• Revenue Cycle Management
  • COVID-19
  • Reimbursement
  • Diabetes Awareness Month
  • Risk Management
  • Patient Retention
  • Staffing
  • Medical Economics® 100th Anniversary
  • Coding and documentation
  • Business of Endocrinology
  • Telehealth
  • Physicians Financial News
  • Cybersecurity
  • Cardiovascular Clinical Consult
  • Locum Tenens, brought to you by LocumLife®
  • Weight Management
  • Business of Women's Health
  • Practice Efficiency
  • Finance and Wealth
  • EHRs
  • Remote Patient Monitoring
  • Sponsored Webinars
  • Medical Technology
  • Billing and collections
  • Acute Pain Management
  • Exclusive Content
  • Value-based Care
  • Business of Pediatrics
  • Concierge Medicine 2.0 by Castle Connolly Private Health Partners
  • Practice Growth
  • Concierge Medicine
  • Business of Cardiology
  • Implementing the Topcon Ocular Telehealth Platform
  • Malpractice
  • Influenza
  • Sexual Health
  • Chronic Conditions
  • Technology
  • Legal and Policy
  • Money
  • Opinion
  • Vaccines
  • Practice Management
  • Patient Relations
  • Careers

Gambling Addiction: When Finances and Medicine Meet


Gambling addiction is another one of those afflictions that people are uncomfortable to acknowledge and talk about – but it is much more widespread than most of us are aware.

Lifestyle, Columns, Personal Finance, Finances, Gambling Addiction, Psychiatry

Gambling addiction is another one of those afflictions that people are uncomfortable to acknowledge and talk about — but it is much more widespread than most of us are aware. This addiction falls right at the intersection of personal finance and medicine, so we need to make sure the problem stays in the light of day and we keep it in our personal and diagnostic sights.

Estimates are that 2.5 million Americans are pathological gamblers, with an additional three million so-called “problem gamblers” and 15 million “at risk.”

Gambling disorder, as it is referred to, is an impulse control problem that is often associated with other behavior and mood disorders, such as attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD), substance abuse, and depression.

The problem pretty much always involves money issues, relationship issues, job issues, and pyramiding stress. People around gamblers usually become aware even though there is a tendency to try to keep the gambling secret or to rationalize and externalize blame.

The proliferation of online gambling, fantasy sport leagues, Indian casinos, and budget-challenged states opening lotteries and licensed commercial casinos have only facilitated an increase in the problem.

For instance, did you know that commercial and Indian casinos each do about $30 billion a year? Or that only Hawaii and Utah have no legalized gambling? Or that Rhode Island leads the nation in reliance upon gambling revenues per person, even exceeding Nevada? Or that Pennsylvania has rapidly become only second to Nevada in total gambling take? Or that 11 million Americans do online gambling, chiefly with unregulated off-shore sites? Or that Macao far exceeds Las Vegas as the number one gambling mecca in the world? Who knew?

The good news is that help is available. Even casinos have (admittedly small, discrete) signs directing people to help hotlines. But they have an obvious conflict of interest and haven’t gotten rich by keeping people away. How can a casino owner not make a fortune knowing what we know about casino gambling?

The internet is, of course, a trove of useful information. But the first, and hardest, decision, like with other behavioral problems, is to admit that a problem exists and that you need help. As you all know, people do not like to admit these things, to themselves or others.

But once done, counseling and medication for the underlying mood and/or substance disorder is easily available, and now more widely covered by insurance than ever, in part due to a provision of the Affordable Care Act. Credit counseling can also help get the usually deeply indebted gambler out of the hole, once they have stopped digging, that is.

Other ways to stay on track are to stick with only non-gambling friends and give control of your finances, credit cards etc., to your spouse or similar, if only until out of the woods. Finding a new fun activity, doing daily exercise, and cognitive behavioral therapy have also been show to help. It isn’t easy to break compulsive habits, but these ideas will 1) remove tempting exposure, 2) take the necessary money out of your pocket, 3) fill your time and 4) help restore self-esteem that was inevitably lost.

Gambling in its many forms has a casual appeal, but when it becomes an obsessive preoccupation it can take over lives and ruin the personal finance structure that we strive so hard to improve. Meaningful and fulfilled lives require knowledgeable control of money. When we lose this ability in our society, because of a gambling addiction, we are doubly handicapped and require help.

Related Videos
Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice