MINNESOTA PROBLEM GAMBLING HELPLINE 1-800-333-4673 (HOPE) • TEXT "HOPE" TO 53342 • CHAT NOW ONLINE info@mnapg.org

Gambling Disorder

Mental Health and Addiction Providers

It’s important for mental health and addiction providers to have an awareness and understanding about gambling disorders. Over 250,000 Minnesotans have mild to severe problem gambling and it’s a common co-morbidity with mental health disorders and substance use disorder. Therefore, it’s important to screen and make referrals when a client is experiencing a gambling disorder.

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You are in a unique position to provide important guidance to those around you. By learning about gambling addiction, you can help those struggling with a gambling problem get the professional help they need.

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Finding Help for a Gambling Disorder

If you need to refer your client to a gambling treatment professional in Minnesota, please call 1-800-333-HOPE (4763). Translation services are available.

If you have a client that may be indicating problematic gambling behavior, please reach out to an approved provider to initiate a full screening. If it’s determined the client would benefit from problem gambling treatment, work with the counselor to coordinate a joint treatment plan for your client. This arrangement will allow each addiction and/or mental health issue to be addressed together. Remember, gambling treatment is usually available at no cost to your client.

Telehealth sessions are available. Any Minnesotan may receive counseling services from an approved provider via video or telephone calls. Treatment is free for those with no private insurance or those with high deductibles. Family counseling is also available even if the gambler isn’t seeking help.

HELP IS AVAILABLE, OFTEN AT NO COST

Most Minnesotans with a gambling disorder and affected family members can get treatment, often at no cost through the state. The Minnesota Department of Human Services manages the gambling treatment program. If someone you are treating for other mental health or addictions is interested in gambling treatment and has little or no insurance, the cost of counseling is usually covered by the state as long as the individual sees a state-approved provider. Families are permitted up to 12 hours of counseling per year at no cost if they have no insurance coverage.

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GAMBLING DISORDER – THE HIDDEN ADDICTION

Gambling disorder, gambling addiction, is often referred as the “hidden addiction” because it has no visible symptoms, such as those associated with drug or substance use disorder. It’s an addiction that impacts over two million Americans.

GAMBLING DISORDER AS DEFINED IN DSM-5

According to DSM-5 diagnostic criteria, gambling disorder is defined as persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress. An individual with gambling disorder exhibits four or more of the behaviors listed in the DSM-5 over the course of a 12-month period.

Warning Signs of a Gambling Disorder

A diagnosis of gambling disorder (DSM-V) requires meeting at least four of the following during the last 12 months. Often referred as the “hidden addiction,” it can take some time before anyone notices that someone has a gambling problem. Gamblers by nature know how to bluff. Know the signs.

Gambling for longer periods of time than originally planned

Bragging about wins, but not talking about losses

Increased frequency of gambling activity

Denying there is a problem

Lying about how money is spent

Pressuring others for money when financial problems arise

Escaping to other excesses (alcohol, drugs, sleep, video games, etc.)

TOOLS FOR YOUR CLIENTS

SCREENING FOR A GAMBLING DISORDER

Screening, as a part of intake or later assessments, can help your client on their overall recovery by uncovering a gambling disorder. Unless you ask specifically about gambling, the individual is not likely to mention it or perhaps even make the connection.

Knowing you may have limited time, using the Brief Bio Gambling Screening can provide a quick indication of a possible gambling disorder. This consists of the following three questions:

1. During the past 12 months, have you become restless, irritable or anxious when trying to stop/cut down on gambling?

2. During the past 12 months, have you tried to keep your family or friends from knowing how much you gambled?

3. During the past 12 months, did you have such financial trouble as a result of your gambling that you had to get help with living expenses from family, friends or welfare?

If your client answers yes to any of the questions, it doesn’t mean they have a gambling addiction, but it’s worth having more conversation.

MNAPG Normative Feedback Tool

This is a survey in which your client will be asked a series of questions relating to their gambling preferences and their attitudes towards gambling. As they answer the questions, they will see how other Minnesotans have replied. At the completion of the survey, they’ll receive a report letting them know where they fall on the problem gambling spectrum. You can check out the survey yourself by clicking here.

GAMBLING DISORDER SCREENING TOOL KIT

MNAPG wants to encourage all who deal with clients with addiction and/or mental health issues to screen for problem gambling. Over 67% of those with gambling issues have a co-occurring issue. The screening kit offers a variety of resources in case your client answers yes to any one of the three questions. Early detection may minimize the harms that come with excessive gambling. Find it here.

GAMBLING DISORDER and it’s relation to

Some helpful information about gambling disorder and its relationship to substance abuse:

  • The rate of current and lifetime substance abuse is higher among problem gamblers than that of the general population.
  • Higher rates and severity of substance use are predictive of more severe gambling problems and vice versa.
  • The greater the number of substances used the more likely severe gambling problems are experienced.
  • Those with problem gambling behavior often have increased impulsivity, antisocial tendencies and the inability to control anger.
  • Gambling at an earlier age increases the risk for multiple addictions and risky behavior.
  • Those with gambling problems and comorbid substance use may make poor decisions because of increased impulsivity.
  • The inability to accurately assess risk and impaired impulse control often occurs with gambling and substance abuse orders.
  • Higher rates of gambling relapse may occur when there is a failure to treat comorbid substance use disorders.
  • People with comorbid substance use and gambling problems are more likely to report other psychiatric histories.

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Some helpful information about gambling disorder and its relationship to mental health disorders:

  • High rates of gambling are often associated with mental health problems. Most problem gamblers have more than one psychiatric disorder.
  • While there is correlation between comorbid problem gambling and other mental disorders, a causative relationship has not yet been determined.
  • The activity of gambling may relieve other conditions, such as anxiety and depression.
  • The early onset of gambling addiction is often associated with pre-existing depression.
  • Gambling may worsen mental disorders such as depression and anxiety.
  • People who have major mental disorders and are socially isolated are most at risk for problem gambling.
  • Behavioral and motivational treatment of problem gambling has been shown to reduce use of psychiatric medication, suggesting that anxiety and depression may be secondary to gambling, at least in some people.
  • Women are more likely to use gambling to escape depressed moods and anxiety. Women with a gambling addiction are also significantly more likely to seek treatment for their mood or anxiety disorder.
  • Mood disorders are more common in problem gamblers than they are in the general population.
  • People with bipolar disorder are more likely to have a gambling addiction than the general population.
  • There is a correlation between those with high rates of anxiety and those with more severe gambling problems.
  • People with ADHD have increased rates of problem gambling.
  • Problem gambling is highly correlated with a variety of personality disorders, including antisocial, borderline and obsessive-compulsive personality disorders.
  • Impulse control disorders (including kleptomania, impulsive shopping and impulsive sexual behavior) and purging-type eating disorders have high comorbidity with problem gambling.

Are there medications that can help gambling disorder?

  • There are no FDA-approved medications for the treatment of gambling disorder; however, several studies suggest that medications used to treat other addictive and psychiatric disorders may reduce problem gambling.
  • Trials evaluating the effectiveness of antidepressants for treating disordered gambling have produced mixed results.
  • Overall, the trials on several medications have had small sample sizes and been short in duration. Thus, more research is needed.

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  • Suicidal thoughts and suicide attempts are much more likely to occur with problem gamblers than with the general population.
  • Early onset problem gambling is associated with increased risk of suicide.
  • Actual gambling-related suicide attempts are more likely to be made by older people.
  • The risk of suicide in people with gambling problems is increased by comorbid substance use and comorbid mental disorders.
  • Gamblers have the highest rate of suicide among all addictions.
  • There is a greater risk of suicide among veteran/active military who have gambling disorders.

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We encourage providers to become members of both MNAPG and the National Council on Problem Gambling (NCPG). This is a great way to stay informed about problem gambling developments in Minnesota and at the federal level. As a member, you can:

  • Attend monthly NCPG webinars for free
  • Receive discounts for conferences
  • Be eligible for MNAPG scholarships to attend the national conference, and
  • Lend support to both organizations at the state and federal levels
INSPIRING SUCCESS STORIES

You and your clients should know that treatment has helped improve the lives of many Minnesotans with a gambling problem. We have a trove of stories reflecting this success.

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