Gambling Disorders – A Growing Role for Primary Care Physicians

Gambling is a form of entertainment where people risk money or something of value on an event that is determined by chance. This could be the roll of a dice, the spin of a wheel or betting on a horse race. The purpose is to win a prize. Gambling is not a morally neutral activity and often has negative social, family and financial effects. Problem gambling, also referred to as gambling disorder, is an addiction that is characterized by compulsive behavior. This includes thinking about gambling all the time, ignoring other activities and spending more money than one can afford. It is a complex issue with many facets and varies from person to person.

Despite its popularity and legality in most countries, gambling can have serious consequences for individuals. It can have a major impact on their lives and families, including work, education and health. The emergence of Internet gambling and other forms of online gambling has increased the potential for problems. It is important to understand the risks associated with gambling and be able to recognize when someone is in danger of becoming addicted.

Many people use gambling as a way to escape reality and seek excitement. In fact, gambling is an industry that trades on people’s vulnerability to temptation and exploits their weaknesses. It appeals to the need for escapism and thrills by glorifying luck and superstition, while denigrating God’s sovereignty. It violates the 1st, 2nd and 10th commandments and enthrones selfish desires as idols (Proverbs 23:4).

A growing role exists for primary care physicians to evaluate patients for addictive disorders, including pathological gambling. However, there are many barriers to the identification of gambling-related problems in clinical practice, especially among adolescents and the underserved. In addition to a lack of awareness about gambling-related issues, there is an undersupply of assessment tools for these populations. A few recently developed instruments have been created to help clinicians identify youth at risk of developing a gambling disorder.

In addition, there is a need to develop new treatments for PG. Several studies have suggested that pharmacotherapies for SUDs may be useful in reducing symptoms of PG, but these strategies have yet to be proven effective in clinical practice.

There is a need to further investigate the effectiveness of psychosocial interventions for PG and to develop new medications that are more efficacious in treating this condition. The current treatment options are primarily based on pharmacotherapies, but the development of newer medications that address the underlying neurobiology of gambling may prove helpful in improving outcomes. This will require further research on the neural circuits regulating reward and motivation. In particular, the dopamine system appears to be central to PG and it is important to determine how this can be manipulated to treat PG. In the future, we may see new medications targeting the dopamine system to reduce impulsivity and cravings and increase recovery from impulsive gambling behaviors.