Gambling and substance abuse are two distinct disorders, but they share several similarities, including their addictive nature, risk-taking behaviors, and negative consequences on mental and physical health. Research indicates that there is a strong link between gambling and substance abuse. People with a gambling disorder are more likely to develop issues with substance abuse, and people with substance abuse issues are more likely to develop a gambling disorder. Gambling disorder is an addiction where someone feels like they have to gamble all the time. This addiction can cause problems in their life such as money troubles, issues with their relationships, and mental health problems like depression and anxiety. It’s also known as compulsive or pathological gambling. Substance abuse disorder is a long-lasting problem where someone can’t stop using drugs, even when it hurts their life, health, and relationships. They keep seeking drugs even though it’s causing them problems. People with substance abuse disorders can develop a physical dependence on the drug, leading to withdrawal symptoms if they try to quit.
What is a Co-Occurring Disorder?When an individual is diagnosed with more than one disorder, it is referred to as aco-occurring disorder. For instance, a person may have a gambling disorder and also experience mental health disorders such as depression or anxiety. Research suggests that individuals with an addictive disorder are more susceptible to developing additional disorders. According to a study, alcohol use disorder is the most commonly reported co-occurring disorder among individuals with a gambling disorder. The study found that 75% of individuals diagnosed with a gambling disorder also had a co-occurring alcohol use disorder, and almost 40% had a co-occurring drug use disorder.
Signs of a ProblemIdentifying the signs of a gambling or substance abuse problem is crucial in seeking help and treatment. Here are some common signs to look out for:
- Increasing obsession with Gambling or Drug use
- Needing to Gamble or use Drugs more frequently to achieve the same effect.
- Experiencing withdrawal symptoms when not gambling or using drugs.
- Neglecting responsibilities such as work, school, or family obligations.
- Lying about Gambling or Drug use.
- Continuing to Gamble or use Drugs despite negative consequences such as financial difficulties, relationship problems, or legal issues.
- Losing interest in activities that were once enjoyable.
- Becoming defensive or irritable when questioned about Gambling or Drug use.
- Borrowing money or stealing to fund Gambling or Drug use.
- Experiencing mood swings or changes in behavior.
What Is Gambling Addiction?Pathological or compulsive gambling also referred to as gambling addiction, is a disorder where an individual has an irresistible urge to gamble despite harmful outcomes. This disorder relates to a lack of control over gambling impulses. Individuals with gambling addiction often experience a preoccupation with gambling, need to gamble more frequently to achieve the same level of excitement, and experience withdrawal symptoms when not gambling. They may neglect responsibilities such as work or family obligations, lie about their gambling habits, and continue to gamble despite financial troubles or other negative consequences.
The Thrill of Gambling can be a Much Bigger Problem When Substance Abuse is PresentIdentifying which disorder came first, the substance use disorder or the gambling disorder can be challenging. Alcohol is commonly available in most casinos, often offered for free while gambling. This is because alcohol consumption can lower inhibitions, leading to increased risk-taking and spending more money. Additionally, alcohol consumption can increase confidence and impair judgment, making it more challenging to assess the risks associated with gambling. The combination of gambling and substance abusecan create a dangerous cycle of addiction and negative consequences. Substance abuse can intensify the experience of gambling leading to an increase in the likelihood of taking risks and losing control. Additionally, substance abuse can make the negative impacts of problem gambling even worse. For example, it can worsen financial struggles, cause problems in relationships, and lead to legal troubles.
Diagnostic CriteriaThe Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) provides diagnostic criteria for gambling disorders, which include, Persistent and recurrent problematic gambling behavior leading to significant impairment or distress, as indicated by at least four of the following in a 12-month period:
- Needing to gamble more money to feel the same level of excitement.
- Trying unsuccessfully to control or stop gambling.
- Feeling restless or irritable when attempting to cut down or stop gambling.
- Using gambling as a way to escape from negative emotions.
- Trying to win back lost money by returning to gambling (chasing losses).
- Lying to hide the extent of gambling.
- Putting important relationships and opportunities at risk due to gambling.
- Asking others for money to cope with financial problems caused by gambling.
Effects of Drug Abuse on Compulsive GamblingDrug abuse can worsen compulsive gambling by increasing risk-taking behavior and impairing judgment, leading to poor choices and significant financial problems. Substance abuse can worsen the negative effects of problem gambling, such as causing problems in relationships, legal troubles, and mental health issues. When drug abuse and compulsive gambling are combined, the resulting addiction can be more severe due to a dangerous cycle where each disorder reinforces the other. As a result, breaking free from either behavior can be more challenging in such cases.
Environmental FactorsEnvironmental factors can play a significant role in the development of both gambling and substance abuse disorders. Some of the environmental factors that can contribute to these disorders include:
- Availability of Drugs or Gambling Opportunities: The easy availability of drugs and gambling opportunities can heighten the risk of developing an addiction. As the more accessible they are, the more likely people are to engage in such activities.
- Social influences: Being around people who have a history of addiction or experiencing peer pressure can increase the likelihood of developing gambling and substance addictions.
- Trauma: Traumatic experiences such as abuse, neglect, or other significant life events can increase the risk of developing a substance abuse or gambling disorder.
- Mental health disorders: People with mental health disorders like depression or anxiety may be at a higher risk of developing gambling or substance addictions.
- Stress: Experiencing stressful life events like financial issues or relationship problems can heighten the likelihood of developing gambling or substance addictions.
Risk Factors You Can’t ChangeWhile there are certain risk factors for addiction, gambling, and substance abuse that can be influenced by environmental or personal factors. There are also some factors that are outside of an individual’s control. Here are four risk factors that cannot be changed:
- Genetics: A family history of gambling or substance abuse disorders can increase the risk of developing these disorders due to their genetic component.
- Age: Young adults and adolescents are more susceptible to gambling and substance abuse disorders than older adults due to brain development and social factors.
- Gender: Although the gap is closing, men are still more prone to developing gambling and substance abuse disorders than women.
- Mental health disorders: People with mental health disorders like depression, anxiety, or PTSD are more vulnerable to developing gambling and alcohol addictions as they may use these as a coping mechanism to self-medicate.
Gambling Disorder and Psychiatric DisordersGambling disorder (GD) is often co-occurring with other psychiatric disorders, such as substance use disorders, mood disorders, anxiety disorders, and personality disorders. Studies have shown that up to 70% of people with GD have at least one co-occurring psychiatric disorder. According to the American psychiatric association Mood disorders, such as depression and bipolar disorder, are the most common co-occurring disorders among people with GD. Anxiety disorders, including generalized anxiety disorder and social anxiety disorder, are also frequently seen in individuals with GD that severely affects their personal life. Personality disorders, particularly antisocial personality disorder, have been found to be more prevalent among individuals with GD compared to the general population. Additionally, substance use disorders, particularly alcohol use disorder, are often co-occurring with GD.
What Treatment Options Are Available?Several treatment options are available for individuals who have a gambling addiction and a substance abuse history. The most appropriate approach will depend on the individual’s specific needs and circumstances. A common treatment option includes cognitive behavioral therapy. CBT helps change negative thoughts and behaviors, and medications such as antidepressants treat co-occurring mental health disorders. Moreover, support groups like Gamblers Anonymous and residential treatment for severe cases involve a structured program with therapy and support groups.
Medication for Addiction Treatment (MAT)Medication-Assisted Treatment (MAT) can be an effective treatment program for individuals struggling with both a gambling addiction and addictive substance disorders. While there are currently no medications specifically approved for the treatment of gambling addiction, medications used to treat other addictions or mental health disorders may be helpful. For example:
- Naltrexone: Naltrexone is a medication that helps people with alcohol and opioid addiction by blocking the effects of opioids in the brain. This reduces the pleasurable effects of addictive behaviors such as gambling.
- Antidepressants: Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), may be prescribed to treat co-occurring depression or anxiety disorders.
- Mood stabilizers: Mood stabilizers, such as lithium or valproic acid, may be used to treat co-occurring bipolar disorder, which is commonly associated with gambling addiction.
12-Step Recovery ProgramThe 12-Step recovery program is a widely used approach to treating addiction that involves a structured program of group meetings, personal reflection, and spiritual principles. This program has been adapted for use in treating substance abuse and gambling addiction. The program emphasizes personal responsibility, admitting powerlessness over addiction, seeking support from a higher power and a community of peers. It involves attending meetings regularly, working through the 12 steps with a sponsor or mentor, and making a commitment to abstaining from addictive behaviors. In the context of gambling addiction and co-occurring substance abuse disorders. The 12-Step program can provide individuals with a supportive community of peers who understand their struggles and can provide guidance and encouragement. It also offers a framework for personal growth and spiritual development, which can be an important part of the recovery process.
Cognitive Behavioral Therapy (CBT)Cognitive Behavioral Therapy (CBT) is a type of therapy that is commonly used to treat gambling addiction and substance addiction. CBT is based on the idea that negative thoughts and behaviors can contribute to addiction, and that by changing these patterns, individuals can overcome their substance addiction. CBT helps individuals with gambling addiction and substance abuse identify triggers, negative thought patterns, and behaviors that reinforce addiction. CBT can also help individuals develop coping skills and strategies to resist the urge to gamble or alcohol abuse. CBT is conducted one-on-one or in groups with a therapist to identify negative patterns and behaviors. Moreover, develop strategies to replace them with positive ones. Several sessions are typically involved in treatment.
The Role of Support Groups in RecoverySupport groups can play a crucial role in the recovery process for individuals struggling with co-occurring gambling and substance use disorders. These groups offer a safe and supportive environment for individuals to share their experiences, receive encouragement and guidance from others who have gone through similar struggles. This helps them gain a sense of community. One of the most well-known support groups for individuals with gambling addiction is Gamblers Anonymous (GA). GA is a 12-step program modeled after Alcoholics Anonymous (AA), and it encourages individuals to take responsibility for their gambling behavior and seek help from a higher power or other individuals who have gone through similar experiences. For individuals with co-occurring substance use and gambling disorders, support groups such as Dual Recovery Anonymous (DRA) may be helpful. DRA is a 12-step program specifically designed for individuals with both substance use and mental health disorders, including gambling addiction. The program stresses the importance of treating both disorders simultaneously to achieve lasting recovery. Other support groups, such as SMART Recovery, offer a non-12-step approach that focuses on self-empowerment and self-reliance. This program uses evidence-based techniques such as cognitive-behavioral therapy and motivational interviewing to help individuals change their problematic behaviors and develop coping skills.
3 Ways to Deal With Your TriggersTriggers are situations or events that can lead to a relapse in gambling and substance abuse. Here are three ways to deal with triggers:
- Avoid Triggers: The best way to deal with triggers is to avoid them altogether. For example, if being around certain people or places triggers the urge to gamble or use substances, it is best to stay away from them. Identifying and avoiding triggers is a key part of relapse prevention.
- Develop Coping Strategies: It is important to develop healthy coping strategies to deal with triggers when they arise. This can include deep breathing, mindfulness meditation, exercise, or engaging in a favorite hobby or activity. Developing healthy coping mechanisms can help individuals manage their triggers without turning to gambling or substance use.
- Seek Support: It can be helpful to seek support from a therapist, support group, a trusted friend, or a family member when dealing with triggers. These individuals can provide encouragement, guidance, and accountability to help individuals stay on track with their recovery.