Compulsive gambling impacts an estimated 5 million U.S. residents. The expenditure on gambling exceeds that on groceries and surpasses the combined total of other recreational activities.
According to the Mayo Clinic, “Compulsive gambling, also called gambling disorder, is the uncontrollable urge to keep gambling despite the toll it takes on your life. Gambling means you're willing to risk something you value in the hope of getting something of even greater value.”
Symptoms can include:
- Constant thoughts about & preoccupation with gambling
- Seeking financial assistance due to gambling-induced problems
- A growing need for larger wagers to achieve the same level of excitement
- Unsuccessful attempts to curb or quit gambling
- Resorting to gambling as an escape from negative emotions
- Trying to recuperate lost money by gambling more
- Concealing the extent of gambling from family & friends
- Compromising essential life aspects like work, relationships, or education because of gambling
Some individuals may experience periods where they abstain from gambling, but these are often temporary. The allure and design of casinos compound the difficulty of quitting.
The Neuroscience Behind Gambling
Gambling disorder alters the brain's chemistry. Dopamine, the neuromodulator responsible for planning, focus, and interest, is significantly impacted. Gambling creates addictive loops in the brain through the release of dopamine, similar to those seen in addictive drugs. Yet, as someone continues to gamble, the brain builds tolerance to this pleasurable release and requires more to feel the rush. This causes the individual to take more risks to achieve the same feeling.
Some studies have shown decreased brain activity in the prefrontal cortex, which is responsible for planning and executive functioning skills. Thus, compulsive gamblers can struggle with making decisions about rewards, not considering the cost.
The Role of Social Workers
The DSM-5 classifies gambling disorders alongside substance-related and addictive disorders. Some populations, such as those with substance or alcohol use disorders, individuals from low socioeconomic backgrounds, and groups like adolescents, older adults, LGBTQ+ people, people of color, and indigenous populations, face a heightened risk of gambling disorders.
Social workers must screen clients for potential gambling disorders, even if briefly. Early intervention can prevent those with predisposed mental health conditions from developing more severe gambling-related problems.
Screening tools include:
- Brief Biosocial Gambling Screen (BBGS) Questionnaire
- Brief Adolescent Gambling Screen (BAGS)
- Lie-Bet tool
- NORC Diagnostic Screen for Gambling Problems (NODS-SA, NODS CLIP, NODS PERC)
- South Oaks Gambling Screen (SOGS and SOGS-RA)
- G.A./Gam-Anon Twenty Questions
- Internet Gaming Disorder Scale – Short-Form (IGDS9-SF)
Social workers play an essential role in assisting clients with gambling disorders. Through diligent screening and identification of gambling-related issues, they can offer tailored treatments to those with gambling disorder. Cognitive therapy, harm reduction, behavioral therapy, and motivational interviewing are particularly effective in facilitating positive change.
Resources for Gambling Disorder
- National Council on Problem Gambling
- 24/7 chat
- Call or text: 1-800-GAMBLER
- Help by state
- Gamblers Anonymous
- In-Person Meetings: Find a location
- Virtual Meetings: Join virtually
- National Association of Administrators for Disordered Gambling Services
Learn more on this topic from this Continued Social Work course: Introduction to Gambling Disorder, presented by Heather Moshier, MBA, CAADC, LSW.
References
Gateway Foundation. (2023). How gambling affects your brain. https://www.gatewayfoundation.org/addiction-blog/how-gambling-affects-brain/
Mayo Clinic. (2022). Compulsive gambling: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/compulsive-gambling/symptoms-causes/syc-20355178
