Gambling is the wagering of something of value on an event that is determined at least in part by chance with the intent to win something else of value. It requires consideration, risk, and a prize. While most people associate gambling with casinos and slot machines, the act can take many forms: betting on sports events, buying lottery or scratch-off tickets, playing bingo, and even participating in office pools can all be considered gambling. While there are professional gamblers who make a living from gambling, it has long been a socially unacceptable activity and, in fact, has sometimes been outlawed on moral or religious grounds or to preserve public order (for example, when gamblers engage in violence).
In addition to money, other goods and services may be wagered as stakes. Marbles and collectible trading cards, for instance, can be used as gambling stakes in games such as Pogs and Magic: The Gathering. This practice has the added benefit of allowing players to build up valuable sets of game pieces and create a meta-game around the value of those collections.
Despite the popularity of gambling, there are significant psychological and health problems associated with it. It is important to recognize the signs and symptoms of problem gambling and seek treatment as soon as possible. In the past, the psychiatric community largely viewed pathological gambling as a compulsion rather than an addiction, and it was only in 1980 that the American Psychiatric Association moved pathological gambling to the chapter on impulse control disorders along with other maladaptive behaviors such as kleptomania and pyromania.
The importance of evaluating for gambling-related issues in the context of primary care is growing as more and more people engage in this form of recreational behavior. It is estimated that at least two million Americans suffer from gambling addiction and, in some cases, the habit interferes with work and family life.
A growing body of evidence indicates that a gambling disorder is similar to other substance use disorders and can be successfully treated with cognitive-behavioral therapy, which teaches individuals how to resist unwanted thoughts and habits. In particular, a key component of this approach is helping the person to confront irrational beliefs such as the belief that a string of losses or a near miss (two out of three cherries on a slot machine) signals an imminent win.
Providing patients with access to resources that can help them overcome their gambling problem is also an essential step. These include peer support groups like Gamblers Anonymous, modeled on Alcoholics Anonymous, and other recovery programs. Additionally, counseling and family therapy can be helpful in addressing the myriad of issues that are often associated with gambling addiction, such as depression, anxiety, stress, and relationship difficulties. These issues, if left unaddressed, can lead to relapse. In some cases, inpatient or residential treatment may be necessary. These programs are aimed at those with severe gambling addiction and who cannot control their behavior without round-the-clock support.