Gambling isn’t just a Vegas weekend anymore. It’s in your pocket, on your screen, and baked into your patients’ day-to-day lives—from push notifications for the next big game to ads between TikToks. This growing accessibility? It’s a serious concern for the rising rates of gambling disorders—and it’s something more of us in medicine need to be paying attention to.
Gambling disorder is a real—and recognized—mental health condition. It’s classified in the DSM-5 under substance-related and addictive disorders, and while it doesn’t always get the airtime other behavioral addictions do, it’s impact is anything but minor.
Despite all this, most healthcare providers don’t routinely screen for gambling behaviors.
Screening doesn’t have to be complicated. Start with this:
“In the past 12 months, have you ever had an issue with your gambling?”
That one question is a validated tool. If it yields a “yes,” you can dig deeper using something like the Problem Gambling Severity Index (PGSI) or more comprehensive behavioral assessments.
Red Flags to Look For:
Note on presentation: While research may point to trends like men favoring sports betting and women preferring slots or bingo, don’t assume. Gambling behaviors cross gender lines, and your screening should, too.
Diagnosing Gambling Disorder: The DSM-5 Criteria
To meet criteria for gambling disorder, a patient must meet four or more of the following in a 12-month period:
Try:
“A lot of people gamble for fun, but sometimes it can become a source of stress. Has this ever been an issue for you?”
If a patient admits to struggles with gambling, explore the impact it has had on their life. Has it strained relationships, affected their finances, or caused emotional distress? These discussions not only help build rapport but also provide essential context for tailoring treatment.
The treatment landscape for gambling disorder includes pharmacotherapy, counseling, and mutual support groups. While no FDA-approved medications exist specifically for gambling disorder, studies suggest that naltrexone, an opioid antagonist, can reduce gambling when used off-label. For patients with co-occurring conditions, SSRIs may help with anxiety or depression, while mood stabilizers like lithium are effective for bipolar disorder.
Behavioral interventions such as cognitive-behavioral therapy (CBT) remain the cornerstone of treatment. These therapies help patients identify and challenge maladaptive thought patterns that fuel gambling. Mutual support groups like Gamblers Anonymous (GA) and GAM-ANON (for friends and family) can also offer crucial peer support and accountability.
Where to Send Your Patients for Help
Even if you’re not an addiction specialist, you’re not alone in this.
Here are resources to help you get patients the support they need:
Gambling disorder is easy to miss—but the consequences are too big to ignore. As clinicians, we’re in a unique position to screen, open up non-judgmental conversations, and connect patients with effective care.
Even if it’s not in your comfort zone today, a few small changes in your history-taking can have a big impact on someone’s life.
Learn more on our episode, "Betting Against the Odds - Gambling Disorder in Primary Care" on Primary Care RAP.
This content includes material generated by ChatGPT to aid in the editing process. All material has been human-reviewed and approved by our content team.