LCL can help plan treatment for gambling addicts

Issue June 2003

Q:Though I have never laid a hand on client funds, I have bankrupted myself through gambling. I'm in recovery from alcoholism, but I haven't been able to stop myself from falling into the trap of an occasional impulsive trip to the casino in Connecticut, to the point of maxing out several credit cards via cash withdrawals. I know that gambling can be considered another addiction, but until now I never thought of adding GA to my AA. Can you enlighten me?

A:The keys to addictive behavior remain enigmatic, but clearly it is influenced by factors beyond those that determine most of our actions. In most cases, we learn from experience and make relatively sane choices, while in the case of an addiction we feel drawn to keep repeating a behavior even though it has already led, recurrently, to negative consequences.

Compulsive (or, as it's called in the diagnostic manual, "pathological") gambling may be even more complicated than chemical dependency, inasmuch as family and psychological factors seem to play a larger role. For example, some studies point to higher rates of childhood abuse and of mood disorders.

Nevertheless, there is a growing body of data to suggest that all addictive behaviors may share a common neural pathway involving the brain's mechanism for producing rewarding experiences. That may be one reason why something like 35 percent of those with substance abuse or dependence also meet the diagnostic criteria for pathological gambling at some point in their lives, while in general it affects 1 percent to 3 percent of adults. It has been reported that as many as half of compulsive gamblers exhibit observable "withdrawal symptoms" (such as sweating and insomnia). Recent studies using functional MRI and PET scans have actually shown that pathological gamblers produce the same patterns of brain activity in reaction to gambling situations as those shown by alcoholics/drug addicts exposed to their substance of choice.

Like those with other active addictions, compulsive gamblers tend to avoid getting help and to deny the need for it unless forced into it by significant others or dire circumstances. And the gambler can even convince himself that continuing the behavior will actually solve the problem (i.e., win enough money to cover debts), though ultimately it only gets him in deeper.

Most people caught in the grip of such an addiction need active and frequent support in order to combat the impulse and avoid slipping back into denial.

This is where both professional treatment (outpatient - there is virtually no coverage for inpatient rehab unless the person is suicidal) and Gamblers Anonymous can be crucial. One needs all the help available to combat the seductive influence of lotteries, casinos, sporting events, and Internet gambling sites.

You might do well to treat your gambling as a "cross-addiction," just as if you had stopped drinking and become dependent on opiates. LCL can assist you in putting together a plan for support and treatment.