As Project Know note, “now that gambling is recognized as actually changing the brain’s chemistry, treatment options have broadened to include medication-assisted therapy that addresses these changes.” Individual therapy and group counselling remain highly effective methods of treating gambling addiction. They allow the person to receive expert support in confronting the underlying issues related to their addiction. They help them to identify methods for coping with them. Group counselling allows gambling addicts to work through their problems with people who understand their struggles and can relate.
Effective, Evidence-Based Gambling Addiction Treatment
With these developments in mind, anyone struggling with gambling addiction should be reassured that their condition is legitimate and common. They should also know that there is help available for them. Organizations such as Trafalgar Addiction Treatment Centres can provide the sort of evidence-based, client-centred treatment that will ensure a strong foundation for recovery from gambling addiction. Committing to treatment is the first step towards recovery.
