Gambling Disorders
Gambling has become more common and accessible in recent years. Previously, it was limited to casinos concentrated in areas like Las Vegas and Atlantic City, but today you can bet on sports events and horse races online, through lotteries or via mobile devices. There are also video games with gambling elements for both adults and children. Moreover, some states have legalized sports betting and more are considering it.
Most people who gamble do so responsibly and find it a fun pastime. However, for some individuals it becomes a problem. This is known as pathological gambling, and it is a mental health disorder. A person with a gambling disorder experiences persistent, severe, and recurrent problems related to gambling that are not infrequently accompanied by feelings of helplessness, guilt, anxiety, or depression. A person who has a gambling disorder may lie to family members, therapists, or others about the extent of his or her involvement in gambling; he or she is often reluctant to accept that he or she has a problem and frequently attempts to convince others that the gambling activity is not a problem (American Psychiatric Association 2000).
Many people have trouble with gambling because they are looking for thrills, a way to escape from stress or a way to make money. When a person is addicted to gambling, the reward pathway in the brain changes and he or she loses control over the behavior. For example, when a person loses, the brain releases dopamine in response. This produces the same pleasure as ingesting a drug, so it becomes very difficult for a person to stop gambling even when he or she is losing large sums of money.
In addition to causing psychological distress, gambling can also affect physical health. Research shows that people who gamble have higher rates of heart disease and high blood pressure. In addition, gambling can lead to financial problems such as credit card debt and bankruptcy. Some people who struggle with gambling also experience social problems such as marital conflict and unemployment.
A growing role exists for evaluation of patients for gambling behaviors in a general medical setting, and the development of screening strategies for problem and pathological gambling and treatments for those who have a gambling disorder are important in this context.
A recurring concern is that gross impact studies focus only on the economic benefits of gambling and fail to recognize the negative effects. These studies do not attempt to distinguish between real and expenditure substitution effects or consider the geographical scope of the study. It is time to move beyond these flawed gross impact studies and undertake more comprehensive analyses that include a thorough consideration of the costs of gambling. Such an analysis is particularly needed in the United States, where the prevalence of gambling is very high.