Gambling Addiction

Are these “behavioral addictions” truly addictions?

During my medical training, I went to Peru with my now ex-wife to learn Spanish and to see how medical care is provided in a different part of the world. We visited an uncle of hers whom I had heard had suffered from problematic gambling. He gave us a tour of his picturesque town in Southern Peru and was quite excited to show us the new casino that had just been built. We later learned that his wife had forbidden him to enter this building under any circumstances. Once we were in the casino, he promptly ditched us and bunkered himself into a corner with a nickel slot machine. We couldn’t get him out. The look in his eyes was a combination of ecstatic and demonic. He appeared feverish. He was putting coins in the machine faster than I though was mechanically or physiologically possible. When we tried to convince him to leave, he didn’t appear to hear us.

Where did he go? What was happening? I wasn’t, at that point, aware that there even was such a thing as gambling addiction.

Is gambling truly an addiction? What about other “behavioral addictions” such as binge eating disorder, compulsive sexual behavior, porn addiction (which brought down a couple we were friends with – the husband completely lost interest in his wife), problematic internet use, problematic video game playing, kleptomania, and compulsive buying disorders?

Do we just call these things “addictions” as a shortcut, or do they truly overlap with addictions such as to opioids or alcohol?

Gambling Disorder as an Addiction

Gambling addiction can be profoundly destructive. It is associated with impaired functioning, reduced quality of life, and high rates of bankruptcy, divorce, and incarceration. In fact, 44% of those with gambling disorder report loss of savings or retirement funds and 22% report loss of homes, or automobiles, and pawning valuables. It can put you into poverty. People steal, they embezzle, and they write bad checks. Gambling disorder is associated with suicide, depression, anxiety disorders, as well as anti-social personality disorder. There is a huge overlap with substance use disorders, particularly alcohol. 35% to 63% of people seeking treatment for gambling disorder also screen positive for some type of drug addiction.