Treatments for Compulsive Gambling

By Scott Teitelbaum, MD

If you have a gambling problem, call the Gambling State Hotline or Gamblers Anonymous Hotline and enlist the support of others who have the same problem. This is paramount.

Many compulsive gamblers go through terrifying experiences before they are ready for help. The compulsive gambler needs to be willing to accept the fact that he has lost control over gambling and have a sincere desire to get well.

Be honest with family members. Tell them the truth because secrets will eventually come out. Enlist the support of family, friends and religious groups. Also, stop gambling; recovery from this illness is impossible if you are actively engaged in gambling.

Treatment Options

Initial treatment necessitates the involvement of people with expertise in the treatment of compulsive gambling. Most counselors in this area will certainly recommend involvement with Gamblers Anonymous.

Your doctor will assess the nature of your gambling problem as well as other potential related psychiatric problems such as depression, anxiety, substance abuse or other addictive disorders, or attention-deficit/hyperactivity disorder, which may affect your efforts at recovery. He may prescribe medications to treat these disorders in addition to addressing your gambling problem.

Treatment in a Clinical Dependency Center

Gambling is part of the addictive illness spectrum and, just as we evaluate and treat alcoholics for their cigarette smoking and eating disorders, we should evaluate them for gambling. Due to the high rates of dual addictions, the following is recommended:

• All patients should be screened for gambling problems.
• Assess risk in substance-dependent patients who are not compulsive gamblers (more in patients with a family history of gambling problems, patients with intense interest in sports and betting lines).
• Treat both disorders simultaneously.
• Educate all patients regarding gambling addiction and switching addiction.
• Do not allow gambling in treatment centers.

Patients treated for opiate dependence with methadone may be at special risk for gambling. Recent survey data has shown that pathological gamblers taking methadone are most likely to use heroin and alcohol are the substances just prior to or while gambling. Marijuana and cocaine were the substances next most likely to be used when gambling. Methadone programs that aim to prevent all illicit drug use have reported gambling associated with relapse.

Gamblers Anonymous

The fellowship of Gamblers Anonymous is the outgrowth of a chance meeting between two men in January 1957. These men had a truly baffling history of trouble and misery owing to a gambling obsession. They began to meet regularly and as the months passed neither had returned to gambling.

They concluded from their discussions that certain character changes were required in order to prevent a relapse. They were guided by certain spiritual principles that had been utilized by thousands of people who were recovering from other compulsive addictions. The word “spiritual” can describe qualities such as kindness, generosity, honesty and humility.

Also, in order to maintain their own abstinence they felt that it was vitally important that they carry the message of hope to other compulsive gamblers. As a result of favorable publicity by a prominent newspaper columnist and TV commentator, the first group meeting of Gamblers Anonymous was held on Friday, Sept. 13, 1957, in Los Angeles, Calif. Since that time, the fellowship has grown steadily and groups are flourishing throughout the world.

The Gamblers Anonymous program addresses both the moral and financial issues troubling the compulsive gambler. Financial issues always seem paramount to the gambler, as this is usually what precipitates the crisis. A financial inventory of assets and debts will lead to a pressured group meeting where the gambler will receive help in straightening out his or her financial woes.

The 12 Steps of Gamblers Anonymous

1. We admitted we were powerless over gambling — that our lives had become unmanageable.
2. We came to believe that a Power greater than ourselves could restore us to a normal way of thinking and living.
3. We made a decision to turn our will and our lives over to the care of the Power of our own understanding.
4. We made a searching and fearless moral and financial inventory of ourselves.
5. We admitted to ourselves and to another human being the exact nature of our wrongs.
6. We were entirely ready to have these defects of character removed.
7. We humbly asked God (of our understanding) to remove our shortcomings.
8. We made a list of all persons we had harmed and became willing to make amends to them all.
9. We made direct amends to such people wherever possible, except when to do so would injure them or others.
10. We continued to take personal inventory and when we were wrong, promptly admitted it.
11. We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having made an effort to practice these principles in all our affairs, we tried to carry this message to other compulsive gamblers.

Counseling and Psychotherapy

In addition to Gamblers Anonymous, individuals often work with a therapist. Sometimes therapists will see the individual with his family since compulsive gambling invariably affects the whole family. It is imperative to seek a therapist who has experience dealing with compulsive gamblers and their treatment.

Pharmacotherapy

Some physicians will prescribe medicine that may help decrease the craving for gambling. Some of the medications that may help include antidepressants such as Prozac, Zoloft, and Luvox, which are also used to treat obsessive-compulsive disorders.

Clomipramine also has been reported to reduce pathological gambling. Wellbutrin, an antidepressant that is also used to treat attention- deficit/hyperactivity disorder, may be prescribed to those who have a history of attention-deficit and depression.

The use of psychotrophic medicine has met with some success. This is especially true if there is a coexisting depression, attention-deficit/hyperactivity disorder, anxiety disorder, alcohol dependence or bipolar disorder. Medications work best when used with concurrent psychological treatment, family therapy and the 12 steps.

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