What is Gambling Addiction?

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D.

Gambling involves risking something of value, in the hopes of gaining something of greater worth.  Customarily, this involves making financial wagers on games or activities that rely heavily on chance.  Gambling addiction describes an impaired ability to resist the impulse to gamble despite the harmful consequences of participation. These harmful consequences may include: 1) risky, dangerous, or unhealthy behaviors (e.g., borrowing money from unconventional sources); 2) damage to relationships, 3) financial consequences; 4) legal consequences, or 5) a failure to fulfill important life roles such as employee, student, spouse, parent, friend, etc.

man gamblingGambling includes a broad range of activities.  Horseracing, lottery tickets, gambling casinos, and online card games are just a few of the most common forms of gambling.  For many people, gambling can be a fun and pleasurable form of entertainment.  Like all addictions, gambling addiction begins in this rather normal realm of the pursuit of pleasure.  Addiction does not develop because of these pleasurable activities. As we will see, the human brain compels us to pursue pleasurable activities.  Addiction becomes evident when someone seems to be unable to limit, control, or stop these pleasurable activities.  Thus, the problem of addiction is not that someone enjoys these pleasures.  The problem of addiction is that they cannot seem to stop.  People who develop addiction experience this as a "loss of control."

Imagine that someone goes gambling for the first time.  Win or lose, it's fun, sometimes very fun. Not too much money gets spent. The experience is affordable, relative to that person's income.  What's the harm in that?   But later, suppose that same person goes to a casino again, to replicate that same fun experience planning to spend only $100 dollars.  Instead, they keep getting credit card cash advances for much more than they can afford and blow their entire paycheck for the next week. There may be substantial remorse and regret about what happened.  Most people would not wish to repeat that experience, and thankfully most do not.  However, people who develop gambling addiction will repeat that experience and return to the casino.  They spend more and more.  As this continues, the negative consequences increase, even surpassing any momentary pleasure.  Although they made commitments to themselves or to others to "never to do that again," the gambling continues.

Ordinarily, these negative consequences serve to decrease or diminish the behaviors that cause them. In the case of addictions, these behaviors continue despite negative consequences. Examples of these consequences include: arguments with a partner over financial losses; being evicted or losing a home or car due to gambling debts; physical assault due to a failure to repay unconventional loans, and other health, legal, and financial problems.

Gambling addiction falls into a specific category of addictions called activity addictions. Gambling addiction meets the definition of addiction that we discuss in our topic center on addiction. We defined addiction as follows:

Addiction is the repeated involvement with a substance or activity, despite the substantial harm it now causes, because that involvement was (and may continue to be) pleasurable and/or valuable.

Gambling addiction is also known as gambling disorder.  Gambling disorder is included in a category of disorders called, "Substance-Related and Addictive Disorders."  The rationale behind this classification stems from substantial research that shows the neurological similarities between gambling addiction and drug addiction.  The diagnosis of gambling addiction is discussed in a later portion of this center.

It may be difficult to understand how someone can become addicted to an activity such as gambling.  When people develop an addiction, they become addicted to the release of certain brain chemicals. It doesn't matter what causes this release of brain chemicals. It could be a drug or an activity that causes this release.  Like drugs, alcohol, and sex; gambling increases levels of dopamine in the brain. Dopamine is the primary neurotransmitter in the brain's reward system.  Dopamine creates pleasurable feelings. Paradoxically, research suggests that it is the "near-misses" (not wins) that lead to increased levels of dopamine during gambling (Chase & Clark, 2010).  People are motivated to repeat behaviors that create these pleasurable feelings. Unfortunately, the brain's reward system (via dopamine) makes us vulnerable to addiction.

Like all addictions, gambling addiction causes changes to the brain's prefrontal cortex. Unfortunately, these changes also make the discontinuation of the addiction more difficult. These brain changes account for two characteristics of gambling addiction: impulsivity and compulsivity.