Gambling is an activity in which people bet money or something else of value on an event with a uncertain outcome. Although most people engage in gambling without problem, a small group of individuals develop serious problems with this recreational activity, which can lead to personal and social distress, family and financial devastation, and even crime and suicide. Despite its widespread popularity and social acceptance, gambling is controversial and a frequent subject of debate among both health care professionals and the public.
A growing role exists for the evaluation of patient gambling behaviors in primary care settings, especially when the patient has a diagnosable addictive disorder such as pathological gambling.1 This article reviews the evidence that defines the disorder and discusses screening strategies and treatment options for problem gambling. It also provides a framework for the discussion of the social impact of gambling, which is rarely included in studies of gambling and its impacts on society.
The definition of gambling is broad and can encompass any monetary activity that involves betting, such as a lottery, sports wagering, casino games, or even the purchase of daily fantasy sports teams. In the clinical and neurobiological literature, these various activities are grouped together into a single category of “gambling” based upon their consistent phenomenology, and many problem gamblers have reported engaging in multiple types of gambling. Several commonalities exist across these different types of gambling, such as:
While most people engage in gambling for entertainment or to make money, a small subset of individuals develop problems with this recreational activity. Problem gambling is defined by the Diagnostic and Statistical Manual of Mental Disorders as a persistent, recurrent pattern of gambling behavior that is associated with substantial distress or impairment. Symptoms include:
Research on the economic impact of gambling has focused mostly on the monetary costs or benefits and have often ignored social impacts, which are non-monetary in nature. Several authors have suggested that the concept of social cost is an important tool in assessing gambling’s overall impact on society, including Walker [37] and Williams et al. [32].
In addition to its entertainment and profit potential, gambling can also have positive educational and developmental outcomes. It can teach valuable skills such as pattern recognition and critical thinking, and it can help with the development of math and statistics skills. In addition, it can be a great way to socialize with friends and family in a safe and enjoyable environment.
Nevertheless, it is important to recognize that gambling is not only an enjoyable pastime for most, but can cause significant harm and loss to some individuals. Understanding the complexity of these issues can help us to better understand why so many individuals continue to gamble, even when they are aware that their habit may be causing them personal and social hardship. This understanding can ultimately lead to better gambling policies and treatment methods. Gambling is a complicated issue, and it’s important to remember that it affects everyone, from the professional trader on Wall Street to the old lady at the penny slots.