Gambling Addiction: Discussion Board Responses

I. Unit 1

A. The act of wagering monetary or material goods on an event’s results has been around for thousands of years. Most recreational activities that can manifest themselves into addictions when abused, (gambling included) began as activities for amusement or even benefit of the participant. In the United States specifically, regulations on gambling have led to tourism centered areas that legally permit and heavily advertise gambling, and illegal activity in other areas that do not allow gambling. Tourist destinations that are heavily marketed towards those who participate in gambling, make gambling accessible and socially acceptable to partake in. Casino games and destinations that portray the image of lavishness and pleasure associated with gambling exacerbate the number of people who have problems with gambling; by attracting those who already have problematic gambling issues, and those who may have addictive personality traits who can fall victim to the seduction of the positive and enjoyable image that gambling can portray.

B. Responses to classmates’ discussions

I. I agree with you in that gambling began as a recreational activity. However, I think to assert that gambling in itself is dangerous for anyone to partake in is a blanket statement. Those who have addictive personalities are at a much higher risk for abuse of any recreational activity, not just gambling. But, to use the wreckage caused by problem gamblers or gambling addicts as the basis for whether gambling presents enough danger for all to abstain from gambling, neglects to take into account that there still is a recreational factor that some can partake in, in a healthy manner.

II. The rush of dopamine is indeed a factor that can lead to people becoming addicted to the “rush” of gambling, just like an illegal substance or alcohol. The consequences of gambling addiction you listed are accurate also; the insanity of addiction will lead to a complete loss of control in the addict’s life. However, the logic you employed that changes to our economic and monetary system lead to gambling addicts “spending way too much money” is not necessarily accurate. In active gambling addiction, the gambler having access to large amounts of money or resources might sustain the gambling for a time, but inevitably the disease of addiction is what drives the gambler and his preoccupation with gambling. Not access to monetary or material goods.

II. Unit 2

A. Addiction is recognized in the DSM as a mental disease. Gambling is one way that the disease of addiction can manifest itself. The disease of addiction lives within the brain’s higher cognitive thinking center – which leads to impulsivity and inevitably unmanageability in the gambling addict’s life, if the addiction remains untreated. For gambling specifically, this can lead to a wide range of consequences depending on what stage of addiction the consequences are observed at. Any level of unmanageability, (personal, familial, fiscal, occupational) is known to be a symptom of addiction. But the varying degrees of these symptoms, leads to different definitions of gambling addiction. A misconception is that gambling addiction is defined by the severity of these symptoms, rather than by the underlying disease in itself.

B. Responses to classmates’ discussions

I. Your hypothesis seems to be correct, as to why there are so many varying definitions of what gambling addiction is. There are different stages, and degrees to which addiction has manifested itself in individuals. These symptoms vary, from case to case – so they cannot be used to define what gambling addiction is, only ways it manifests itself.

II. This assertion succinctly defines what problematic gambling is. The addiction begins as a recreational activity, and leads to destructive behavior to maintain the gambling. As typical of addiction, consequences have little effect on the gambler – as the obsession to continue gambling outweighs any rational thinking.

III. Unit 3

A. Custer and Lesieur’s three stages of gambling addiction (winning, losing, and desperation) are applicable to the progressive stages of gambling addiction, as it is currently understood. The euphoric effects of chancing and winning initially hooks the gambler, but inevitably the gambler loses after a certain amount of time. The exhilaration associated with winning initially is what drives the addict to continue gambling, thus resulting in desperation or resorting to illegal or morally frowned-upon ways to fund the gambling habit. Technological advancements have no bearing on the progression of the gambling, only different ways that the addict can gamble.

B. Responses to classmates’ discussions

I. Progression of addiction in general can be characterized by stages similar to those coined by Custer and Lesieur. One partakes in an activity that results in high levels of dopamine and serotonin being released in the brain, those levels eventually falter due to withdrawal from the activity or negative consequences, and in desperation to achieve the euphoria again the addict will succumb to whatever means necessary. The phrase “chasing the dragon” is an appropriate one for the cyclical nature of how addiction progresses.

II. Modern technology has very little to do with how addiction progresses. Modern advancements may make gambling more accessible to addicts, but does not affect the model and stages of addiction progression. The “winning, losing, and desperation” concepts can be transferred to any addiction and remain appropriate, the terms are just specific in this case to gambling.

IV. Unit 4

A. Physical and emotional signs of a person that is struggling with a gambling addiction can tip family and friends of the gambler off of a problem, despite the addict’s best attempts to hide any issues. Observed symptoms of gambling addiction in problematic gamblers include, but are not limited to: pathological lying (to obtain money, appease fears of family and friends that there is a problem, or escape from responsibilities to continue gambling), money related problems, lack of personal care, and becoming increasingly irresponsible and non-dependable.

B. Responses to classmates’ discussions

I. The symptoms listed are absolutely indicative of a gambling addiction. They are common among all addictions and are signs of the unmanageability in the addict’s life, as the addiction has become priority to maintain. However, these symptoms may not be noticeable for quite some time.

II. These symptoms of gambling addiction can be applied to most who suffer from the disease of addiction. The disease of addiction is rooted in self-centeredness. The addictive gambler becomes obsessive about maintaining the gambling, selfishly disregarding any other responsibility or relationship that is not associated with such.

V. Unit 6

A. Experience with a personal friend of mine, who suffers from the disease of addiction (manifesting itself in both drug and gambling addiction) has resulted in personal insight in how to approach addicts who are in denial about having a problem, and this denial being exacerbated by cultural upbringing. This personal friend’s gambling addiction preceded his addiction to narcotics, and progressed to the point of having to lie and steal from family members to sustain gambling habits. However there was an extreme amount of opposition to admitting that he suffered from the disease of addiction, until the drug use progressed to the same point. This was powerfully related to his ‘Old-School’ Italian upbringing. In his own words, “We Italians are pig-headed individuals. It took me a long time to admit that there was a problem, let alone a problem I couldn’t fix by myself.” This can be related to an appropriate way of counseling those of different cultural backgrounds, and how focusing on how the gambling is but a symptom of a disease not a matter of self-will, is a suitable way to approach clients of different cultural backgrounds.

B. Responses to classmates’ discussions

I. Cultural backgrounds do need to be taken into consideration when considering how to approach a client’s treatment plan. Depending upon cultural beliefs, a client could become more or less receptive to treatment options depending upon how they are presented. Some cultures are less receptive to criticism, and a great many people (regardless of cultural background) still believe that addiction is not a disease. To impress upon a client the severity of addiction, it’s important to note cultural beliefs, to best address how this is done, to achieve the best results.

II. Do you believe that being white had any bearing on his receptiveness to the warnings you heeded to your friend? It seems that your friend may have experienced enough of a ‘rock bottom experience’ with their gambling to rationally consider whether placing a bet would be wise or not. It would also be important in this situation to impress upon your friend that the disease of addiction is progressive, chronic, and fatal – if not treated properly.

VI. Unit 7

A. Those with addictive personalities, or who have the disease of addiction in a different form than gambling (sex, drugs, alcohol, shopping, etc.) are at much higher risk for a cross-addiction, or to substitute one addiction for another. Doing a risk-assessment test or screen for gambling problems is vital to provide appropriate therapy for a client. The consequences of ineffectively addressing and educating clients of possible risks to gambling addiction could ultimately lead to a substitution of gambling for another addiction. This could lead to the same unmanageable symptoms as other addictions, such as substance abuse: financial and legal problems, isolation from family and loved ones, and dishonesty and self-centered behaviors.

B. Responses to classmates’ discussions

I. Education is key to any person who has an addictive personality, or at high risk for developing a gambling problem. Addiction can only be truly recovered from when all addictive behaviors are ceased. Screening for this risk can help prevent these symptoms you’ve listed from manifesting.

II. There are in fact, physical symptoms related to gambling addiction. They may not be as severe or noticeable as drug addiction, but the addiction can progress to the point where personal well-being is neglected, as in any addiction. It is, however imperative to assess the risk the client has to potentially developing or possessing a gambling problem, as gambling is not a tangible narcotic or substance that affects physical motor skills, as drugs do.

VII. Unit 8

A. Many who seek addiction treatment have legal problems as a result of their addictions. Having a knowledge of current legislation and laws regarding gambling, can be of benefit to counselors of gambling addicts. An addict coming in seeking treatment with current legal issues related to a gambling addiction, might only be able to focus on the legal issues at hand – which would inhibit any real progress to be made in counseling. A knowledge of gambling laws and regulations, and state laws in general may ease the client’s fears of legal repercussions enough to proceed with therapy. Knowledge of gambling laws also can serve as a tool for counselors looking to dissuade clients from partaking in illegal activities, if gambling is prohibited in their area.

B. Responses to classmates’ discussions

I. Generally speaking, current laws do not give much insight regarding the underworld of gambling. This knowledge is gained through working with gambling addicts. A thorough knowledge of the disease model of addiction, client’s improvements, and necessity of treatment are the only professional advocacy a counselor can provide for a client who has legal problems relating to addiction, not legal counsel or advice.

II. It’s my understanding that federally, gambling is legal in the United States. But gambling age is not dictated and regulated by the federal government, but by states instead. Familiarity with gambling legislation and regulations could have the potential to benefit families of addicts, as addiction is a family disease. Education of the family of the gambler would be just as important as educating the addict.

VIII. Unit 9

A. Understanding of the three models of gambling addiction will aid as a diagnostic tool for gambling addiction clientele. It serves to not only address which model the client resembles closest, but also will allow the counselor to appropriately create a treatment plan for the client. For example, it may not be appropriate for a counselor to suggest in-patient treatment for a client whose behavior closely resembles that of a ‘Behaviorally Conditioned Problem Gambler’, but might be appropriate for a client displaying behaviors that fit into the category of the‘Antisocial Impulsivist Problem Gambler’. Personally, I was unaware of the three categories, by their names – but they seem to encompass most people who may have a problem with gambling, and the different levels to which the addiction exists for individuals. The ‘Behaviorally Conditioned Problem Gambler’ category interests me, as I can draw parallels between the characteristics of one who might fall into that category, and someone whose drug addiction started as a physical dependence on medication. I would be interested to learn how one could successfully return to gambling after reaching a point where it became problematic enough to seek treatment.

B. Responses to classmates’ discussions

I. If one were to substitute “drugs” or “alcohol” in for the word “gambling” in these pathways, the behaviors and traits that are described would remain the same. The model of the disease of addiction does not change depending on the substance, or activity the addict indulges in. It is vital to have some sort of standard, like this expresses, to base therapeutic suggestions for treatment off of.

II. To effectively determine whether a client has underlying mental issues, or if addiction has manifested itself in other ways besides gambling, a thorough bio-psycho-social evaluation on the client is needed. With that data, the client and therapist can then effectively create a treatment plan for the problematic gambling. These pathways, as you asserted, are an excellent tool in formulating a plan of action for the client.

IX. Unit 11

A. There are several ways to address and assess clients’ risk for suicide. There are different questionnaires that clients can fill out upon admission to assess their risk of suicidal behaviors. The Safe-T (Suicide Assessment Five-Step Evaluation and Triage) and Suicide Behaviors Questionnaire (SBQ-R) forms both are effective in suicidal risk assessments of clientele. Both questionnaires address different factors that are involved in effectively assessing the risk that a client has of suicidal tendencies. Risk factors for suicide include history of prior suicide attempts, current or past psychiatric disorders, family history of suicide attempts, and stressors. Other internal and external factors play a role as well in assessing a client’s suicide risk – such as religious beliefs, and responsibility to children or family. A suicide inquiry is then performed to address whether or not the client has made a plan of action in carrying out the suicide, and the level of risk the client is to him/herself defines what steps are taken to prevent the suicide attempt. These can range from out-patient recommendation, to mandatory committal to a psychiatric facility. Although extenuating circumstances do arise when working in the field of mental health, where these assessments are not adequate in detecting suicidal thoughts, and there’s always the risk of the client being untruthful – but if the procedures are followed, there is much less of a risk to the client and therapist.

X. Unit 12

A. Cognitive Behavioral Therapy, and Substance Abuse methodology would be the best modalities to therapeutically use on clients suffering from any kind of addiction – whether it be substance dependence or a gambling problem. The identification of irrational thoughts through CBT is key in overcoming any addiction. A 12-step program, can then be implemented into the client’s life, but only after the insanity and irrationality is recognized, and understood to need a remedy. Although the original12-step program is Alcoholics Anonymous – alcohol was recognized to be but a symptom of the underlying disease of addiction. This remains true to this day, as other 12-step fellowships exist to address specific addictions others may have, including GA – or Gamblers Anonymous.

XI. Unit 13

A. Recovery from gambling addiction is not something that the addictive gambler will be able to conquer on his/her own. The support network of people from a 12-step fellowship will be vital in preventing relapse into active gambling again. As addiction is a family disease, the addiction affects the family of the gambler just as much as the addict. (Although the family of the gambler cannot force them into recovery, it has to be a personal decision and willingness on the part of the addict to want to better themselves) Al-ANON meetings help those who are close to addiction and those afflicted with the disease. A huge part of recovery from gambling is the family and loved ones of the addict learning to no longer enable or support the habits that lead to active gambling.

XII. Unit 14

A. If a theoretical client was diagnosed as being cross-addicted to gambling and to other substances, such as alcohol – these two addictions would need to be dealt with simultaneously. One very likely exacerbates the other, and the client will have very little chance at success if one is dealt with separately from the other. Addictive behaviors in any sense typically will lead to relapse in whatever form the addiction manifests itself strongest. The cross-addict will never be able to successfully drink or gamble. Smoking however, (although detrimental to ones health in the long run) is a crutch that many in early recovery hold on to, or pick back up again – as a temporary void-filler. Most counselors and those working a 12-step program will recommend only giving up the addictions that have, or have the propensity to make one’s life unmanageable first, before attempting to give up smoking as well.

XIII. Unit 16

A. Having client involvement when formulating a treatment plan is necessary, as the client is going to be the one implementing the plan into his or her life. Besides taking measures to change addictive gambling behaviors, it’s important for the client to make both short and long term goals to be achieved through recovery from addiction. Many clients will feel a sense of loss, or impending boredom without the gambling – so addressing types of healthy leisure activities or goals the client can work towards achieving is vital to long-lasting recovery. A relapse plan of action is just as important. Should cravings to engage in gambling occur, the relapse plan is vital in providing the client with a step-by-step process in order to work through these feelings, without relapsing into old addictive behaviors.

XIV. Unit 17

A. Some of the most important parts to any relapse plan are the steps one takes to prevent the relapse from occurring in the first place. Warning signs, or recognition of emotional or physical triggers that could send the client into an obsession with gambling are to be avoided. Supportive friends to call (typically from a 12-step program), and distractions the client can engage in to allow the craving to pass are all important factors in preventing relapse. Should relapse occur, another important part of the relapse plan is what the client should do and how it should be handled.

XV. Unit 18

A. The public health approach to the disease of addiction is a ‘three-prong’ system. The three tenants of the public health approach are the host, the agent, and the environment. The concept is that to affect any one of the tenants will have an effect on the other two. An example of this is the harm reduction strategy, which is a public health approach to addiction control. Methadone programs, while only being a substitute opiod, are aimed at providing relief for opiate/heroin addicts, therefore reducing the crime and ‘harm’ on the general public. The public health model focuses on the general health of the public, whereas the traditional healthcare system focuses on the health of the individual, and their personal needs regarding treatment for addiction. The public health system does support that education of the general public of addiction would result in fewer people engaging in addictive behaviors. This is debatable, but education in any sense is never of detriment to anyone, including clients.

XVI. Unit 19

A. The social impacts of pathological gambling can be costly and be of detriment to society. A high amount of money is lost in areas that are highly affected by pathological gambling. This can be related back to job loss due to addiction, as well as bankruptcies and prison fees. Although having a large number of people affected in one area by a specific addiction, is tempting to try and address through a public health model, to truly address and remedy the problem of gambling addiction in society, a combination of education on the disease of addiction and a medical model approach to each individual case is necessary.

XVII. Unit 20

A. Natural recovery from gambling addiction states that those who suffer from a gambling problem, may not have the same ‘kind’ of addiction as others do – as it is not characterized by being progressive or chronic, because given the chance some people show no symptoms of gambling relapse, through “natural” causes. What is not addressed in the study, is whether or not these participants in the study had transferred their addictions from gambling, to other addictive behaviors that were not addressed within the limits of the study. Promotion of natural recovery entails a risk, as even in the single study – no where close to a majority of people were able to “naturally” recover from pathological gambling. Gambling addiction is recognized in the DSM-IV to be a mental disorder; similar to substance abuse, there will always be exceptions to the rule of thumb, that a 12-step program is the cure-all, but for the majority of cases natural recovery is not a viable option; it promotes apathy in actively working a program of recovery. Which, in the very worse case scenario (if natural recovery does not work) could lead to death of the client.

Reference

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). doi:10.1176/appi.books.9780890423349