The Facts, Figures and Genetics of Compulsive Gambling

Gambling has been a part of human culture from the earliest days of human interaction. Archaeologists have even discovered six-sided dice dating back to 3000 BC. It is also a major international commercial activity worth over $10 trillion. Jobs, tourism and taxes from the industry have a positive impact on the economy. Some forms of gambling such as lotteries have been used to raise funds for charitable projects in several countries. More than 80% of people are believed to have placed a bet or wager at one time or another, and about 26% of the human population gambles yearly. Although the practice is illegal or controlled by the government in some countries, some form of gambling is believed to occur all over the world.

While most people gamble responsibly — mixing a bit of gambling with other fun pastimes and not paying too much attention to their bets — some people develop harmful gambling. Harmful gambling has been associated with several unwanted consequences such as bankruptcy, lost time at work, crime, divorce, suicide and treatment costs. For people involved in harmful gambling, their families and communities, gambling is a source of considerable harm.

Harmful gambling also called disordered gambling, problematic gambling, or problematic gambling behavour, is a blanket term for any gambling that is excessive or undesirable. About 5.5% of the population meets the criteria for harmful gambling. There are two main types of harmful gambling:

1. Problem gambling, which is classified as being ‘at risk’
2. Gambling disorder, which is the more severe form

Problem gambling is a milder form of harmful gambling. Problem gambling accounts for two-thirds of harmful gambling. People with problem gambling have shown symptoms of harmful gambling but not enough symptoms to qualify as having a gambling disorder. People with problem gambling are at risk of developing gambling disorders. Sometimes people use the term ‘problem gambling’ to mean all kinds of harmful gambling but this is confusing.

Gambling disorder, also called compulsive gambling, ludomania, gambling addiction, or pathological gambling, is a mental health disorder. It is characterized by the uncontrollable urge to gamble even when gambling causes physical, social and psychological problems for you and interferes with your normal life. Gambling disorder accounts for one-third of harmful gambling. Gambling disorder is an impulse control disorder. People with this disorder cannot control the urge to gamble. People with gambling disorder continue gambling despite the negative consequences of gambling on their health, finances and relationships.

Gambling disorder often coexists with other mental health conditions such as mood disorders, anxiety, substance use disorders, attention-deficit/hyperactivity disorder and impulse control disorders. Several studies have been conducted into the coexistence (also called comorbidity) of gambling disorder and other mental health conditions and these were some of the findings:

The reported prevalence of harmful gambling varies in different countries due to different survey methods and cultural differences. However, wherever people gamble, harmful gambling has been reported. The rates of problem gambling are usually about double those for gambling disorder. The global average prevalence for harmful gambling  is about 0.5 to 7.6%.

The age of onset for harmful gambling is not fixed. People have developed the condition at any stage of their lives.

Data suggests that the natural course of gambling disorder ebbs, flows, tends to improve and can remit. This oscillatory pattern shows that individual and societal factors are involved. People with coexisting mental health disorders and a lack of social support are less likely to improve.

While gambling problems occur in all genders and at all levels of intelligence, certain groups have a higher risk of developing gambling problems than others. Research shows that the following groups have a higher risk of developing gambling problems than others:

• Men
• Young adults
• Single people
• Incarcerated people
• Low-income earners
• Unemployed people

There are additional factors associated with a higher risk. These include:

• Living close to gambling venues
• Lack of formal education
• Belonging to some religious groups
• Living in disadvantaged neighbourhoods
• Some indigenous and ethnic minority groups

Gambling stimulates the brain’s reward system just like drugs and alcohol do. Dopamine, a neurotransmitter, is a chemical in the brain released during pleasurable activities like eating. Dopamine is also released during gambling. The release of dopamine during gambling mimics its release in drug abuse. Dopamine release during gambling occurs irrespective of the outcome. The mere possibility of a reward is enough to trigger dopamine release. The effect of gambling on dopamine release and the subsequent thrill it produces explains why people with a gambling addiction will continue to gamble despite losing large sums of money. The thrill doesn’t come from winning but from the uncertainty or the anticipation of reward. High levels of dopamine release during gambling are associated with more severe gambling symptoms, leading people to become compulsive gamblers.  Other neurotransmitters in the brain such as norepinephrine, serotonin and glutamate,  have also been implicated in the development of gambling addiction.

• Preoccupation with gambling, constantly thinking of how to get more money to gamble
• A need to keep increasing the amount of money gambled to feel the same thrill
• Unsuccessful attempts to reduce or stop gambling
• Gambling as a means of escape from feelings of hopelessness, guilt, anxiety or sadness
• Lying about your gambling habit

• Restlessness or irritability when you try to gamble less
• Chasing losses by betting more to receiver lost money
• Hiding your gambling from your loved ones
• Losing or risking important relationships and opportunities because of gambling
• Depleting your savings to gamble
• Stealing or defrauding others to get money for gambling

When a person displays any of these symptoms but less than five of them, they are regarded as having problem gambling. People who exhibit five or more of these symptoms are considered to have a gambling disorder or to be compulsive gamblers.

Some people with compulsive gambling have periods of remission where they gamble less or not at all for a while. However, without treatment, remission is often followed by relapse.

To assess yourself and decide if you need professional help, you can take a free self-test online. There are several self-tests available online as simple questionnaires that help you determine if you need to seek professional help. You can find one here, here or here.

• It has been established that the level of gambling involvement differs between men and women.
• Men gamble more frequently and have more gambling problems than women. Men also have higher losses and wins than women. One study found that men gamble two times more than women, while a college study found that 91% of the male students gambled compared to 84% of the female students.
• Earlier findings showed that women prefer gambling based on chance and were more likely to gamble on scratch cards, lotteries, bingo and electronic gaming machines;  while men prefer gambling based on skill and favoured sports betting, wagers and table games. Recent research shows that women are have increased their participation in skill-based gambling.

• Women also find it harder to seek help for gambling problems because being a woman with a gambling problem attracts stigma.
• Women tend to begin gambling later in life than men but they develop gambling problems more quickly. Gambling addiction among women appears to be growing at more than double the rate seen in men.
• Harmful gambling was found in 2.9% of women and 4.2% of men. However, the factors responsible for this difference are unclear.

What are the genes involved in gambling?

The exact genes involved in gambling have not been identified yet. Many scientists think a particular gene responsible for compulsive gambling will not be found because of the complex nature of the condition.

A few studies conducted on the human genome failed to identify a specific gene or set of genes responsible for harmful gambling. The human genomic studies found some genetic relationship between gambling disorders, Parkinsonism and alcohol use disorders. Animal studies suggest that the genes involved could be those involved in the release of neurotransmitters.

What role does the environment play?

The environment plays a huge role in the development of compulsive gambling. Some studies place this role at 50%, while others think it might be higher. The following risks have been observed:

• People living with family members with gambling problems have a higher risk of gambling than others.
• Relatives of compulsive gamblers have a huge risk of developing compulsive gambling themselves if they live in disadvantaged neighbourhoods.
• Gambling is affected by the opportunities available. Cities with larger numbers of Electronic Gaming Machines per person were found to have higher gambling rates than cities with fewer machines.

There are no DNA tests for gambling addiction. The genes associated with gambling have not been identified, so genetic testing isn’t possible yet. However, you have a higher risk of developing gambling problems if your relative has gambling problems. Or if you have any of the risk factors earlier mentioned.

If mood disorders, obsessive-compulsive disorder or attention deficit disorders are part of the problem, the doctors may prescribe medication such as antidepressants and mood stabilizers. Antidepressants have also been used primarily to treat compulsive gambling. Medicines used for treating substance abuse, such as narcotic antagonists, can also be used.

Cognitive behavioural therapy and family therapy can be useful to overcome gambling addiction. Cognitive behavioural therapy focuses on unlearning harmful behaviour, learning skills to reduce the gambling urge and replacing negative beliefs with healthy ones.

Groups such as Gamblers Anonymous have proven to be useful for people who want to overcome problem gambling. Some people find that being in a group with other people who share the same goals is helpful.

Natural recovery for compulsive gambling is also possible, and evidence suggests that the symptoms tend to wane with age. People have recovered from problem gambling without any treatment, but this seems less likely with severe forms of the condition. Natural recovery from gambling addictions has not been fully studied.

In-patient, out-patient and residential treatment options are available.

Some steps you can take include:

1. Encourage them to seek professional help
2. Have open conversations about the problem and how it is affecting your relationship
3. Let them know you want to help
4. Support their treatment but don’t take over their responsibilities or pay their debts

You should also take steps to protect yourself from financial harm, such as:

• Closing any joint accounts
• Taking control of finances and bills
• Keeping financial records
• Safeguarding any assets and documents such as the house title or important certificates.
• You should also seek support for yourself and attend to your health and well-being.

Important – You must be 19 to gamble anywhere in Canada with the exception of the following regions which allow gambling at 18 : Montreal, Ottawa, Quebec, Manitoba, Alberta and Calgary