It’s clear that problem gambling has been accurately classified as a real addiction, comparable to almost all substance abuse. Treatment is generally similar, with a few important wrinkles…
Presently, problem gambling is generally screened through the DSM-IV (The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). This focuses on the psychological impulse behind problem gambling, as developed by the American Psychiatric Association.
Treatment for gambling addiction includes counseling, 12-step support programs, medication, and peer support – often a combination of all. No one treatment is considered to be the most efficient. The FDA has not approved any specific medication for treatment of pathological gambling. This would be akin to discovering a medication that treated kleptomania. However, there are certain medications that have proven to be quite helpful at this early stage of research. The SSRI paroxetine has proven to have some positive effect in the treatment of problem gambling. Also, on a dual diagnosis platform, sustained release lithium has shown promising results in an early, limited clinical trial when treating both pathological gambling and a comorbid bipolar spectrum condition. Furthermore, the opiate antagonist drug nalmefene has also shown potential in early research.
Gamblers Anonymous is, of course, a 12-step model that has been effective in treating this affliction, focusing heavily on peer support, as well as fellowship. In terms of therapy and counseling, cognitive behavioral therapy has demonstrated reduction in symptoms of gambling-related compulsion. It focuses on recognizing the gambling-related thought processes, frame of mind and cognitive disorders that amplify one’s susceptibility to uncontrollable gambling. Additionally, the CBT method often utilizes skill-building techniques geared toward relapse prevention, forcefulness and gambling refusal, problem solving and strengthening of activities that are not consistent with gambling behavior and interests. Recently, some positive headway has been shown in the area of activity scheduling and time-management, as well as desensitization in treatment of chronic gambling addiction.
Motivational interviewing is one of the latest treatments of compulsive gambling. The motivational interviewing’s fundamental objective is encouraging willingness to transform through thinking and resolving mixed feelings. Steering clear of hostile confrontation, argument, blaming, and direct persuasion, the interviewer provides empathy and guidance to compulsive gamblers to characterize their objective. In the end, the essential aim is encouraging freedom of choice and furthering confidence in the ability to change.
Lastly, an increasing method of treatment is peer support. With the expansion of online gambling, many gamblers experiencing concerns and uncertainties use a variety of online peer-support groups to bolster their recovery. This shields their anonymity while enabling them to endeavor recovery on their own, often without having to reveal their issues to loved ones. This could indeed be a double-edged sword, but at this stage it appears to be a useful tool.
Speaking of the internet, the profligate expansion of on-line gambling certainly isn’t reducing the number of new gambling addicts. Several states have laws that require age verification when utilizing a gambling website, but we all know how effective that can be (NOT…). As usual, we cannot depend on lawmakers to police our addiction issues. They know what side of their bread is buttered, and the level of corruption in this scene is, to put it mildly, nauseating. It’s up to us and the recovery community through education and interdiction to stem the tide of what certainly appears to be an epidemic of monolithic proportions.