Gambling addiction: 7 steps for treatment

Gambling addiction is a compulsive need to gamble despite negative consequences. It involves a preoccupation with gambling, the need for increasingly higher stakes to experience pleasure, and repeatedly failing to stop or limit the behavior.

According to the Center for Addiction Research, there are 40,000 problem gamblers and 76,000 at-risk gamblers in the Netherlands. In total, there are 116,000 people with risky gambling behavior. AGOG considers both groups as gamblers in need of help.

Gambling is addictive because it releases dopamine in the brain, creating feelings of euphoria. It can lead to a cycle where individuals try to recoup their losses, which reinforces the addiction.

Gambling addiction can be treated in the following 7 steps, depending on the severity of the addiction.

1. Self-help: Developing strategies to reduce gambling behavior.
2. Helping a partner or friend: Offering support and addressing the issues together.
3. Intervention: Confronting the gambling behavior and encouraging treatment.
4. Counseling: Seeking professional help for underlying issues.
5. Therapy: Behavioral therapy or cognitive therapy to change thoughts and behavior.
6. Medication: For treating co-occurring conditions or reducing urges.
7. Clinical admission: Intensive treatment in a controlled environment.

Withdrawal symptoms can be severe, and treatment may differ from other behavioral addictions due to the unique triggers and behavior patterns of gambling.

1. Self-help

There are several self-help strategies to overcome mild gambling problems.

• Stay alert to situations that lead to gambling and avoid them.
• Find alternatives to gambling; sports, hobbies, or other activities that provide motivation and enjoyment. Competitive sports often work well due to their drive to win, which can be a good substitute for gambling.
• People matter; involve family and friends for support and avoid social isolation. Remind yourself of the risks of gambling and make it a topic of discussion so you can also see the impact on others.
• Use online tools; there are many free programs available, such as “Gokkenondercontrole,” that can prevent mild issues from worsening.
• Get to know yourself well; understanding your triggers and weak moments helps manage the urge to gamble.
• Don’t be too hard on yourself; difficult moments are part of the process and do not mean you are weak.
• Don’t give up; keep trying, even when things get tough.

2. Helping a Partner or Friend

To help a partner or friend with gambling problems, it’s important to seek professional help. Remind them that they are not alone; many people face similar issues. It’s crucial to address the problem directly; the sooner gambling is stopped, the easier the recovery.

Also, protect finances by limiting access to money and ask them to be open about expenses, but do this without being confrontational. Offer loving support and give time; recovery takes steps and time. Encourage the development of coping strategies and suggest seeking group therapy or addiction treatments.

Avoid guilt or accusations; these can hinder recovery. Help them realize that their actions have consequences without enabling them. Set boundaries and rules, and be assertive without threats.

Be honest about feelings and accept that rewards and pleasure are possible without harmful behavior. A therapist or counselor can assist in handling emotions and developing strategies for support. Remind them that recovery is possible and that they are worth fighting for.

3. Intervention

An intervention is the next step in stopping a gambling habit. Family members and friends confront the gambler, often with the help of a professional. The key is to communicate calmly and clearly.

The goal is to raise awareness of the harm caused and to prompt the individual into treatment. An intervention plan includes specific goals and possible consequences if help is refused. Choosing an intervention specialist, such as a social worker, is important as they can provide guidance.

Preparation is crucial. Involved individuals practice their message and sometimes write a letter to read aloud. This ensures everyone is confident in saying what they need to. An intervention is sensitive and can provoke resistance. It’s essential that the gambler feels understood and is open to recovery.

4. Counseling

Gambling addiction counseling is an effective treatment for individuals struggling with gambling problems. It can assist with managing budgets or finding the right resources to quit. It can also go as far as therapies, although we will address those separately in the next section.

Group and family counseling offer a supportive environment where experiences and struggles can be shared, and work can be done to restore relationships and finances. Additional options like self-help groups, workbooks, and helpline support can complement counseling and offer extra assistance in reducing or eliminating gambling behavior.

It’s important to find a therapeutic approach that resonates with the person’s specific needs to increase the chances of recovery. Sometimes, this may involve more intensive therapy.

5. Therapy

Gambling addiction therapy is versatile and includes cognitive-behavioral therapy (CBT), psychodynamic therapy, group therapy, and family therapy.

CBT focuses on changing unhealthy gambling thoughts and behaviors. It teaches skills such as relapse prevention and identifying underlying psychological factors contributing to the addiction.

Psychodynamic therapy seeks psychological causes of gambling addiction by addressing deeper emotional issues, while motivational enhancement therapy works on the mixed motivations accompanying gambling activities.

Harris, J. (1988) demonstrates in “A Model for Treating Compulsive Gamblers Through Cognitive-Behavioral Approaches” that the cognitive-behavioral addiction model is also effective in treating compulsive gambling. It reduces relapse and improves treatment outcomes by teaching patients relapse prevention techniques and identifying underlying issues.

6. Medication

Medications for gambling addiction include antidepressants, mood stabilizers, and opioid receptor antagonists. Research by Marin et al. (2017) in European Psychiatry indicates that pathological gambling can be effectively treated with antidepressants and psychological treatment. This improves economic self-management and depression recovery in individuals with psychotic disorders.

Studies suggest that naltrexone and nalmefene, which reduce the urge to gamble, can be effective. Antidepressants like paroxetine and sertraline, and mood stabilizers such as lithium and valproate, have shown favorable results in clinical trials. Antipsychotics like olanzapine and anticonvulsants like topiramate are sometimes prescribed.

It is crucial that medication is always prescribed by a qualified healthcare provider and is often used in conjunction with psychological therapy.

7. Clinical admission

Clinical admission for gambling is intensive and focused on recovery. Detox clinics offer professional care, often with a multidisciplinary team where patients stay in the facility. Here, they receive structured programs along with individual and group therapy.

Treatments include various forms, such as cognitive-behavioral therapy, motivational enhancement, and skill training. The right approach is crucial, with individual needs matched to the type of program.

When choosing a detox clinic, factors such as accreditation, success rate, cost, and whether insurance covers it are important.

Successful rehabilitation requires dedication and a willingness to learn new life skills.

How does gambling addiction start?

Triggers for gambling addiction often begin at a young age. A complex combination of personality traits, such as impulsivity, and social factors, like a culture that promotes winning, contributes to development. Traumatic life events or psychological issues, such as depression, increase the likelihood of developing a gambling addiction, and young people exposed to gambling early are at higher risk, especially if family members also gamble.

Gambling addiction goes through various stages with warning signs that are important to recognize. In the early stage, it may seem like harmless fun, but later it can lead to a cycle of chasing losses and continuing to gamble despite the consequences.

What are the stages of compulsive gambling?

Compulsive gambling goes through several stages that follow one another. These are the winning phase, losing phase, despair, hopeless phase, and recovery phase.

The first phase, the “winning phase,” often begins with large wins that feed the dream of “easy money.” Gamblers feel invincible at this stage, and the urge to keep going is strong.

As gambling progresses, the “losing phase” begins. Losses accumulate, often exceeding monthly or annual income. The gambler becomes obsessed with the idea of winning back the losses, leading to even more gambling.

After bigger losses, “despair” sets in. Gambling addicts lose control over their gambling behavior. The gambler still believes in a big win that will fix everything. However, behavioral changes occur, such as lying to loved ones, borrowing money, and even stealing to fund gambling. Feelings of shame and guilt are high, but the urge to continue remains.

The next phase, the “hopeless phase,” is significant. Control is completely lost, and gambling dominates the life of the addict. The gambler may feel there is no way out of their addiction. They may have lost everything and experience a lack of hope for the future.

The final phase is the “recovery phase.” This begins when the gambler acknowledges the need for help and is ready to seek treatment. Recovery options include professional help and support from loved ones. With the right help, gamblers can overcome their addiction and lead a fulfilling life again.

What are the warning signs of a gambling addiction?

There are several warning signs of a gambling addiction. Loss of money often leads to financial problems, such as difficulty paying bills. Gamblers spend more time and money on gambling than planned. They may notice their work performance deteriorating and experience personal relationships under strain.

Lying about gambling behavior is common, as is using gambling as an escape from stressful situations.

What Are the Types of Gambling Addiction?

According to Dr. Robert L. Custer, there are 6 types of gambling addictions: the professional gambler, the antisocial or personality gambler, the gambler who gambles to escape, the gambler who gambles due to insecurity, the gambler who seeks sensation, and the impulsive gambler.

Professional gamblers view gambling as a legitimate and often profitable way of life. Antisocial gamblers often engage in illegal activities as part of their gambling behavior. Gamblers who gamble to escape seek relief from negative feelings or traumatic experiences. Gamblers who gamble due to insecurity are often seeking approval and validation. Sensation seekers enjoy the adrenaline and the risk. Impulsive gamblers have a strong tendency to engage in unplanned gambling behavior.

Casino, poker, slot machine, and lottery addictions are manifestations of how the addiction shows itself. These forms can overlap with the categories described by Custer.

Casino Addiction

A casino is a venue where people can gamble by playing games such as slot machines, roulette, blackjack, and poker.

Casinos are addictive because they create an environment that stimulates the senses and makes control difficult. Bright lights and the cheerful sounds of winning machines give players the feeling that a win is always just around the corner.

Game design, such as the unpredictability of slot machines, encourages repeated play. Free drinks and the absence of clocks make customers stay longer and spend more money. Music and sound effects influence emotions and behavior, while the chance of a big win entices players to continue, despite losses.

Easy access to money, such as ATMs, and the use of chips instead of real money, make it easier to lose track of the value of money. All these elements together create a setting in which stopping is difficult and the reality of loss is clouded.

Poker Addiction

Poker is a card game where players bet on the strength of their hand, aiming to win the pot either by having the best combination of cards or by forcing other players to fold.

Although some do not consider it a game of chance, poker can be addictive because it is a combination of skill, control, and luck, which triggers increased stimulation of the brain’s reward system, similar to the effects of drugs or alcohol. This can lead to a gambling addiction problem.

Players may compulsively continue betting and chase their losses, which can lead to the depletion of savings. Addiction manifests when an individual experiences an intense preoccupation, constantly thinking about poker, prioritizing it over personal obligations, and showing an inability to stop spending time and money on the game.

Slot Machine Addiction

Slot machines are gambling devices with reels that spin and randomly determine outcomes.

A study in the Journal of Neuroscience shows that stimuli associated with rewards, such as the lights and sounds of slot machines, can promote risky decision-making behavior, especially when audiovisual elements are used together. Winning releases dopamine in the brain, which creates intense feelings of pleasure. This reward system encourages players to keep playing, even after losses. The high frequency of play increases the time spent taking risks, which enhances the likelihood of addiction.

Lottery Addiction

Lotteries are games of chance where participants pay for the opportunity to win prizes, often organized as a form of gambling.

Lotteries are addictive because they activate the pleasure centers in the brain, similar to substances like alcohol and cigarettes. Regularly buying lottery tickets can lead to a compulsive disorder, where people are driven to participate repeatedly. The accessibility of lotteries at gas stations and supermarkets increases the ease with which people can keep playing.

According to the Association for Consumer Research, frequent lottery players display characteristics of addicted gamblers: they are often older, have a higher income, fantasize more about the future, and engage in other forms of gambling. Some also show compulsive consumption behavior in the form of window shopping and excessive purchasing, sensation-seeking, and risk-taking. The dream of winning the lottery seems to align well with their strong need for fantasy.

What Are the Withdrawal Symptoms of Gambling?

Gambling can lead to severe withdrawal symptoms. Symptoms vary and depend on the severity of the addiction. Physical symptoms include headaches, muscle tension, sleep problems, and weight gain. Emotional symptoms are restlessness, irritability, and difficulty concentrating. Mental health issues such as depression and anxiety may worsen.

In a gambling addiction, a relapse can occur. It is important to find alternative activities when the urge to gamble strikes. This helps shift the focus and reduce the chance of relapse.

Is Relapse Common Among Gamblers?

Relapse is common among problem gamblers. The Wisconsin Department of Health states that about 90% of problem gamblers relapse. Independent recovery without professional treatment is rare.

Lack of support makes them vulnerable. People without help feel isolated and lose control. They believe that continued gambling will solve their financial problems. Emotional triggers like boredom, stress, or unexpected expenses increase the pressure. Social pressure from friends or family can amplify the urge. Overconfidence leads to underestimating the risk of relapse.

What Can You Do Instead of Gambling?

There are many things you can do when you feel the urge to gamble. Physical activities, such as yoga or outdoor exercises, help relieve stress and improve the mind. Regular exercise can boost overall health and has been proven effective in preventing gambling addiction. Seeking nature is also helpful; hiking or fishing provides time to relax and can aid in maintaining a clear mind. You can also rediscover old hobbies.

Writing about your thoughts and feelings can help you deal with the urge to gamble in a rational way, and meditation has been shown to reduce stress levels and distract people from addictive gambling patterns.

Is Quitting Gambling Different from Other Behavioral Addictions?

There are similarities between gambling addiction and other behavioral addictions: both involve compulsive behavior and a drive for a ‘high.’ Treatments focus on retraining the brain and developing healthy coping mechanisms. However, gambling addiction differs in its emphasis on financial management and debt handling.

Gambling addiction also shares similarities with alcoholism and drug addiction. All three addictions can lead to severe stress and impact mental health, often resulting in anxiety and mood disorders.

Is Gambling Addiction Similar to Alcoholism?

Yes, gambling addiction is similar to alcoholism. Both are behavioral addictions with common features: an inability to stop despite negative consequences, failed attempts to cut back, obsession with the behavior, and continuing despite losses and legal issues.

They also share high comorbidity rates with other disorders and are often influenced by similar environmental factors, such as the availability of casinos for gamblers and bars for alcoholics.

Neurological studies suggest that gambling and alcohol addiction involve similar brain circuits related to reward and impulsivity. People with a predisposition for compulsive behavior may be more vulnerable to both addictions due to genetic and neurological similarities.

Lesieur, H., & Blume, S. (1991) showed that combined treatment for alcohol, drug, and gambling addiction effectively reduces gambling behavior and improves legal, familial, social, and psychological functions.

How Addictive is Gambling Compared to Drugs?

Gambling addiction and drug addiction activate similar reward circuits in the brain. Studies show that both gambling addicts and drug addicts display similar signs of dependency, such as loss of control and continued involvement in the behavior.

Gambling can be just as addictive as drugs, with some individuals developing a pathological urge to gamble, leading to serious personal and legal problems. The likelihood of developing a gambling addiction is higher in people with poor impulse control, which is also a factor in drug addiction.