In the hopeless phase the pathologic gambler literally hits rock bottom. They lose all hope and belief that anything or anyone can help them. They do not care if they live or die, they consider or attempt suicide. They abuse drugs and alcohol to dull the pain, to escape. Essentially, they give up. They are basically forced into a corner; social isolation, death, incarceration, or treatment.
Additional Risk Factors for Pathologic Gambling
The growth of riverboat and Indian casinos, state and national lotteries, and Internet access to offshore sports/parlor betting has dramatically increased gambling access for all Americans. You do not have to leave the chair you are perched at to make a bet, make a killing, or lose it all.
Factors that increase risk for pathologic gambling:
- Age: There is an increased risk of pathologic gambling with individual who begin to gamble at a young age. Pathologic gambling usually begins in early adolescence in males. Additionally, older adults may be the most vulnerable age group to pathologic gambling considering their dependence on fixed incomes.
- Gender: Men are more likely than are women to develop a gambling addiction. Pathologic gambling is typically a problem of men between 21 and 55 years of age. Onset for females is between ages 20 and 40 years in females.
- Location: People who live close to a casino are twice as likely to develop a gambling problem as are those who live farther away.
- Family influence: 50% of the children of pathological gamblers become pathological gamblers themselves.
- Substance Abuse: People who are alcohol or substance dependent have pathological gambling rates ranging from 13-33%.
- Military: Pathological gambling is significantly more prevalent among military veterans than in the US general population and has been associated with combat-related posttraumatic stress disorder. Studies have shown that 20% of veterans have problematic gambling.
- Medications used to treat Parkinson's disease: Studies have identified a link between the use of dopamine agonists and the onset of compulsive gambling.
Pathologic Gambling and Crime
There is an irrefutable correlation between pathologic gambling and criminal behavior. A study by the U.S. Department of Justice demonstrated that 30% of pathologic gamblers arrested in Las Vegas had committed a robbery within the past year; 13% had assaulted another individual. The motive was simply to obtain money to pay for gambling, or gambling debts. Studies by Gamblers Anonymous members are even more troubling. 67% admitted to committing crimes or civil fraud to finance their gambling or to pay gambling-related debts. 47% admitted to having engaged in some form of insurance fraud, embezzlement or arson. Not surprisingly, pathological gamblers are much more likely to have sold drugs than other arrestees.
Comparing crime rates for murder, rape, robbery, aggravated assault, burglary, and motor vehicle theft reveals Nevada is the most dangerous state to live in the United States. Nevada also rates as the number one state for suicides, divorce, prostitution, women killed by men, and gambling addictions. It rates number three in high school dropouts, poor mental health and alcohol related deaths. Additionally, it rates number four for bankruptcies and deaths from firearms.
Treatment for Pathological Gambling
Like other impulse control or addictive disorder pathological gambling is a treatable disease. Treatment for people with pathological gambling begins with recognizing the problem. Because pathological gambling is often associated with denial, people with the illness often refuse to accept that they are ill or need treatment. Most people with pathological gambling enter treatment under pressure from others. Treatment for problem gambling involves cognitive and behavioral therapy; 12 step-based programs (Gamblers Anonymous), self-help, and peer-support. Psychotropic medications to treat pathologic gambling include: antidepressants (Paxil, Zoloft, Prozac, Celexa, Luvox, Lexapro), opioid antagonists (Nalmefene), and mood stabilizers (Lithium). A combination of treatment modalities is fundamentally optimal.
If You Suspect That Someone You Care About Has a Gambling Problem