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Co-Occurring Gambling Disorder and Substance Use

When we think of substance use disorders and the conditions that often co-occur, it’s normal to think about depression or anxiety or any of the mental health disorders discussed in other articles. What we don’t often think of is gambling. While only about 1% of the general population struggles with gambling problems, more than 20% of people with substance use disorders gamble at a rate considered addictive. In 1980, gambling disorders were officially classified in the DSM as a Disorder of Impulse Control alongside drug and alcohol addiction. Including these diagnoses in the same classification of disorders has allowed rehab facilities to administer treatments that effectively address both conditions together.

Substance Abuse and Co-Occurring Gambling

Why Gambling Disorder and Substance Misuse Co-Occur

Studies have found that men and women who struggle with any sort of gambling disorder have much higher rates of both drug and alcohol use than the general public. Almost 50% of men at one inpatient facility who were undergoing treatment for gambling also met diagnostic criteria for substance use disorders. Though these individuals use a variety of substances, alcohol use was reported highest. While substance use and gambling co-occur across age groups and gender, one study found that these individuals are more likely to be unmarried men. 


There are several reasons as to why these conditions co-occur, but the motivations of men and women who suffer from both are different thant people who only gamble. The number one motivation was the need to win money in order to address financial problems caused by both gambling and drug use. Other causes for heavy gambling include the need to seek excitement-inducing experiences, increased access to socialization, and early onset of gambling at a young age.


Gambling and Alcohol Use

The highest rate of co-occurrance is seen in individuals who gamble and also participate in heavy drinking. Studies have looked at all of the research currently out there and show that the more an individual participates in gambling, the more they are likely to participate in heavy alcohol abuse. Pathological gamblers are 3.8 times more likely to develop an alcohol use disoder. There are many other statistics that show the rate of developing a lifetime occurrence of alcohol abuse and the rate at which these conditions are, or are not, addressed in treatment facilitities, but the overarching theme is that gambling and alcohol use co-occur at an extremely high rate and are difficult to treat if not addressed at the same time.

For adolescents who began gambling under the age of 18, about 3% to 8% are problem gamblers and 10% to 15% are at risk for continued problem gambling well into adulthood. Unfortunately, the earlier an individual develops a gambling disorder, the higher their risk is for developing alcoholism. Because of this, anywhere from 19% to 48% of people who suffer from pathological gambling have a lifetime occurrence of alcohol misuse and abuse.

Studies have looked into the way the brain works in men and women who struggle with gambling. Because of the poor emotion regulation and high impulsivity that these individuals show, abnormal alcohol use is more likely and contributes further to the worsening of emotion regulation and the increasing rate of impulsive behaviors. Negative emotions, thoughts, and behaviors contribute to the high rate of alcohol use, specifically because these individuals have a harder time dealing with these emotions without the assistance of alcohol.

Gambling and Marijuana

While there are few studies that currently discuss the effects of marijuana use on people with gambling conditions, the abuse of this drug has been highly correlated with problematic gambling. Approximately 35% of adolescents who reported to experiencing problematic gambling currently struggle with or are at risk for developing a marijuana use disorder. Conversely, about 21% of the adolescents that sough professional treatment for marijuana addiction also met criteria for gambling disorders. Knowing that these adolescents are experiencing both conditions at such an early age is critical in determining how best to treat these conditions, especially because adolescents are more susceptible to developing lifelong negative habits such as gambling and smoking simultaneously.

Gambling and Smoking

Extensive research has also investigated the rate at which pathological gamblers smoke or use nicotine products and how that rate is much higher than the general population of nicotine users. Approximately 41% to 69% of problematic gamblers smoked cigarettes on a daily basis, and these results also showed an increasing rate of drug use in individuals with both gambling and nicotine addiction.

Gambling and Other Co-Occurring Disorders

When it comes to gambling, substance use is not the only other condition that co-occurs. Around 38% of people who gamble also suffer from a mood disorder and 37% suffer from anxiety disorders. The combination of these conditions may be one reason why more than 50% of gamblers partake in excessive drinking and drug use. 

Because problematic gambling is often associated with other mental health or substance abuse disorders, it is important to understand how all of them link and worsen one another. At it’s most basic form, addiction, mental illness, and gambling problems all deal with the brain and the amount of serotonin, dopamine, or other neurotransmitters that are lacking. Gambling is often the result of impulsivity, which is often also associated with alcohol and drug use. Combining the two conditions poses a threat to the individual and makes each condition harder to treat.

Gambling Treatment

Treating These Conditions

Many inpatient and outpatient treatment facilities are now offering programs that deal with gambling addictions alongside any mental health or substance abuse problems. The main goal is to treat these conditions simultaneously. If kept separate, one condition that is left untreated may lead to a relapse in the other. 

Some of the most effective forms of treatment for co-occurring gambling disorder include supervised detoxification, relapse prevention training, coping skill development classes, different forms of individual and group therapy, cognitive behavioral therapy, and 12-step meetings like Gamblers Anonymous.

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