Compulsive gambling
Encyclopedia
Problem gambling is an urge to continuously gamble despite harmful negative consequences or a desire to stop. Problem gambling often is defined by whether harm is experienced by the gambler or others, rather than by the gambler's behavior. Severe problem gambling may be diagnosed as clinical pathological gambling if the gambler meets certain criteria. Although the term gambling addiction is common in the recovery movement pathological gambling is considered to be an impulse control disorder
and is therefore not considered by the American Psychological Association
to be an addiction
.
led to a universal definition for that country which appears to be the only research based definition not to use diagnostic criteria.
Most other definitions of problem gambling can usually be simplified to any gambling that causes harm to the gambler or someone else in any way. However, these definitions are usually coupled with descriptions of the type of harm or the use of diagnostic criteria.
According to DSM-IV
, Pathological gambling is now defined as separate from a manic episode. Only when the gambling occurs independent of other impulsive, mood, or thought disorders is it considered its own diagnosis. In order to be diagnosed, an individual must have at least five of the following symptoms:
As with many disorders, the DSM-IV definition of pathological gambling is widely accepted and used as a basis for research and clinical practice internationally.
Institute for Addiction Recovery, recent evidence indicates that pathological gambling is an addiction similar to chemical addiction. It has been seen that some pathological gamblers have lower levels of norepinephrine
than normal gamblers.
According to a logical study conducted by Alec Roy, M.D. formerly at the National Institute on Alcohol Abuse and Alcoholism
, norepinephrine is secreted under stress, arousal, or thrill, so pathological gamblers gamble to make up for their under-dosage.
Further to this, according to a report from the Harvard Medical School
Division on Addictions there was an experiment constructed where test subjects were presented with situations where they could win, lose or break even in a casino
-like environment. Subjects' reactions were measured using fMRI, a neuro-imaging technique very similar to MRI. And according to Hans Breiter, MD, co-director of the motivation and Emotion Neuroscience Centre at the Massachusetts General Hospital
, "Monetary reward in a gambling-like experiment produces brain activation very similar to that observed in a cocaine
addict receiving an infusion of cocaine."
Deficiencies in serotonin
might also contribute to compulsive behavior, including a gambling addictions.
, pyromania
, and trichotillomania
. Other mental diseases that also exhibit impulse control disorder
include such mental disorders as antisocial personality disorder
, or schizophrenia
.
According to evidence from both community- and clinic-based studies, individuals who have pathological gambling are highly likely to exhibit other psychiatric problems at the same time, including substance use disorders
, mood
and anxiety disorder
s, or personality disorder
s.
As debts build up people turn to other sources of money such as theft
, or the sale of drugs
. A lot of this pressure comes from bookies or loan shark
s that people rely on for capital to gamble with.
In a 1995 survey of 184 Gamblers Anonymous members in Illinois, Illinois State Professor Henry Lesieur found that 56 percent admitted to some illegal act to obtain money to gamble. Fifty-eight percent admitted they wrote bad checks, while 44 percent said they stole or embezzled money from their employer.
Compulsive gambling is often very detrimental to personal relationships. In a 1991 study of relationships of American men, it was found that 10% of compulsive gamblers had been married more than twice. Only 2% of men who did not gamble were married more than twice.
Abuse
is also common in homes where pathological gambling is present. Growing up in such a situation leads to improper emotion
al development
and increased risk of falling prey to problem gambling behavior.
. Problem gambling is often associated with increased suicidal ideation
and attempts compared to the general population.
Early onset of problem gambling increases the lifetime risk of suicide. However, gambling-related suicide attempts are usually made by older people with problem gambling. Both comorbid substance use and comorbid mental disorders increase the risk of suicide in people with problem gambling.
A 2010 Australian hospital study found that 17% of suicidal patients admitted to the Alfred Hospital
's emergency department were problem gamblers.
Gambling Commission, the "British Gambling Prevalence Survey 2007", found that approximately 0.6% of the adult population had problem gambling issues, the same percentage as in 1999. The highest prevalence of problem gambling was found among those who participated in spread betting
(14.7%), fixed odds betting terminals (11.2%) and betting exchange
s (9.8%).
Available research seems to indicate that problem gambling is an internal tendency, and that problem gamblers will tend to risk money on whatever game is available, rather than a particular game being available inducing problem gambling in otherwise "normal" individuals. However, research also indicates that problem gamblers tend to risk money on fast-paced games. Thus a problem gambler is much more likely to lose a lot of money on roulette
or slot machine
s, where rounds end quickly and there is a constant temptation
to play again or increase bets, as opposed to a state lottery
where the gambler must wait until the next drawing to see results.
Dopamine agonist
s, in particular pramipexole
(Mirapex), have been implicated in the development of compulsive gambling and other excessive behavior patterns (e.g., PMID 16009751).
The DSM-IV diagnostic criteria presented as a checklist is an alternative to SOGS, it focuses on the psychological motivations underpinning problem gambling and was developed by the American Psychiatric Association. It consists of ten diagnostic criteria. One screening measure based upon the DSM-IV criteria is the National Opinion Research Center DSM Screen for Gambling Problems (NODS). This measure is currently used frequently. The Canadian Problem Gambling Inventory (CPGI) is another newer assessment measure. The Problem Gambling Severity Index (PGSI) is composed of nine items from the longer CPGI. The PGSI focuses on the harms and consequences associated with problem gambling.
Gamblers Anonymous
(GA) is a commonly used treatment for gambling problems. Modeled after Alcoholics Anonymous
, GA uses a 12-step model
that emphasizes a mutual-support approach.
One form of counseling, cognitive behavioral therapy (CBT) has been shown to reduce symptoms and gambling-related urges. This type of therapy focuses on the identification of gambling-related thought processes, mood and cognitive distortions that increase one’s vulnerability to out-of-control gambling. Additionally, CBT approaches frequently utilize skill-building techniques geared toward relapse prevention, assertiveness and gambling refusal, problem solving and reinforcement of gambling-inconsistent activities and interests.
As to behavioral treatment, some recent research supports the use of both activity scheduling and desentization in the treatment of gambling problems In general behavior analytic research in this area is growing
There is evidence that the SSRI paroxetine
is efficient in the treatment of pathological gambling. Additionally, for patients suffering from both pathological gambling and a comorbid bipolar spectrum condition, sustained release lithium has shown efficacy in a preliminary trial. The opiate antagonist drug nalmefene
has also been trialled quite successfully for the treatment of compulsive gambling.
Other step-based programs are specific to gambling and generic to healing addiction, creating financial health, and improving mental wellness. Commercial alternatives, designed for clinical intervention using the best of health science and applied education practices have been used as patient centered tools for intervention since 2007. They include measured efficacy and resulting recovery metrics.
Impulse control disorder
Impulse control disorder is a set of psychiatric disorders including intermittent explosive disorder, kleptomania, pathological gambling, pyromania , and three body-focused repetitive or compulsive behaviors of trichotillomania , onychophagia and dermatillomania...
and is therefore not considered by the American Psychological Association
American Psychological Association
The American Psychological Association is the largest scientific and professional organization of psychologists in the United States. It is the world's largest association of psychologists with around 154,000 members including scientists, educators, clinicians, consultants and students. The APA...
to be an addiction
Addiction
Historically, addiction has been defined as physical and psychological dependence on psychoactive substances which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain.Addiction can also be viewed as a continued involvement with a substance or activity...
.
Definition
Research by governments in AustraliaAustralia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
led to a universal definition for that country which appears to be the only research based definition not to use diagnostic criteria.
- Problem gambling is characterized by many difficulties in limiting money and/or time spent on gambling which leads to adverse consequences for the gambler, others, or for the community.
Most other definitions of problem gambling can usually be simplified to any gambling that causes harm to the gambler or someone else in any way. However, these definitions are usually coupled with descriptions of the type of harm or the use of diagnostic criteria.
According to DSM-IV
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
, Pathological gambling is now defined as separate from a manic episode. Only when the gambling occurs independent of other impulsive, mood, or thought disorders is it considered its own diagnosis. In order to be diagnosed, an individual must have at least five of the following symptoms:
- Preoccupation. The subject has frequent thoughts about gambling experiences, whether past, future, or fantasy.
- Tolerance. As with drug tolerance, the subject requires larger or more frequent wagers to experience the same "rush".
- Withdrawal. Restlessness or irritability associated with attempts to cease or reduce gambling.
- Escape. The subject gambles to improve mood or escape problems.
- Chasing. The subject tries to win back gambling losses with more gambling.
- Lying. The subject tries to hide the extent of his or her gambling by lying to family, friends, or therapists.
- Loss of control. The person has unsuccessfully attempted to reduce gambling.
- Illegal acts. The person has broken the law in order to obtain gambling money or recover gambling losses. This may include acts of theftTheftIn common usage, theft is the illegal taking of another person's property without that person's permission or consent. The word is also used as an informal shorthand term for some crimes against property, such as burglary, embezzlement, larceny, looting, robbery, shoplifting and fraud...
, embezzlementEmbezzlementEmbezzlement is the act of dishonestly appropriating or secreting assets by one or more individuals to whom such assets have been entrusted....
, fraudFraudIn criminal law, a fraud is an intentional deception made for personal gain or to damage another individual; the related adjective is fraudulent. The specific legal definition varies by legal jurisdiction. Fraud is a crime, and also a civil law violation...
, or forgeryForgeryForgery is the process of making, adapting, or imitating objects, statistics, or documents with the intent to deceive. Copies, studio replicas, and reproductions are not considered forgeries, though they may later become forgeries through knowing and willful misrepresentations. Forging money or...
. - Risked significant relationship. The person gambles despite risking or losing a relationshipInterpersonal relationshipAn interpersonal relationship is an association between two or more people that may range from fleeting to enduring. This association may be based on limerence, love, solidarity, regular business interactions, or some other type of social commitment. Interpersonal relationships are formed in the...
, job, or other significant opportunity. - Bailout. The person turns to family, friends, or another third party for financial assistance as a result of gambling.
As with many disorders, the DSM-IV definition of pathological gambling is widely accepted and used as a basis for research and clinical practice internationally.
Biological basis
According to the IllinoisIllinois
Illinois is the fifth-most populous state of the United States of America, and is often noted for being a microcosm of the entire country. With Chicago in the northeast, small industrial cities and great agricultural productivity in central and northern Illinois, and natural resources like coal,...
Institute for Addiction Recovery, recent evidence indicates that pathological gambling is an addiction similar to chemical addiction. It has been seen that some pathological gamblers have lower levels of norepinephrine
Norepinephrine
Norepinephrine is the US name for noradrenaline , a catecholamine with multiple roles including as a hormone and a neurotransmitter...
than normal gamblers.
According to a logical study conducted by Alec Roy, M.D. formerly at the National Institute on Alcohol Abuse and Alcoholism
National Institute on Alcohol Abuse and Alcoholism
The National Institute on Alcohol Abuse and Alcoholism , as part of the U.S. National Institutes of Health, supports and conducts biomedical and behavioral research on the causes, consequences, treatment, and prevention of alcoholism and alcohol-related problems...
, norepinephrine is secreted under stress, arousal, or thrill, so pathological gamblers gamble to make up for their under-dosage.
Further to this, according to a report from the Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....
Division on Addictions there was an experiment constructed where test subjects were presented with situations where they could win, lose or break even in a casino
Casino
In modern English, a casino is a facility which houses and accommodates certain types of gambling activities. Casinos are most commonly built near or combined with hotels, restaurants, retail shopping, cruise ships or other tourist attractions...
-like environment. Subjects' reactions were measured using fMRI, a neuro-imaging technique very similar to MRI. And according to Hans Breiter, MD, co-director of the motivation and Emotion Neuroscience Centre at the Massachusetts General Hospital
Massachusetts General Hospital
Massachusetts General Hospital is a teaching hospital and biomedical research facility in the West End neighborhood of Boston, Massachusetts...
, "Monetary reward in a gambling-like experiment produces brain activation very similar to that observed in a cocaine
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...
addict receiving an infusion of cocaine."
Deficiencies in serotonin
Serotonin
Serotonin or 5-hydroxytryptamine is a monoamine neurotransmitter. Biochemically derived from tryptophan, serotonin is primarily found in the gastrointestinal tract, platelets, and in the central nervous system of animals including humans...
might also contribute to compulsive behavior, including a gambling addictions.
Relation to other problems
Pathological gambling is similar to many other impulse control disorders such as kleptomaniaKleptomania
Kleptomania is an irresistible urge to steal items of trivial value. People with this disorder are compelled to steal things, generally, but not limited to, objects of little or no significant value, such as pens, paper clips, paper and tape...
, pyromania
Pyromania
Pyromania in more extreme circumstances can be an impulse control disorder to deliberately start fires to relieve tension or for gratification or relief. The term pyromania comes from the Greek word πῦρ . Pyromania and pyromaniacs are distinct from arson, the pursuit of personal, monetary or...
, and trichotillomania
Trichotillomania
Trichotillomania, which is classified as an impulse control disorder by DSM-IV, is the compulsive urge to pull out one's own hair leading to noticeable hair loss, distress, and social or functional impairment. It is often chronic and difficult to treat....
. Other mental diseases that also exhibit impulse control disorder
Impulse control disorder
Impulse control disorder is a set of psychiatric disorders including intermittent explosive disorder, kleptomania, pathological gambling, pyromania , and three body-focused repetitive or compulsive behaviors of trichotillomania , onychophagia and dermatillomania...
include such mental disorders as antisocial personality disorder
Antisocial personality disorder
Antisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...
, or schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
.
According to evidence from both community- and clinic-based studies, individuals who have pathological gambling are highly likely to exhibit other psychiatric problems at the same time, including substance use disorders
Substance abuse
A substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...
, mood
Mood disorder
Mood disorder is the term designating a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature...
and anxiety disorder
Anxiety disorder
Anxiety disorder is a blanket term covering several different forms of abnormal and pathological fear and anxiety. Conditions now considered anxiety disorders only came under the aegis of psychiatry at the end of the 19th century. Gelder, Mayou & Geddes explains that anxiety disorders are...
s, or personality disorder
Personality disorder
Personality disorders, formerly referred to as character disorders, are a class of personality types and behaviors. Personality disorders are noted on Axis II of the Diagnostic and Statistical Manual of Mental Disorders or DSM-IV-TR of the American Psychiatric Association.Personality disorders are...
s.
As debts build up people turn to other sources of money such as theft
Theft
In common usage, theft is the illegal taking of another person's property without that person's permission or consent. The word is also used as an informal shorthand term for some crimes against property, such as burglary, embezzlement, larceny, looting, robbery, shoplifting and fraud...
, or the sale of drugs
DRUGS
Destroy Rebuild Until God Shows are an American post-hardcore band formed in 2010. They released their debut self-titled album on February 22, 2011.- Formation :...
. A lot of this pressure comes from bookies or loan shark
Loan shark
A loan shark is a person or body that offers unsecured loans at illegally high interest rates to individuals, often enforcing repayment by blackmail or threats of violence....
s that people rely on for capital to gamble with.
In a 1995 survey of 184 Gamblers Anonymous members in Illinois, Illinois State Professor Henry Lesieur found that 56 percent admitted to some illegal act to obtain money to gamble. Fifty-eight percent admitted they wrote bad checks, while 44 percent said they stole or embezzled money from their employer.
Compulsive gambling is often very detrimental to personal relationships. In a 1991 study of relationships of American men, it was found that 10% of compulsive gamblers had been married more than twice. Only 2% of men who did not gamble were married more than twice.
Abuse
Child abuse
Child abuse is the physical, sexual, emotional mistreatment, or neglect of a child. In the United States, the Centers for Disease Control and Prevention and the Department of Children And Families define child maltreatment as any act or series of acts of commission or omission by a parent or...
is also common in homes where pathological gambling is present. Growing up in such a situation leads to improper emotion
Emotion
Emotion is a complex psychophysiological experience of an individual's state of mind as interacting with biochemical and environmental influences. In humans, emotion fundamentally involves "physiological arousal, expressive behaviors, and conscious experience." Emotion is associated with mood,...
al development
Child development
Child development stages describe theoretical milestones of child development. Many stage models of development have been proposed, used as working concepts and in some cases asserted as nativist theories....
and increased risk of falling prey to problem gambling behavior.
Suicide rate
A gambler who does not receive treatment for pathological gambling when in his or her desperation phase may contemplate suicideSuicide
Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...
. Problem gambling is often associated with increased suicidal ideation
Suicidal ideation
Suicidal ideation is a common medical term for thoughts about suicide, which may be as detailed as a formulated plan, without the suicidal act itself. Although most people who undergo suicidal ideation do not commit suicide, some go on to make suicide attempts...
and attempts compared to the general population.
Early onset of problem gambling increases the lifetime risk of suicide. However, gambling-related suicide attempts are usually made by older people with problem gambling. Both comorbid substance use and comorbid mental disorders increase the risk of suicide in people with problem gambling.
A 2010 Australian hospital study found that 17% of suicidal patients admitted to the Alfred Hospital
The Alfred Hospital
The Alfred, also known as Alfred Hospital or The Alfred Hospital, is a major hospital in Melbourne, Victoria. It is the second oldest hospital in Victoria, and the oldest Melbourne hospital still operating on its original site...
's emergency department were problem gamblers.
Prevalence
A study by the United KingdomUnited Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
Gambling Commission, the "British Gambling Prevalence Survey 2007", found that approximately 0.6% of the adult population had problem gambling issues, the same percentage as in 1999. The highest prevalence of problem gambling was found among those who participated in spread betting
Spread betting
Spread betting is any of various types of wagering on the outcome of an event, where the pay-off is based on the accuracy of the wager, rather than a simple "win or lose" outcome, such as fixed-odds betting or parimutuel betting. A spread is a range of outcomes and the bet is whether the outcome...
(14.7%), fixed odds betting terminals (11.2%) and betting exchange
Betting exchange
A betting exchange is an entity which provides "trading" facilities for retail or bookmaker customers to buy and sell contracts. Contracts are structured as binary options. Some betting exchanges may also offer CFD products...
s (9.8%).
Available research seems to indicate that problem gambling is an internal tendency, and that problem gamblers will tend to risk money on whatever game is available, rather than a particular game being available inducing problem gambling in otherwise "normal" individuals. However, research also indicates that problem gamblers tend to risk money on fast-paced games. Thus a problem gambler is much more likely to lose a lot of money on roulette
Roulette
Roulette is a casino game named after a French diminutive for little wheel. In the game, players may choose to place bets on either a single number or a range of numbers, the colors red or black, or whether the number is odd or even....
or slot machine
Slot machine
A slot machine , informally fruit machine , the slots , poker machine or "pokies" or simply slot is a casino gambling machine with three or more reels which spin when a button is pushed...
s, where rounds end quickly and there is a constant temptation
Temptation
A temptation is an act that looks appealing to an individual. It is usually used to describe acts with negative connotations and as such, tends to lead a person to regret such actions, for various reasons: legal, social, psychological , health, economic, etc...
to play again or increase bets, as opposed to a state lottery
Lottery
A lottery is a form of gambling which involves the drawing of lots for a prize.Lottery is outlawed by some governments, while others endorse it to the extent of organizing a national or state lottery. It is common to find some degree of regulation of lottery by governments...
where the gambler must wait until the next drawing to see results.
Dopamine agonist
Dopamine agonist
A dopamine agonist is a compound that activates dopamine receptors in the absence of dopamine. Dopamine agonists activate signaling pathways through the dopamine receptor and trimeric G-proteins, ultimately leading to changes in gene transcription.-Uses:...
s, in particular pramipexole
Pramipexole
Pramipexole is a non-ergoline dopamine agonist indicated for treating early-stage Parkinson's disease and restless legs syndrome...
(Mirapex), have been implicated in the development of compulsive gambling and other excessive behavior patterns (e.g., PMID 16009751).
Assessment
The most common instrument used to screen for "probable pathological gambling" behavior is the South Oaks Gambling Screen (SOGS) developed by Lesieur and Blume (1987) at the South Oaks Hospital in New York City. This screen is undoubtedly the most cited instrument in psychological research literature. In recent years the use of SOGS has declined due to a number of criticisms including that it over-estimates false positives.The DSM-IV diagnostic criteria presented as a checklist is an alternative to SOGS, it focuses on the psychological motivations underpinning problem gambling and was developed by the American Psychiatric Association. It consists of ten diagnostic criteria. One screening measure based upon the DSM-IV criteria is the National Opinion Research Center DSM Screen for Gambling Problems (NODS). This measure is currently used frequently. The Canadian Problem Gambling Inventory (CPGI) is another newer assessment measure. The Problem Gambling Severity Index (PGSI) is composed of nine items from the longer CPGI. The PGSI focuses on the harms and consequences associated with problem gambling.
Treatment
Most treatment for problem gambling involves counseling, step-based programs, self-help, peer-support, medication, or a combination of these. However, no one treatment is considered to be most efficacious and no medications have been approved for the treatment of pathological gambling by the US Food and Drug Administration (FDA).Gamblers Anonymous
Gamblers Anonymous
Gamblers Anonymous is a twelve-step program for problem gamblers. GA began in Los Angeles on September 13, 1957. As of 2005 there were over 1000 GA meetings in the United States and meetings established in the United Kingdom, Spain, New Zealand, Australia, Brazil, Israel, Kenya, Uganda, Korea and...
(GA) is a commonly used treatment for gambling problems. Modeled after Alcoholics Anonymous
Alcoholics Anonymous
Alcoholics Anonymous is an international mutual aid movement which says its "primary purpose is to stay sober and help other alcoholics achieve sobriety." Now claiming more than 2 million members, AA was founded in 1935 by Bill Wilson and Dr. Bob Smith in Akron, Ohio...
, GA uses a 12-step model
Twelve-step program
A Twelve-Step Program is a set of guiding principles outlining a course of action for recovery from addiction, compulsion, or other behavioral problems...
that emphasizes a mutual-support approach.
One form of counseling, cognitive behavioral therapy (CBT) has been shown to reduce symptoms and gambling-related urges. This type of therapy focuses on the identification of gambling-related thought processes, mood and cognitive distortions that increase one’s vulnerability to out-of-control gambling. Additionally, CBT approaches frequently utilize skill-building techniques geared toward relapse prevention, assertiveness and gambling refusal, problem solving and reinforcement of gambling-inconsistent activities and interests.
As to behavioral treatment, some recent research supports the use of both activity scheduling and desentization in the treatment of gambling problems In general behavior analytic research in this area is growing
There is evidence that the SSRI paroxetine
Paroxetine
Paroxetine is an SSRI antidepressant. Marketing of the drug began in 1992 by the pharmaceutical company SmithKline Beecham, now GlaxoSmithKline...
is efficient in the treatment of pathological gambling. Additionally, for patients suffering from both pathological gambling and a comorbid bipolar spectrum condition, sustained release lithium has shown efficacy in a preliminary trial. The opiate antagonist drug nalmefene
Nalmefene
Nalmefene is an opioid receptor antagonist developed in the early 1970s, and used primarily in the management of alcohol dependence, and also has been investigated for the treatment of other addictions such as pathological gambling and addiction to shopping.Nalmefene is an opiate derivative...
has also been trialled quite successfully for the treatment of compulsive gambling.
Voluntary exclusion
Some casinos and state lottery programs offer a Self/Voluntary Exclusion program. When a person signs up for one of these programs, they are effectively banned from the casino, and will be arrested upon entry; in the case of a state lottery program, they are not permitted to cash out winnings, thereby removing the positive incentive to gamble. Once a person signs up for a Self Exclusion program, the ban may or may not be permanent. However, it must be stated that the actual execution of the program is more difficult than it would appear in theory, because it involves security finding the people and then removing them. There have been lawsuits because people have still been able to gamble in a casino after signing up for the programs.Step-based programs
One step-based program for gambling issues is Gamblers Anonymous. Gamblers Anonymous uses a 12-step program adapted from Alcoholics Anonymous and also places an emphasis on peer support.Other step-based programs are specific to gambling and generic to healing addiction, creating financial health, and improving mental wellness. Commercial alternatives, designed for clinical intervention using the best of health science and applied education practices have been used as patient centered tools for intervention since 2007. They include measured efficacy and resulting recovery metrics.
Peer support
A growing method of treatment is peer support. With the advancement of online gambling, many gamblers experiencing issues use various online peer-support groups to aid their recovery. This protects their anonymity whilst allowing to attempt to self-recover often without having to disclose their issues to loved ones.See also
- Gambling CommissionGambling CommissionThe Gambling Commission is Great Britain's regulatory body for most, but not all, gambling.-History:It was established under the Gambling Act 2005 and assumed full powers in 2007, taking over responsibility from the Gaming Board for Great Britain, in regulating arcades, betting, bingo, casinos,...
(Great Britain) - Gaming lawGaming lawGaming law can be described as the set of rules and regulations that apply to the gaming or gambling industry. Gaming law is not a branch of law in the traditional sense but rather is a collection of several areas of law that include criminal law, regulatory law, constitutional law, administrative...
- National Council on Problem Gambling (Singapore)National Council on Problem Gambling (Singapore)The National Council on Problem Gambling was set up in Singapore on 31 August 2005 to address problem gambling, following the government's decision to legalise casino gambling and build two integrated resorts at Marina Bay and Sentosa....
- National Council on Problem Gambling (United States)National Council on Problem Gambling (United States)The National Council on Problem Gambling was founded in 1972 by Msgr. Joseph A. Dunne and Dr. Robert Custer, among others. From the outset the Council established two principles that it continues to espouse today: that the organization would be the advocate for problem gamblers and their families,...
- Problem Gambling Foundation of New ZealandProblem Gambling Foundation of New ZealandThe Problem Gambling Foundation of New Zealand is a national non-profit organisation in New Zealand predominantly funded by the Ministry of Health with funds received from the gambling levy....
- GamCareGamCareGamCare offers guidance and counselling towards their efforts of dealing with the social ramifications of gambling in the United Kingdom. GamCare, a charitable organization, was founded in April 1997. In October of that year, Adrian Scarfe, then Head of Clinical Services at GamCare, launched the...