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People with gambling addiction are more likely to have alcohol use disorders.
It’s therefore important to think about why that might be and what it means.
Unlike alcoholism which usually becomes quite obvious, gambling addiction can remain hidden for a long time.
The government reported that in 2018, 24.5 million people in England gambled (that includes those who played the National Lottery).
Those considered “problem gamblers” are estimated as being around 0.5% of the population which in 2018 was around 279,900 people. Another 7% of the population is impacted by someone else’s gambling. [1]
One study revealed that 9% of people in treatment for substance addiction were pathological gamblers and an additional 10% were problematic gamblers. [2]
These figures are much higher than it is in the general population (0.5% as mentioned above).
Both alcohol misuse and gambling addiction are clearly defined by their compulsive behaviour and withdrawal symptoms, which suggests that there underlying factors that make them more likely to co-occur.
For a long period of time, there was quite a debate as to whether pathological gambling constituted an addiction. This is because addictions were seen only as substance use disorders.
Substances have chemicals that directly impact brain functioning, which changes how a person thinks, feels, and thereafter behaves. In fact, the brain becomes reliant on the substance used to function in particular areas the more it is used.
Substances can cause a person to become psychologically and physically dependent.
It wasn’t until 2013 that the American Psychiatric Association labelled pathological gambling as a “process addiction”. This is also referred to as a “behavioural addiction” by some professionals.
Behavioural addictions are considered either passive (watching TV) or active (gambling). [3] Shopping, tanning, gaming, sex, and porn addictions would commonly be described as active behavioural addictions.
Gambling doesn’t have the same effect as substances in how it interacts with brain chemicals directly, however it is a behaviour that stimulates. In relation to behavioural science, this is what’s relevant.
If participating in behaviour makes a person feel good, then they’re more likely to return the behaviour, and therein lies the sticking point.
Research shows that there are neurobiological factors behind behavioural addictions. There is maladaptive functioning when it comes to the brain network which guides appropriate responses and this is linked to craving and the development of an impulse control disorder.
Various brain networks are also influenced by mental health conditions such as depression which is highly linked to gambling and alcohol use; this can increase problematic gambling through a loss of impulse control. On top of this, Autonomic Nervous System dysfunction is linked to behavioural addiction. [4]
Being unable to control behaviour (or lack of self-regulation) is one of the key elements that define addiction. As well as this, there are many other signs that reveal that a behavioural addiction has developed.
Interestingly, gambling can be done at a professional level or social level, as well as at a problematic level. It can move from the first two levels towards the addictive level.
For many people, it can be difficult to identify and admit that they have a problem (a key sign of addiction in itself).
Signs of gambling addiction include:
There are particular factors that, especially when found together, can increase the likelihood of gambling addiction developing.
Many people call it alcoholism or alcohol addiction. What’s important to bear in mind in relation to alcohol use, however, is that problematic use can take many forms from binge drinking at weekends to heavy daily drinking.
There are 602,391 people dependent on alcohol in England and only 18% of those people are in treatment. 24% of adults in England and Scotland drink above the recommended guidelines. [5]
The signs of alcohol addiction include (very similar to gambling addiction):
Alcohol use disorder covers a range of behaviours in how people use it. Addiction will be described by a professional as mild, moderate, or severe. At its most extreme, alcohol use causes dependency, where you come to need it to function and withdrawal without professional input can be fatal.
Looking more in-depth at alcohol disorder and pathological gambling reveals that the two have further similarities than simply the signs of withdrawal.
It goes without saying that if both conditions create similar withdrawal symptoms, then it’s likely that what’s going on in the brain during the act of participation in the behaviour (i.e. drinking and gambling) is going to be similar too.
Both drinking and gambling result in brain activity. While alcohol is a psychoactive substance that causes a chemical reaction, the act of gambling triggers a reaction.
Both actions lead to a release of dopamine in the brain’s reward system. At the start of addictive behaviour, this can create feelings of euphoria which can be especially difficult to resist for some people (i.e. those where addiction is more likely).
The person thereafter returns to the act of drinking or gambling to experience the “high” again. Of course, as the behaviour is repeated neurological pathways in the brain are being formed and the brain’s networks are implicated, which makes the act more automatic, and more compulsive.
Because of the similarities between problematic alcohol use (especially heavy drinking) and gambling on the brain, it’s very likely that developing one addiction creates “prime conditions” for the other to develop.
Comorbid disorders are similar in their background factors in what makes them more likely as well as in how they impact the brain and how they manifest in behaviours.
Therefore, someone with pre-existing alcoholism has already fully formed the addictive neural functioning in the brain that accommodates and perpetuates a gambling addiction and vice versa.
Another important thing to consider is how the two conditions can impact each other. A person who gambles might drink to ease disappointment around losses or to try and ease cravings around gambling, which of course increases the likelihood of alcoholism forming.
Environmental choices can also influence the co-occurring condition. Addiction is stigmatised so people usually seek out places where they feel comfortable which often makes the addiction worse.
Someone with a gambling addiction might go to a casino where gambling is encouraged, but of course, drinking is also acceptable.
In relation to addictive gambling behaviour and any level of problematic drinking, it’s important that treatment is sought.
Both conditions alone have serious and grave consequences but together risks are increased and input from medical professionals who specialise in giving treatment for gambling addiction and alcohol use makes all the difference in the future health and well-being outcomes of the individual.
The best place to go for treatment for this comorbid condition is a private rehab clinic. There are many throughout the UK that address both illnesses. Private clinics assess the individual and form a treatment plan suited to the person’s needs.
Behavioural therapies will make up a key part of the programme as this is where a lot of work needs to be done. Cognitive behavioural therapy is especially useful in this situation. As well as this, other treatments that are likely to be offered include:
A dual diagnosis is the same as a comorbid condition (or co-occurring condition); in this case alcohol use disorder and gambling addiction.
While there is no medication available to stop you drinking or gambling, there are medications that might be prescribed if you’re experiencing any mental health symptoms.
At rehab, many people are identified as having depression or anxiety, both of which are associated with addictions. Both of these mental health conditions can be treated through medication.
A professional will assess the patient and decide what’s appropriate.
It’s useful to bear in mind that it can take a while to see the effects of medications and this can be difficult, too, if you’re going through withdrawal.
Staying at a clinic for around four to six weeks is usually advised in order to get through withdrawal, detox, and learn and practise skills to manage addictions.
The residential environment also provides an excellent opportunity to stabilise and see how effective necessary medications might be.
When excessive gambling occurs with alcohol use it’s termed a co-occurring condition or dual diagnosis. The two are thought to be inextricably linked because of similar causation factors and how brain functioning is implicated.
Gambling addiction is much more likely to be seen in people with alcohol use and other substance use disorders than in the general population.
Rehabilitation treatment is really important in order to address both conditions and to improve future health outcomes.
If you’d like support in finding a treatment centre near you, contact Rehab 4 Alcoholism today.
It’s impossible to identify one cause of gambling addiction. There are, however, factors that increase the likelihood of it developing including a psychiatric history (i.e. depression), a history of substance abuse, and being a young adult male.
Some common signs that a person has developed a gambling addiction include; secretive behaviours, mood swings, increasing gambling, compulsive behaviours, and debt.
Behavioural addiction is linked to maladaptive functioning in the brain. This means different parts of the brain increase compulsive behaviours and healthy decision-making becomes more difficult.
As well as this, the reward system is impacted making gambling behaviour more likely.
While nobody can stop anybody from gambling, there are things you can do to help.
Try having an open and compassionate conversation where you outline your concerns about gambling habits. Find out about local treatment clinics and discuss this with the person concerned.
Addiction by its nature is usually impossible to overcome without professional input. This is because it’s an illness that changes brain functioning and related compulsive behaviours.
As such, therapies are required. Seeking support is highly recommended.
For more information and advice, please call our dedicated helpline at 0800 111 4108.
[2] https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1530-0277.1986.tb05610.x
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/
[4] https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00003/full