Pathological Gambling and Poly-Behavioral Addiction
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Pathological Gambling and Poly-Behavioral Addiction
Overview
Summary
"What Happens in Vegas (Losing) Stays in Vegas (Your Money)"During a recent trip to Atlantic City for a family reunion, I noticed a neon sign reading, "You drive, you speed, you lose." After spending a week there, I suggested a tweak: "You drive to Atlantic City, you lose." Whether in Las Vegas, Atlantic City, or online, gambling can draw people in, leading to significant losses. An estimated 20 million Americans experience gambling issues, losing roughly $0.5 trillion annually (Feigelman, 1998). The tax burden falls on all of us to cover societal costs of $5 billion yearly due to problem gambling. The real winners? Casino owners and stockholders.
Key Points
The Gambling Epidemic
Approximately 2 million Americans are pathological gamblers, 3 million are problem gamblers, and 15 million are at-risk (NGISC, 1999). The costs to society are staggering, affecting healthcare, bankruptcy, crime, and more.
Challenges in Treatment
Two national surveys highlight that 61%-64% of individuals who attempted to quit gambling relapsed within a year (NGISC, 2002). A possible reason for poor treatment outcomes is the failure to address other co-existing behavioral addictions.
Diagnosing Pathological Gambling
Pathological Gambling is marked by recurrent gambling behaviors disrupting personal, familial, or vocational pursuits. It involves losing control, obsessing over money for gambling, and continuing despite negative consequences (DSM-IV-TR, 2000).
Screening and Tools
Tools like the South Oaks Gambling Screen (Lesieur & Blume, 1987) and the LIE/BET questionnaire (Johnson, 1997) aid diagnosis. It is vital to recognize related addictions when treating pathological gambling.
Poly-Behavioral Addictions
Many gamblers also struggle with alcohol abuse, depression, and dependencies such as sex, food, and religious addictions. Treating one addiction when others exist is often ineffective, highlighting the need for comprehensive assessments.
The Complexity of Addictions
Religious addiction can accompany other addictions as individuals seek rewarding behaviors to alleviate guilt. Similar to other addictions, it involves cravings, loss of control, and continued use.
Addicts often come from backgrounds of co-dependence, poor parenting, and trauma. Successful treatment must address all facets of an individual's life.
A New Approach
Proposed Diagnostic and Treatment Framework
The DSM-IV-TR lacks a diagnosis for complex, poly-behavioral addictions. A new multidimensional diagnosis, Poly-behavioral Addiction, is proposed to better address the intertwined nature of behavioral and substance addictions.
A Multidimensional Treatment Plan
Successful outcomes depend on thorough assessments and comprehensive treatment plans addressing all aspects of addiction. A proposed Addictions Recovery Measurement System (ARMS) aims to address these needs, integrating holistic care across multiple dimensions.
Conclusion
To combat pathological gambling and poly-behavioral addiction, coordinated efforts among service providers, government, and community organizations are crucial. Support for mental health and addiction programs is vital. Tools like the ARMS can be instrumental in fighting this battle effectively.
For more information, explore resources like Gamblers Anonymous and Alcoholics Anonymous, as well as Dr. James Slobodzien's work on Poly-Behavioral Addiction and the Addictions Recovery Measurement System.
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