0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letters   |    
Little Use of Treatment Among Problem Gamblers
John A. Cunningham, Ph.D.
Psychiatric Services 2005; doi: 10.1176/appi.ps.56.8.1024-a

To the Editor: Estimates of the prevalence of gambling problems range between .4 percent and 2.0 percent in the general population of the United States and Canada (1). Problem gambling has substantial costs, both economic and personal (1): the estimated economic cost of problem gambling in the United States is $5 billion, and the personal costs include jeopardized relationships and employment. Effective treatments for gambling dependence have been developed, and there is growing awareness in the general population and the treatment and research communities of the importance of providing these services (2).

Central to the planning of services for people with various addiction problems are estimates of the proportion of those in need who obtain treatment. Such information is often used to emphasize the importance of the development of additional services, because many addicted individuals who might benefit from help never receive it. Prevalence estimates of service use are available for most addictive behaviors, such as for alcohol abuse and dependence (3). However, one notable exception is problem gambling, perhaps because epidemiologic surveys of addictive behaviors rarely ask about both gambling problems and use of treatment services. One recent exception was the 2002 National Epidemiologic Survey on Alcohol and Related Conditions, a face-to-face survey of a large (N=43,093), nationally representative U.S. sample (4). Included in this survey was an assessment of gambling dependence that used DSM-IV criteria. The survey found a prevalence rate of .4 percent. Respondents who met a lifetime definition of gambling dependence were asked whether they had "ever gone to Gamblers Anonymous" and whether they had ever gone to "any kind of counselor, therapist, doctor, psychologist, or any other person like that for help with your gambling?" Use of Gamblers Anonymous or treatment was low—6.7 percent and 5.1 percent, respectively; the combined rate of attendance for either was 9.1 percent. Further subgroup analyses were not possible because of the low prevalence rates of gambling dependence and treatment use.

Thus, even among people with severe gambling problems, only one in ten ever obtain any type of services. What can be concluded from these findings? They might be used as evidence that there is a need for more services for problem gamblers. Alternatively, the low prevalence of treatment use could be used as an argument that treatment is an epiphenomenon—a response provided by society to the existence of problem gambling that serves little or no purpose. Is there a middle ground between these conclusions? Problem gambling will rarely be treated, but it is worthwhile to provide services because they do help those who use them. Finally, are there ways to improve the accessibility of services for problem gamblers? Further research on barriers to obtaining gambling treatment might clarify why so few problem gamblers seek treatment. In addition, it is possible that the provision of a range of treatment services, both inside and outside the walls of traditional treatment services—for example, intensive, brief, and self-help interventions—might allow more people with gambling dependence to seek help for their problems (5).

Dr. Cunningham is affiliated with the social, prevention, and health policy research department at the Centre for Addiction and Mental Health in Toronto, Ontario.

Petry NM, Stinson FS, Grant BF: Comorbidity of DSM-IV pathological gambling and psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 66:564—574,  2005
[PubMed]
[CrossRef]
 
Petry NM, Armentano C: Prevalence, assessment, and treatment of pathological gambling: a review. Psychiatric Services 50:1021—1027,  1999
[PubMed]
 
Cunningham JA, Breslin FC: Only one in three people with alcohol abuse or dependence ever seek treatment. Addictive Behaviors 29:221—223,  2004
[PubMed]
[CrossRef]
 
Grant BF, Stinson FS, Dawson DA, et al: Co-occurrence of 12-month alcohol and drug use disorders and personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 61:361—368,  2004
[PubMed]
[CrossRef]
 
Hodgins DC: Implications of a brief intervention trial for problem gambling for future outcome research. Journal of Gambling Studies 21:13—19,  2005
[PubMed]
[CrossRef]
 
+

References

Petry NM, Stinson FS, Grant BF: Comorbidity of DSM-IV pathological gambling and psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 66:564—574,  2005
[PubMed]
[CrossRef]
 
Petry NM, Armentano C: Prevalence, assessment, and treatment of pathological gambling: a review. Psychiatric Services 50:1021—1027,  1999
[PubMed]
 
Cunningham JA, Breslin FC: Only one in three people with alcohol abuse or dependence ever seek treatment. Addictive Behaviors 29:221—223,  2004
[PubMed]
[CrossRef]
 
Grant BF, Stinson FS, Dawson DA, et al: Co-occurrence of 12-month alcohol and drug use disorders and personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 61:361—368,  2004
[PubMed]
[CrossRef]
 
Hodgins DC: Implications of a brief intervention trial for problem gambling for future outcome research. Journal of Gambling Studies 21:13—19,  2005
[PubMed]
[CrossRef]
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Web of Science® Times Cited: 27

Related Content
Books
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 45.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 4.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 49.  >
Topic Collections
Psychiatric News