What is Gambling Addiction?
Gambling Addiction is a widespread problem in the United States, with 2.5 million people falling under the category of pathological gambler, and another three million being considered problem gamblers. It is estimated that up to 15 million adults are at risk for developing a gambling problem.
Gambling can be defined as taking part in an activity or game that offers the chance for bets. Gambling takes place in various forms such as horse and dog tracks, off-track-betting parlors, lotteries, casinos, card rooms, bingo and the stock market. It is also important to note that not all gambling is pathological. Many individuals participate in recreational gambling without it becoming a problem.
Pathological gambling is a progressive disease that affects gamblers and their family and friends. It can cripple the gambling addict’s professional and social life. In 1980, the American Psychiatric Association accepted pathological gambling as Impulse Control Disorder. An Impulse control disorder is a set of psychiatric disorders which also include intermittent explosive disorder, kleptomania, fire starting, compulsive hair pulling and compulsive skin picking. Impulsivity is the main feature of these disorders. The behavior pattern is seeking instant gratification at the expense of a long term negative consequences. Impulse control disorders are grouped in the obsessive-compulsive disorder category of behavioral addictions.
The addictive qualities of gambling can be understood from both a behavioral and neurological perspective. Gambling is a form of “operant conditioning learning” in which a voluntary action becomes linked with a specific outcome. The random reinforcement provided by gambling is actually the strongest form of conditioning, well ahead of a consistent reward. When a payoff is not expected every time the conditioned behavior is much more resistant to erasure than when a payoff is always expected. Losses or no-returns are still consistent with the action-reward relationship.
On a neurological level gambling effects the same neural pathways as addictive drugs. The primary neurotransmitter in addiction is Dopamine. Dopamine is sometimes described as the brain’s reward mechanism; with the amount of dopamine released being directly related to how positive an experience is perceived.
While gambling does not involve the unnaturally elevated levels of dopamine that drug abuse does, it is still able to result in dopamine levels which represent a much more rewarding experience than the gambler actually experiences because both payouts and near-wins result in a release of Dopamine. In a real-world environment a near-payoff usually represents a situation where trying a second time is likely to result in success due to increased experience, and often a situation where a second attempt requires smaller investment because the tools and/or plans have already been made. With gambling, however, the odds of winning do not increase with successive attempts, and the resources needed for each attempt do not decrease, turning normally-beneficial perseverance into a harmful trait.
Much like drug and alcohol addiction, gambling addiction is both chronic and progressive, but it can also be treated once diagnosed. Cognitive behavioral therapy with medication for anxiety or depression is common. There are also 12 step support groups like Gamblers Anonymous. Pathological gamblers typically are at risk to also use tobacco, alcohol, and other drugs more often than their non-gambling addicted counterparts. Many are also treated for co-occurring disorders or addictions.
Compulsive gambling causes negative consequences in many areas of an individual’s life including the psychological, physical, social and work aspects. Addictive gambling can be quite tricky to spot since there are usually no readily apparent symptoms as there are with drug and alcohol addiction. Since gambling doesn’t impair an individual’s ability to drive or function coherently it may be hard to tell when they are “under the influence” of the disease. Compulsive gambling is usually well concealed by the gambler until finances are out of control. While on the surface it may appear that addiction to gambling is solely for pleasure-seeking, the roots of this addition can also be traced to an attempt to suppress or avoid emotional pain.
Pathological gambling can be categorized into two types: action gambling and escape gambling.
- Action gambling: is the term used when the problem gambler is addicted to the thrill of the risk of gambling. The action itself becomes the drug which the brain wires to need more of to achieve the feeling. Action gambling takes place with other players so the addicted person can become a “winner.” This form of gambling is less isolating than “escape gambling.” More men tend to fall into this category.
- Escape gambling: is the term used when the problem gambler seeks to erase upseting or painful feelings. The act of gambling is secondary to the numbing effect desired. Escape gamblers prefer to gamble alone like at a slot machine or on internet gambling websites, where they can avoid other people. Women tend to become “escape gamblers.”
The American Psychological Association reports ten diagnostic criteria, for determining the extent of gambling addiction. These criteria from the DSM -IV are:
- Preoccupation – Preoccupied with gambling (e.g., preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money to gamble)
- Tolerance – Needs to gamble with increasing amounts of money in order to achieve the desired excitement
- Withdrawal – Is restless or irritable when attempting to cut down or stop gambling
- Escape – Gambles as a way of escaping from problems or relieving dysphoria (e.g., feelings of helplessness, guilt, anxiety or depression)
- Chasing – After losing money gambling, often returns another day in order to get even (“chasing one’s losses”). Chasing is a classical behavior pattern characterizing pathological gambling.
- Lying – Lies to family members, therapists or others to conceal the extent of involvement with gambling
- Illegal acts – Has committed illegal acts (e.g., forgery, fraud, theft or embezzlement) in order to finance gambling
- Risked significant relationship – Has jeopardized or lost a significant relationship, job or educational or career opportunity because of gambling
- Bailout – Has relied on others to provide money to relieve a desperate financial situation caused by gambling
- Loss of control – Has made repeated unsuccessful efforts to control, cut back or stop gambling
- Five or more of these signs = pathological gambler
- Three or four = problem gambler
- One or two = “at risk” gambler