Gambling

Problem or pathological gambling is persistent and recurrent maladaptive gambling behaviour despite its detrimental effect (disruption of personal, family or work life). It is undoubtedly a dependence disorder similar to alcohol and other drugs with a similar approach to management.

Prevalence: 2–3% of adult population

Dangers

• Suicide risk (high)

• Major depression (up to 75%)

• Stress-related problems

• Domestic violence

Key warning signs

• Gambling >$200 wk

• Chasing losses

Other telltale signs

• Spending many hours gambling

• Placing larger, more frequent bets

• Lying about behaviour

• Being secretive

• Promising cutting back but not doing it

• Impulsive activity

• Mood swings

• Gambling at expense of other pleasant social activities

• Growing debts

• Excessive drinking

Management

• Ask (as part of social history)

• Consider South Oaks Gambling screen

• Firm confrontation if suspected

• Consider using the Prochaska and DiClemente model of change

• Give education and basic counselling

• Look at family (?domestic violence)

• Advise family not to provide ‘rescue money’

• Refer for specialist counselling if necessary; this includes CBT

• Drug treatment inadvisable

• Helpful agencies: Lifeline 13 11 14; Gambler’s Help 1300 131973; eheadspace.org.au (young adults)