Gambling Disorders – A Growing Role For Primary Care Clinicians to Treat Gambling Disorders

Gambling is an activity that involves placing a bet on an event that is primarily determined by chance. It is a common activity and has existed in virtually every society throughout recorded history. It is a socially acceptable form of entertainment that can result in positive or negative personal, family, and financial consequences for the gambler. Although most people enjoy gambling as a recreational activity, a significant minority develop pathological gambling that requires intervention and can cause serious distress and impairment in their lives. There is a growing role for primary care clinicians to evaluate patients for gambling disorders.

A number of different activities can be considered gambling, but the core definition is the risking of something of value (known as consideration) on an event that is primarily dependent on chance with the intention of winning something else of value. This includes betting on a game of chance, such as horse racing or basketball, and on events that are not part of a game of chance, such as lotteries, bingo games, and card games.

The act of gambling is regulated by law in most countries and can be punished by fines, jail time, or probation. Misdemeanor convictions typically result in a year or less in prison, while felony convictions may carry up to 10 years in jail and/or hefty fines. In addition, many states have laws prohibiting certain types of gambling activities.

The most common forms of gambling include pari-mutuel racing (horse and dog tracks, off-track-betting parlors, Jai Alai), lottery games, casino gaming (slot machines and table games), sports wagering, and bookmaking (sports books and horse and race track odds). Besides these traditional forms of gambling, the Internet and other new technologies have allowed people to place bets around the clock and from any location with an Internet connection. Moreover, many video games and other online activities have gambling elements, making them attractive to young people and adults who do not gamble.

When someone gambles, their brain releases dopamine, a neurotransmitter that makes them feel excited. This feeling is most likely caused by the anticipation of winning, which is often heightened by advertising that shows how much money can be won and by the compulsion to play more. Whether they win or lose, this neurological response keeps them coming back for more.

There are a number of myths about gambling, including that it is addictive and that people are wired to gamble. These myths have not been proven scientifically, but they can be harmful to those who are struggling with a gambling addiction.