You Bet Your Life: Gambling as an Addiction

DASA Treatment InstituteJuly 6-8, 2006

Linda Graves, MA, NCGC-IIProblem Gambling Program ManagerDivision of Alcohol and Substance Abuse

DSM-IV CriteriaSubstance Dependence 303.90

A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

• Tolerance, as defined by either of the following:– A need for markedly increased amounts of the substance to achieve intoxication

or desired effect– Markedly diminished effect with continued use of the same amount of the

substance.

• Withdrawal, as manifested by either of the following:– The characteristic withdrawal syndrome for the substance– The same (or closely related) substance is taken to relieve or avoid withdrawal

symptoms

• The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance

DSM-IV CriteriaSubstance Dependence 303.90

DSM-IV criteriaPathological Gambling 312.31

A. PERSISTENT AND RECURRENT MALADAPTIVE GAMBLING BEHAVIOR AS INDICATED BY AT LEAST FIVE OF THE FOLLOWING:

1. Is preoccupied with gambling

2. Needs to gamble increasing amounts of money in order to achieve the desired excitement

3. Has repeated unsuccessful efforts to control, cut back, or stop gambling

4. Is restless or irritable when attempting to cut down or stop gambling

5. Gambles as a way of escaping from problems or of relieving a dysphoric mood

6. After losing money gambling, often returns another day in order to get even

7. Lies to family members, therapist, or others to conceal the extent of involvement with gambling

DSM-IV criteriaPathological Gambling 312.31

DSM-IV criteriaPathological Gambling 312.31

8. Has committed illegal acts, such as forgery, fraud, theft, or embezzlement, in order to finance gambling

9. Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling

10. Relies on others to provide money to relieve a desperate financial situation caused by gambling

B. THE GAMBLING BEHAVIOR IS NOT BETTER ACCOUNTED FOR BY A MANIC EPISODE.

ACTION GAMBLERS

Often male

Competitive

Grandiose

Low frustration tolerance

ACTION GAMBLERS

Poor coping and intimacy skills

Traditional use of Gambler’s Anonymous

Use of the first step is important

Importance of surrender theme

ACTION Gamblers

Quantity theme, meeting size & length

Abstinence is the beginning of a normal life

Support from family and friends

Improvement seen early

Escape Gamblers

Often female

Non-competitive

Passive

Often a victim of abuse

Escape Gamblers Poor assertiveness skills

Poor coping skills

Non-traditional use of Gambler’s Anonymous

Use of other first step programs Women for sobriety)

Escape Gamblers Importance of empowerment model

Quality theme, meeting intimacy, depth

Abstinence=the loss of a best friend, safety

Lack of support

No improvement early, and may in reality get more depressed

Suicidal ideations

Escape Gamblers

Lie/Bet Tool• 1) Have you ever felt the need to bet more and more money?

• 2) Have you ever had to lie to people important to you about how much you gambled?

Reference: Johnson, E.E., Hamer,R., Nora, R.M., Tan, B., Eistenstein, N., & Englehart, C. (1988). The lie/bet questionnaire for screening pathological gamblers. Psychological Reports, 80, 83-88.

Administer Lie-Bet Screening Instrument

“Yes” to one or both questions “No” to both questions

Further assessment needed. Refer client to gambling treatment program.

Call the Problem Gambling Helpline:1-800-547-6133

No referral.Follow-up as necessary.

CrimeFinancial problems

AlcoholismDrug abuse

Other mental health issues

Problem Gambling Treatment Provider Locations

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Confidential, 24/7, from any place.

Linda Graves360-725-3813gravell@dshs.wa.gov