Taking its toll
The impact of problem gambling on
individuals and families
CO-MORBIDITY
Studies have shown that for males
with a gambling problem, alcohol
consumption is heavier than for those
classed as non-problem gamblers, and
they are also more likely to be smokers.
Statistics from an earlier Health Survey
for England quoted in a 2018 Gambling
Commission briefing paper, Gambling-
related harm as a public health issue 14
shows that almost a fifth of male
problem or at-risk gamblers drink more
than 35 units per week, while a third
are smokers.
Clearly the links between alcohol –
and other substances – and gambling
are strong. People are not only more
likely to gamble when their inhibitions
have been lowered by alcohol, they
may also turn to alcohol to cope with
gambling-related guilt or stress, or
‘drown their sorrows’ after incurring a
heavy loss. ‘In addition to the well-
documented evidence of the potential
for dependency in both drinking
and gambling there is an increasing
evidence base for the co-occurrence
of pathological alcohol consumption and gambling behaviour,’ states the
Alcohol Change UK website. 15
ONLINE ADDICTIONS
The internet has revolutionised many aspects of our lives, and one of these
is access to gambling. There’s no longer even a need to visit a bookmakers’
– gambling is available instantly, 24 hours a day, on the smartphones in our
pockets. The internet has also dramatically increased the opportunities for
advertising and marketing, with one in eight young people now reported to
be following gambling companies on social media. 16
What’s more, as video games and online gaming become ever more
sophisticated, it’s no longer necessary for money to be involved in order for
people to experience problems. The 11th revision of WHO’s International
Classification of Diseases now includes ‘gaming disorder’, 17 a pattern of
behaviour characterised by ‘impaired control over gaming, increasing
priority given to gaming over other activities to the extent that gaming takes
precedence over other interests and daily activities, and continuation or
escalation of gaming despite the occurrence of negative consequences’.
WWW.DRINKANDDRUGSNEWS.COM
P
roblem gambling can have
a devastating impact on
both the gambler and
their family. Gambling
can become an obsession, leading
people to neglect their work
and their loved ones. Bills can go
unpaid, debts can accumulate, and
in extreme cases people can face
bankruptcy, lose their job or home,
or even resort to criminal activity.
According to the charity
GamCare, there is a ‘higher number
of people identified as problem
gamblers in the criminal justice
system than the wider population,
especially if those going through
the system possess vulnerable
characteristics such as ADHD,
impulsivity, poor mental health,
and substance abuse’. 18 While the
most common offences committed
by problem gamblers are ‘income-
producing crimes’ like fraud, theft or
drug dealing, offences can sometimes
be more violent, the charity adds,
including domestic abuse.
FAMILY BREAKDOWN
The stress associated with a
gambling disorder can obviously
have a devastating effect on family
and other relationships, eroding
closeness and trust. People with
a gambling disorder can become
withdrawn and isolated, or angry
and defensive, and marriages and
partnerships can be irrevocably
damaged. Children are ‘heavily
impacted’ both financially and
emotionally by the gambling of a
family member, says a Faculty of
Public Health position statement. 19
‘This “ripple effect” of gambling leads
to a number of feelings for children
which are hard to manage, including
anger, guilt, helplessness, shame and
feeling neglected,’ it states.
The toll on mental and physical
health can also be significant. ‘We
know that problem gambling can
have a major impact on health,’
says the government’s July 2019
green paper Advancing our health:
prevention in the 2020s 20 , adding
that the government now ‘has an
active agenda on this’. Sleep and
appetite can suffer, and the impact
on mental wellbeing can be severe.
As well as anxiety and depression,
the psychological issues associated
with addictive behaviours, such
as guilt, shame and stigma, can
compound feelings of isolation.
In extreme cases, and often when
significant sums of money have
been involved, people can be driven
to suicide.
WHEN TO REFER
The Royal College of Psychiatrists’
2014 report Gambling: the hidden
addiction 21 recommends that drug
and alcohol treatment services and
wider health professionals such as
GPs should routinely screen ‘high
risk’ patients for problem gambling
issues, with anyone recording a
positive score first offered a brief
intervention and then referral to
specialist care.
Widely used for people
considered to be drinking at risky
levels, ten- to 15-minute brief
interventions are designed to stop
people moving from being ‘at risk’
to developing a full disorder. ‘They
are also helpful when working with
patients who are currently unwilling
to seek formal or more intensive
treatment for their disorder,’ the
document states.
WIDER HEALTH SERIES • DRINK AND DRUGS NEWS • 5