The Madison County Council on Alcoholism & Substance Abuse, Inc.

What does Gambling Have to Do With Substance Use?

brought to you by BRiDGES

Katie Byrd
Prevention Educator

March is Problem Gambling Awareness Month.  You might be asking yourself why would Madison County’s Council on Alcoholism and Substance Use be addressing gambling?

The answer is that not only do we see people become addicted to gambling, like substances, but often we see these addictions co-occur, which means they are both happening simultaneously in the same person.

Most people can gamble without developing an addiction, but there are times when someone’s casual gambling becomes problematic.  Gambling disorder, is recognized in the Diagnostic Statistical Manual-5 (DSM-5) as a behavioral addiction and, according to surveys, affects two million people in the US.  In addition to this, survey answers also indicated that as many as 20 million people in the US are experiencing problem gambling.1  The surveys asked questions that pertained to the DSM-5 diagnostic criteria for gambling disorder and problem gambling.  Those criteria are as follows:
A person requires at least four of the following issues to take place during the past year:

  1. A person feels the need to gamble with an increasing amount of money in order to achieve the desired excitement.
  2. A person becomes angry, restless or irritable when someone tells them to cut back on their gambling, or to stop it altogether.
  3. A person will have unsuccessfully tried to cut back or stop gambling on their own.
  4. A person has frequent thoughts about gambling, including reliving past gambling adventures, planning their next gambling outing, and thinking of ways to get money to gamble with.
  5. A person will often gamble when they are feeling distressed.
  6. After a person loses money, they return to try and “get even” (referred to as “chasing” one’s losses)
  7. A person will not hesitate to lie to hide their gambling activity.
  8. A person will jeopardize or lose a significant relationship, job or educational/career opportunity because of gambling.
  9. A person will begin relying on others to help with money problems caused by their gambling habits.2

Many of these diagnostic criteria are the same that we see in substance use disorders, tolerance, preoccupation, unsuccessful attempts to stop, restlessness/irritability when trying to stop the behavior, and escalation over time.  In addition to similarities in diagnostic criteria, we also see similarities in age of onset, gender, age projection, triggers, life problems (financial, social, legal, and work), and a high instance of depression and suicidality.3

Studies have found a strong correlation between gambling disorder and substance use disorder, including nicotine dependence.  More than half of the people diagnosed with gambling disorder are also nicotine dependent1.  One sample showed that 52% of the participants had a co-occurring substance use disorder.3  The risk factors for gambling disorder and substance use disorder are almost identical and include a family history of addiction, impulse control issues3, ease of access, and parental behavior.4, 5

To have a better understanding of the link between substance use disorders and gambling disorders, we need to look at the biological mechanisms of addiction.  Addiction is caused by the rewards center of our brain being activated.  When engaging in an activity our brain finds pleasurable, a chemical called dopamine is released.  Some activities, such as the use of certain mind-altering substances and wins in gambling can cause our dopamine to surge more than others.  We then want to repeat these activities to achieve the same good feeling.  Over time we begin to crave those ‘highs’ and return to the intense sensory experience that brought them to us.

Knowing what we know about addiction and the brain, it is easy to see why someone who becomes addicted to one thing may easily become addicted to another.  They could be trying to find different ways to achieve a high or they could simply be genetically predisposed to addiction.  Other possibilities include correlating behaviors, for example alcohol being served at casinos or smoking being allowed at casinos while prohibited elsewhere.  Additionally a common occurrence we see is people who have been in recovery from substance use then turning to gambling.6  This replacement addiction may be seen as a less damaging alternative, but still a rush.  The brain has been rewired to seek that dopamine reward.

In the wake of the legalization of online sports betting across New York State, numerous betting apps have begun to take center stage in a place where you once had to physically travel to a casino in specific areas to gamble.  The new ability to wager money online has made it easier for people to engage in this activity when and where they want and in increased frequency.  Due to the nature of co-occurring disorders and the correlation between gambling disorder and substance use disorders, it is important to watch for the following indications of problem gambling in yourself and/or loved ones, if you choose to partake in gambling.
Physical symptoms of excessive gambling include problems sleeping, weight gain or loss, dark circles under the eyes and extreme headaches.

  • Keeping gambling habits a secret
  • Having trouble controlling their gambling habit
  • Continuing to be involved with a gambling habit when they cannot financially afford to do so.
  • Resorting to illegal activities to pay for their gambling habit1

If you or someone you know is suffering from a gambling problem reach out to the NYS Problem Gambling Resource Centers

To learn more about how pre-teens and teens move from gaming to gambling please join us for our free webinar, The Blurred Lines Between Gaming and Gambling.
Register here:
March 30th 6-7pm EST
March 31st 11am-12pm EST

1. Riddle, John. (2020, October, 9). Gambling Addiction: Stats, Symptoms, and Treatment Options. Psycom.

2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013. [Google Scholar]

3. Grant, John E., & Chamberlain, Samual R. (2015). Gambling Disorder and Its Relationship with Substance Use Disorders: Implications for Nosological Revisions and Treatments. The American Journal on Addictions, Vol 24. (Issue 2), Pages 126-131).

4. Rash, Carla J, Weinstock, Jeremiah, & Van Patten, Ryan. (2016). A Review of Gambling Disorder and Substance Use Disorders. Substance Abuse and Rehabilitation, Vol 7. (Pages 3-13).

5. Centers for Disease Control and Prevention. (2020, October, 22). High-Risk Substance Use Among Youth. Adolescent and School Health.

6. PsyGuides. (2020). The Connection Between Gambling and Substance Abuse. An American Addiction Centers Resource.

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