Dual Diagnosis - Process Addiction

Gambling, etc

Problem gambling is gambling behavior which causes disruptions in any major area of life: psychological, physical, social or vocational. The term "Problem Gambling" includes, but is not limited to, the condition known as "Pathological", or "Compulsive" Gambling, a progressive addiction characterized by increasing preoccupation with gambling, a need to bet more money more frequently, restlessness or irritability when attempting to stop, "chasing" losses, and loss of control manifested by continuation of the gambling behavior in spite of mounting, serious, negative consequences.

Gamblers no longer need to trek to Las Vegas or Atlantic City to find the action they crave. It is available today in their own hometowns.

Legalized gambling is one of the fastest growing industries in the United States. Gambling's tremendous popularity is evident in the recent increase in the number of off-track betting parlors (OTBs) and riverboat casinos that dot the Midwest and the Mississippi Delta. Billboards on major highways depict the action and excitement available at such facilities.

What is the difference between casual social gambling and pathological gambling?

Gambling can be defined as playing a game of chance for stakes. Gambling occurs in many forms, most commonly pari-mutuels (horse and dog tracks, off-track-betting parlors, Jai Alai), lotteries, casinos (slot machines, table games), bookmaking (sports books and horse books), card rooms, bingo and the stock market.

Pathological gambling is a progressive disease that devastates not only the gambler but everyone with whom he or she has a significant relationship. In 1980, the American Psychiatric Association accepted pathological gambling as a "disorder of impulse control." It is an illness that is chronic and progressive, but it can be diagnosed and treated.

The Custer Three Phase Model

Robert L. Custer, M.D., identified the progression of gambling addiction as including three phases:

• The winning phase
• The losing phase
• And the desperation phase.

During the winning phase, gamblers experience a big win or a series of wins that leaves them with unreasonable optimism that their winning will continue. This leads them to feel great excitement when gambling, and they begin increasing the amounts of their bets.

During the losing phase, the gamblers often begin bragging about wins they have had, start gambling alone, think more about gambling and borrow money legally or illegally. They start lying to family and friends and become more irritable, restless and withdrawn. Their home life becomes more unhappy, and they are unable to pay off debts. The gamblers begin to "chase" their losses, believing they must return as soon as possible to win back their losses.

During the desperation phase, there is a marked increase in the time spent gambling. This is accompanied by remorse, blaming others and alienating family and friends. Eventually, the gamblers may engage in illegal acts to finance their gambling. They may experience hopelessness, suicidal thoughts and attempts, arrests, divorce, alcohol and/or other drug abuse, or an emotional breakdown.

Who is affected?

Current estimates suggest that 3% of the adult population will experience a serious problem with gambling that will result in significant debt, family disruption, job losses, criminal activity or suicide.

Pathological gambling affects the gamblers, their families, their employers and the community. As the gamblers go through the phases of their addiction, they spend less time with their family and spend more of their family's money on gambling until their bank accounts are depleted. Then they may steal money from family members.

At work, the pathological gambler misuses time in order to gamble, has difficulty concentrating and finishing projects and may engage in embezzlement, employee theft or other illegal activities. IIAR works with employers to offer a comprehensive program of evaluation, treatment, counseling and support for employees and their families.