Compulsive Gambling

Compulsive gambling is a progressive addiction characterized by increasing preoccupation with gambling, a need to bet more money more frequently, restlessness or irritability when attempting to stop, "chasing" losses, and loss of control manifested by continuation of the gambling behavior in spite of mounting, serious, negative consequences. This year alone, an estimated 8 million Americans will gamble in ways that cause harm to themselves and their families.

The term "addiction" is usually reserved to explain a compulsive attraction or pathological attachment to a substance, normally a drug. However, we now recognize that some behaviors can be addicting, such as eating, sex and gambling. All addiction is characterized by loss of control, preoccupation, compulsivity, narrowing of interests, dishonesty, guilt and chronic relapse.

Although gambling may not produce the cognitive or physical impairment associated with alcohol or drug abuse, an obsession with gambling can be just as devastating. Compulsive gambling behavior risks disruptions in any and/or all major areas of life: psychological, physical, social or vocational.

Addictions to behavioral processes are called "process addictions." The process of engaging in these behaviors leads to typical addiction symptoms (withdrawal, tolerance, heightened excitement or euphoria).

Problem gambling is marked by:

1. Preoccupation

2. Narrowing of other interests

3. Continued gambling despite adverse consequences

4. Failed attempts to cut down

Compulsive gamblers:

1. Have distortions of thinking such as denial, superstitions, inflated confidence, or a sense of power and/or control

2. Believe that money is both the cause of and the solution to all of their problems

3. Tend to be highly competetive, energetic, restless and become bored easily

4. Can be generous to the point of mania or extreme extravagance

5. Often are workaholics or binge workers (those who wait until the last moment before working hard)

When people describe their subjective experience related to gambling or other process addictions, their stories are qualitatively similar to users’ descriptions of their drug addictions. Compulsive gamblers indicate that they seek "being in action," referring to the "high" or euphoric state associated with the act of gambling. Gamblers also describe the anticipated high or "rush" prior to being in action.

The description of these aroused states is remarkably similar to that described by cocaine addicts. A study involving 298 cocaine abusers found that a diagnosis of compulsive gambling could be made in 15 percent of the population -- 19 percent of the males and 5 percent of the females. This is about five to seven times the rate expected in the general population.

Course of Gambling Addiction

The course of the gambling and process addictions is remarkably similar to that of drug addiction or alcoholism. Some divide pathological gambling into four phases: winning, losing, desperation and helplessness.

The early or winning phase is similar to the learning phase of a substance addict where the high is fun and the consequences minimal or nonexistent. As the disease progresses, there is a marked narrowing of interests as the gambler becomes preoccupied with gambling and obtaining money to gamble.

Home life and interpersonal relationships are affected as the gambler lies and covers up losses and is careless about the welfare of his family. Interests narrow to gambling and planning to gamble. There are often "bailouts," where the family members lend the gambler money to pay off debts. This is akin to enabling behavior seen in families of alcoholics and addicts. Finally, as the gambler becomes alienated from family and friends, helplessness, demoralization, divorce, suicidal thoughts and other catastrophic consequences occur as the gambler "hits bottom."

Phases of Compulsive Gambling

Compulsive gamblers go through the following four phases:

Phase 1: Winning phase

* more common in "action seekers" (usually men) than escape gamblers (usually women)

* initially occasional gambling followed by more frequent gambling big win

* increasing bet amount

* unreasonable optimism -- feeling of omnipotence

* big shot -- brags about winning while minimizing losses

* lasts months to years

Phase 2: Losing phase ("the chase")

* often begins with unpredictable losing streak

* can't stop gambling ("chasing")

* borrows money (bailouts)

* covering-up, lying

* home and work life affected

* spouse, even if aware of gambling, usually unaware of extent of debt incurred

* personality changes -- irritable, restless and withdrawn

Phase 3: Desperation phase

* often begins with gambling away funds from a bailout that were supposed to pay debts

* options decrease

* illegal/immoral acts (e.g., fraud, embezzlement, writing bad checks)

* reputation affected

* alienation from family and friends

* most common time for seeking help "hitting bottom"

Phase 4: Helplessness

* suicide thoughts and attempts (15 to 25 percent prevalence rate of suicide)

* major depression

* co-morbid substance abuse

* divorce

* emotional breakdown

* arrests