Ep. 75 - Answers to Common Questions About problem gambling
As a counsellor, I’ve been helping people overcome gambling problems for about fifteen years. When I first meet with people, the two most common questions I hear are: Why did the gambling get so out of control? AND How can we make sure this doesn’t happen again?
These are smart and important questions - both for the person who gambled and also for their spouses and family. The more you understand gambling problems and the more prepared you are to prevent them from happening again, the more successful you will be.
In this episode of our podcast, Fold em: Help for Gambling Problems, we ask someone who knows A LOT about the research on gambling addiction to answer these questions. I’m joined by Dr. Marc Potenza, a psychiatrist and professor at Yale University specializing in problem gambling.
Listen to episode 75 and hear about:
Why is it that some people go from being a casual gambler to a compulsive gambler and others don’t?
What’s happening in the brain when gambling gets out of control?
Are there medications that can help with cravings?
Does treatment work?
Listen now to episode 75 of Fold em by clicking on the green play button at the top of the blog.
If you prefer to tune in directly from Apple Podcasts or Google Podcasts, click on the red “Listen and Subscribe” button below.
What causes gambling problems? What can I do to make sure it doesn’t happen again?
Let’s hear what the research has to say in response to these questions.
Why Do Some People Develop a Gambling Problem and Others Don’t?
In this episode of Fold em, you hear from Dr. Marc Potenza, who is a psychiatrist and professor at Yale University and the Director of the Centre of Excellence in Gambling Research. I asked him about the causes of gambling problems. Here’s what stood out in his answer:
What we know from research is that gambling problems are 50% attributable to genetic factors and 50% to environmental factors.
Environmental factors are things that happen in a life time that create a vulnerability for a gambling disorder.
The main environmental factors that create risk for a gambling disorder are mental health issues, including experiencing Depression, Anxiety, Bipolar Disorder, ADHD and also alcohol and drug concerns.
According to the National Comorbidity Replication Survery, 96% of individuals with gambling problems have one or more of these mental health concerns and 64% have three or more.*
Early life trauma can also create risk for gambling problems.
What’s Happening in the Brain When Gambling Gets Out of Control?
Dr. Potenza explains that brain scan technology has allowed us to observe how the brain changes as gambling gets out of control. One of the most interesting findings was that both individuals with Gambling Disorder and Substance Use Disorder show more activation in the Ventral Striatum (Reward Hub of the brain) in anticipation of monetary rewards and less activation in anticipation of “natural rewards.” We’re hard-wired to be motivated towards rewards involving food, connection and sex for our survival as a species. The Reward Hub in our brain typically lights up in response to these things.
Dr. Potenza says that addiction has been described as “misdirected motivation” in which the brain is directing attention and desire towards gambling related triggers, particularly involving money (as opposed to natural rewards such as food, connection and sex).
We further explored what’s happening in the brain with gambling problems in episodes 40 and 51 of Fold em. Dr. Iris Balodis and Deirdre Querney, MSW, from BrainConnections.ca told us that the good news is that you can re-wire your brain to respond to “natural rewards” with time away from gambling and by purposing building in more non-gambling rewards into your recovery, such as exercise, being in nature, and connecting with supportive people.
Are There Medications to Help With Cravings?
Medications such as Naltexone have been used with success to treat alcohol dependence.** Could medication also help with gambling urges?
Dr. Potenza explains that there currently are no medications approved in North America for decreasing cravings, although there are some studies underway. However, he notes that for people experiencing mental health issues as well as gambling problems, treating the mental health issue with medication has shown to also help the gambling issue.
Given that mental health issues commonly occur alongside of gambling issues, Dr. Potenza recommends getting a mental health assessment as you pull away from gambling. Treating mental health and substance use issues, whether with medication or with counselling is often a helpful part of a recovery plan. And, while you’re at it, get a physical check-up from your doctor too to check out any health issues that need attention.
Is There Hope? Does Treatment Work? Can I Stop Gambling and Stay Stopped?
Dr. Potenza says that there absolutely is hope for people with gambling problems to improve and change. The key for this, he says, is to get help. Unfortunately, he notes that 10% or less of people with Gambling Disorder seek treatment.
The research clearly shows that behavioural therapies, particularly Cognitive Behavioural Therapy works for addressing gambling issues. However, people respond differently to counselling and their pathways for recovery will be different. Fortunately, there are many options for help including Gamblers Anonymous, SMART Recovery, local outpatient counselling and peer support programs, as well as residential treatment. Explore different options that are available. Try something different if you aren’t getting good results and stick to it.
To hear more from Marc Potenza in response to these common questions about the causes and treatment of gambling issues, listen to episode 75 of Fold em. Listen now by clicking on the green play button at the top of this blog or the red Listen Now to Fold em button at the bottom.
You can also listen to earlier episodes of Fold em in which Deirdre and Iris from Brain Connections share more about problem gambling and the brain. Listen now by clicking on the play buttons below.
What Support is Available to Help With Gambling Concerns?
Gambling Support BC
If you live in British Columbia, you can connect with Gambling Outreach Support anytime. To do so, click on the red “Connect with Support in BC” button below. Or, go to the Gambling Support BC website. You can also access these services through the Gambling Support Line. It is available 24/7 at 1-888-795-6111.
Gambling Support BC services are available to any British Columbia resident experiencing problems from gambling, including spouses and family impacted by a loved one’s gambling. For those who gamble, you don’t need to stop or quit gambling or be self-excluded to access these free supports.
Our counselling and outreach services can help you figure out how to manage gambling concerns, including how to control or stop gambling. You decide what will work for you.
You can talk to an outreach support person about next steps for yourself if you aren’t wanting counselling. They can help you find self-help resources or local community resources and make a plan that meets you where you are at.
If You Have Concerns About Your Own Gambling - Help Outside of British Columbia
Canada: www.gamblingguidelines.ca/getting-help
United States: National Council on Problem Gambling
United Kingdom: GamCare
Australia: Gamblers’ Help
If you live outside of these countries, search online for “Gambling Help” in your country
Online Support and Meetings:
GamTalk (online chat forum)
To learn more about gambling concerns and how to access resources and support, go to the home page of this website, click on the red “Learn More” button below, or connect with us through Facebook.
Fold em is funded by Gambling Support BC.
We welcome your feedback and ideas for topics for upcoming episodes. Reach out through the Contact Us page on this website or through email at Foldempodcast@gmail.com.
* DSM-IV Pathological Gambling in the National Comorbidity Survey Replication. Kessler et al (2008)
** Alcohol Use Disorder: Pharmacologic Management. Holt, S. (2023)