Addressing a Gambling Problem
A Destructive Cycle
Legal gambling can be an enjoyable form of entertainment when people engage on a very limited basis. However, when trips to the casino become too frequent, debts and negative consequences build, and attempts to get gambling activity under control fail; it's a problem that needs to be addressed.
Several signs point to an obvious problem with gambling. Frequent gambling and mounting debts are two of the clearest signs you are heading toward, or dealing with an addiction. Other signs of a gambling addiction include salience, where gambling become the most important thing in life; the gambler plans all activities and finances around gambling. Chasing loses and increasing wagers in an attempt to win higher amounts to cover those loses is another indicator of a gambling addiction. People with a gambling addiction experience changes in mood, irritability, and even panic when they are unable to gamble. This in part is due the the shame, guilt, and constant need to return to gambling activity to make up for the losses and escape those feelings. Gambling addiction is a destructive cycle that progresses if not understood or addressed.
Diagnosing a Gambling Addiction
Studies have shown that pathological gambling usually goes unrecognized in clinical settings mainly because clinicians fail to screen for the behavior. However, diagnosing the problem is usually straightforward and can be done by asking patients if they feel they cannot control their gambling or if they are preoccupied with gambling. An affirmative answer can be followed up with questions determining the degree of impairment (whether it’s affecting patients’ social or family life, their financial well-being, or their work) and the distress that this behavior causes. It must also be determined that a patient’s gambling behavior is not simply a symptom of bipolar disorder. Simple self-reporting and clinician-administered screening and diagnostic measures for pathological gambling and bipolar disorder are available.
Barriers to Seeking Help
Denial of a gambling problem is a common barrier to addressing it for many dealing with a gambling addiction. Even when the addiction to gambling reaches the point of severe financial, personal, and social consequences, the gambler still feels they can stop on their own. Unfortunately, acknowledging the problem and accepting help, usually only happens when criminal activity, arrest, or a failed suicide attempt occurs. It is quite common in the later stages of the addiction for the gambler to commit theft, fraud, and other illegal offenses in order to continue gambling activity, often resulting in serious legal problems, arrests, and prison. Another common barrier to seeking help is accepting the addiction concept. Many people who have a gambling problem don't realize they may be dealing with an addiction. Misconceptions about gambling disorders still exist in society, so many in the troughs don't think about it being something that requires help or treatment. Loved ones also have difficulties in talking to the gambler in their lives about getting help because they too are caught in the emotional grips of the addiction, often directly impacted by the behavior and losses, and sometimes unaware that help is even available or needed. It is not uncommon for people close to a compulsive gambler to consider it a moral weakness and a behavior that can just stop without help if the gambler just puts their mind to it. Fallacies about gambling addiction often plague effective treatment and is common contributor to why people don't seek help.
Types of Gambling Addiction Recovery
There are four types of recovery that pertain to addiction.
Complete Abstinence - When the gambler abstains from all types and forms of gambling activity, to include all forms of bidding and betting where money is involved. Some gamblers who choose this type of recovery also choose not to bet in any capacity; even when money isn't involved. For example, I bet you a coffee the Patriots will win the Superbowl.
Primary Abstinence - When the gambler abstains from their primary gambling activity, but still may engage in other types and forms of gambling. It should be understood that someone who is addicted to sports betting, may not be addicted to playing BINGO, or someone addicted to casino gambling may not be addicted to lottery scratch off's. Most gamblers who have developed an addiction usually have just one or two forms of gambling that have become destructive and uncontrollable. There are many, many forms of gambling, and problem gamblers are not addicted to every form of gambling. Just as someone addicted to alcohol, may not be addicted to marijuana or other substances. With this, many gamblers are successful when choosing to abstain from their primary gambling activity, but can and do engage in other gambling activities with responsibility and without problems.
Harm Reduction - When the gambler chooses this type of recovery, they are choosing to reduce their gambling behavior and activity to what is considered a "sub-clinical" level. Where the activity is no longer causing problems or negative consequences, and no longer meets clinical criteria for addiction. This type of gambling addiction recovery has proven to be successful for many when counseling and support are involved. When a gambler is able to work through the underlying issues, and address the reasons why gambling became a problem in the first place, sometimes they are able to develop a different relationship with the activity, and are able to engage without abusing or misusing it. Same holds true for substances.
MAT - Medicated Assisted Recovery - This recovery type uses medication to assist in recovery. Currently there are no surgical procedures or medications that can directly treat gambling addiction as there are for substance use disorders, however research and trials have determined that some medications such as mood stabilizers and serotonin re-uptake inhibitors can prove effective in assisting a problem gambler with recovery.
Not all providers or programs of problem gambling services practice in, or are knowledgeable about the types of recovery. Many still only promote and practice in abstinence. Those in the grips of a gambling addiction need to understand the options and pathways to recover. Understanding there are choices makes it a little easier to take a step to addressing it. A rapidly growing service role that teaches and practices in all the types of recovery are credentialed peer providers and recovery coaches. Recovery peer coaches are those with a lived experience of gambling addiction and recovery and are trained to introduce, educate, and guide problems gamblers with a recovery type and pathway of their choice.
There are numerous pathways to addressing a gambling addiction and getting life back to manageable again. Depending on the stage or severity of the addiction often depends on what may be effective. Although there are many pathways to recover from addiction, some common pathways with gambling are treatment (in or out-patient), counseling, self-help groups, recovery, life, and spiritual coaching, peer services, and some people are able to just quit on their own. Actual treatment for gambling addiction is typically based on counseling and behavior modification therapy. Although gambling for someone who has developed an addiction produces similar reactions in the brain as alcohol does for an alcoholic, and drugs do for a drug addict, there is no medication or surgical procedure that can stop in and of itself addiction to gambling. It is not uncommon for addicted gamblers to also have problems and other addictions with drugs or alcohol. For many, substance abuse and gambling addiction go hand in hand.
If multiple addictions are co-occurring, or if the gambling addiction has reached a severe state, residential or in-patient treatment is usually the best option. If a gambling addiction co-occurs with a substance addiction, it may require detoxification of the substance before the gambling addiction can even be addressed, this can be complex. If a person seeks this level of treatment an evaluation is conducted to determine if substance abuse issues need to be addressed prior to, or along side the gambling problem.
Depending on the severity of the addiction, and the desire and commitment of the individual, one may choose out-patient services and counseling over in-patient or residential help. Out-patient therapy or counseling is often effective if the gambler seeks help as soon as they recognize and admit there is a problem. Out-patient and counseling services often involve cognitive therapy, support groups, and peer coaching from trained gamblers in recovery who have been there. Although this is similar to residential in those aspects the key difference is that with out-patient and counseling the gambler remains in their natural environment while working on their gambling problem. In other words they have their day-to-day, work, and home life still in place.
If a someone addicted to gambling continues to deny he or she has a problem, and gambling has caused them to suffer the loss of a job or business, devastated his or her finances, relationships, or they have committed a criminal offense as a result of their gambling, a residential or in- program is usually necessary, and is often the only means of breaking the cycle. A residential program is also usually needed if someone is dealing with a gambling addiction and substance abuse issues simultaneously; common with many compulsive gamblers. Residential programs ensures that the patient is fully supervised, and is unable to engage in any form of gambling or addictive activity.
Quitting a gambling addiction on ones own can be possible, meaning without the services of others or programs. Success of self-quitting is usually contingent on the stage or severity of the addiction. Most people with a gambling addiction repeatedly try to "quit" and/or cut back prior to getting any formal help. Key factors in self-quitting, are:
- The gambler has a strong support system in place from family and loved ones.
- Everyone involved becomes well educated on gambling addiction and recovery.
- A plan is in place that is understood by all.
- Have an understanding that it is a process, and the gambler may have to start by cutting back, before all destructive gambling activity stops.
For someone dealing with a gambling addiction, whose funds have become depleted because of it, it feels near impossible to pay for help; even the most basic of help, let alone a residential program. Programs are aware of the financial difficulties gamblers needing treatment have. In many cases, insurance will cover some, if not all costs. Most programs also provide for comfortable payment arrangements, and some cover costs through scholarships and grants. Payment policies vary based on whether the program is state-run, non-profit, private, etc. Regardless, many gambling addiction programs take into account how gambling has impacted the finances of those seeking help, and will work with you to accommodate if insurance doesn't cover care.
Most important, if you or someone you care about has a gambling problem, help and support is available. If you don't know how to begin your search, start with your local mental health services, or search the internet for resources and programs in your area. This can guide you in the right direction to getting the help you need.