“Club Recovery was the right place at the right time with the right people. I don't know what I would have done if it hadn't been for Club Recovery.”
- JL, Apple Valley
(952) 926-2526
Free initial consultations
PATHOLOGICAL GAMBLING
AN ADDICTION THAT RESPONDS TO TREATMENT
by Orrin Tietz
This article contains highlights of an address by Richard J. Rosenthal, director of the Gambling Treatment Program at CPC Westwood Hospital, and an assistant clinical professor of psychiatry, University of California. Persons in the gambling treatment program at Club Recovery have reviewed the article and affirm that its content is consistent with their experience.
Pathological gambling is a progressive disorder characterized by a continuous or periodic loss of control, preoccupation with gambling and obtaining money with which to gamble, irrational thinking, and a continuation of the behavior despite adverse consequences.
Those familiar with chemical addiction recognize the similarity to other addictions including an emphasis on loss of control, progression, preoccupation, and disregard for consequences.
While money is usually the medium for gambling, most gamblers say, “It’s not about the money.” Most say they are seeking action, an aroused, euphoric state comparable to the high derived from cocaine and other drugs. The desire to stay in action is so intense that many gamblers will go for days without sleep and for extended periods without eating or relieving themselves. Clinicians have reported the presence of cravings, the development of tolerance, and the experience of withdrawal. Some gamblers report a rush characterized by sweaty palms, rapid heartbeat, and sensations of nausea or queasiness. There may be blackouts.
For some gamblers action isn’t as important as escape, the deliberate seeking of emotional numbness and oblivion. In either case the urge to gamble may increase during periods of stress or depression. As a result, problems that arise because of gambling lead to more gambling.
The course of the addiction typically has several stages.
Winning. A gambler may initially have been successful or lucky at achieving significant winnings. But even aside from actual winnings are the fantasies of winning, which may include fantasies of a wealthy life style and generosity to others.
Losing. Usually, even when the gambler has had a big win, he doesn’t leave the game. He plays for the action until he loses any gains he may have had. After a series of losses he tries to win back everything all at once. This is known as chasing. There is a sense of urgency; betting is more frequent and heavier. Only the most essential debts are paid, jobs are exploited for the money they bring for gambling, savings are cashed in, loans are taken, and legitimate sources are exhausted. Denial and cover up are a hallmark of this phase.
Desperation. At some point there is a crossing of the line, when the gambler does things previously inconceivable: writing bad checks, stealing from employer, and other illegal activity. Initially this is rationalized as a short-term loan easily paid back with the next win, but any wins are quickly lost. Irritability and anger toward family members and others who may question the gamblers action are common during this phase.
Hopelessness. Some gamblers describe a fourth phase where the gambler no longer believes he will win. He doesn’t care. He is in this for the action only. This phase is more like the laboratory animal responding to the electrodes implanted in the pleasure sensor of the brain.
A gambler may seek help in an early phase but often does not until someone has intervened. Most do not seek help until later stages. By that time two thirds will have committed illegal acts and 20% have made at least one attempt at suicide.
Surveys conducted in states where gambling is prevalent indicated 1.2% and 2.3% of the adult population are probable pathological gamblers. In states where gambling is less prevalent and wagering opportunities are fewer, studies showed prevalence rates of 0.9% and 0.1%. With the growth of the gambling industry, the increased availability of gambling, and increased availability of credit, an increase in the rate of pathological gambling is expected. Internet gambling brings the possibility of gambling into every home.
Various studies indicate 9%-14% of alcoholics are also problem gamblers. These clients rarely bring up gambling as an issue at admission, and unless specifically screened, it will be missed. For these clients, untreated gambling problems will be an issue for relapse.
Pathological gambling is a treatable disorder. Abstinence is essential for recovery. While there are many similarities with treatment for chemical dependency, there are also important differences. Treatment is best accomplished in a separate group with a therapist trained in this addiction. The earlier the disease is diagnosed and treated, the more likely some of the more dire consequences can be avoided.