Anyone who has been to a casino or visited Las Vegas knows gambling is popular.

And while many people engage in it occasionally and without experiencing adverse effects, gambling may become habit-forming for certain individuals.  In other words, it can become addictive.

Those addicted to gambling may find themselves, for instance, “chasing losses,” taking increasing risks, lying about their behavior or debts, and even engaging in illegal activities (e.g., theft, fraud) to fund their gambling activities.  Roughly 1-4% of the population has clinically significant problem gambling.

In this article, we discuss the diagnosis and treatment of problem gambling, which is also called gambling disorder or addiction.


According to the Diagnostic and Statistical Manual of Mental Disorders, the diagnostic criteria for gambling disorder include problematic gambling behavior resulting in distress or impairment, as suggested by the following:

  1. Needing to wager larger amounts in order to feel the same level of excitement as before.
  2. Experiencing restlessness and irritability when trying to stop gambling or even just cutting down.
  3. Previous unsuccessful attempts to control gambling behavior.
  4. Constant preoccupation with gambling (e.g., constantly thinking about how to obtain money to play).
  5. Gambling when experiencing unpleasant emotions, such as when feeling anxious, depressed, guilty, or powerless.
  6. Trying to win back the money lost, by gambling even more (i.e. “chasing” losses).
  7. Lying about gambling behavior.
  8. Having endangered jobs, educational opportunities, or important relationships because of gambling addiction.
  9. Reliance on others for money alleviates the financial consequences of gambling.

To be diagnosed with gambling disorder, a patient must exhibit at least four of the above symptoms during a 12-month period.

Risk factors for gambling disorder include both genetic and environmental factors.  For instance, problem gambling is associated with antisocial personality disorder, mood disorders, and substance abuse (particularly alcohol use disorder).

Compared to women, men tend to have an earlier age of onset.

Treatment of problem gambling

Treatments for gambling disorder include support groups, medications, and psychotherapy.

Many people with problem gambling have found support groups helpful for the purposes of reducing isolation, sharing knowledge, and exchanging experiences.

One example is Gamblers Anonymous, which is modeled after Alcoholics Anonymous, and requires attending meetings and obtaining a sponsor.

Of course, Gamblers Anonymous and similar 12-step programs are not suitable for everyone, nor do they replace professional treatment, such as psychotherapy and medication.

Medications prescribed for gambling disorder may include:

  • Mood stabilizers: Lithium is one example.
  • Opioid antagonists: Nalmefene (Selincro) or naltrexone (ReVia).
  • Antidepressants: Selective serotonin reuptake inhibitors (SSRIs), such as paroxetine (Paxil) or escitalopram (Lexapro).

Medications are frequently used during the initial detoxification phase, with the goal of reducing withdrawal symptoms (e.g., restlessness, irritability) and increasing the likelihood of sustained abstinence.

Psychotherapy, which is more important during the recovery phase, usually consists of motivational, cognitive, and behavioral therapies.

Psychotherapy includes teaching patients ways to…

  • Identify gambling triggers (e.g., stress, being alone, gambling advertisements)
  • Practice adaptive responses to triggers, such as engaging in outdoor activities instead of online gambling.
  • Apply effective strategies (e.g., mindfulness) for coping with cravings.
  • Replace unhealthy beliefs (e.g., being “due” for a win) with those that are adaptive.
  • Maintain motivation and prevent relapse.

Concluding thoughts

Admitting to a gambling problem and needing help is difficult for many people.  Perhaps the same is true for you.  But once you take this first step, you are already on the path to healing.

Treatment can improve your health, positively impact strained relationships, and reduce financial worries.  In other words, treatment can help you feel in control of your life again.