Problem Pathological Gambling (PPG) is a huge problem in the United States and throughout the world. PPG is now on the rise here in the United States. Most people do not realize that Problem Pathological Gambling has been around for years. It was very common with horse racing and games of chance back in the colonial days. The difference between then and now is that there are so many more ways to lose your money.

Current estimates show that 2% – 3 % of the adult population of the United States suffers from problem gambling. Men outnumber women two to one; but women problem pathological gamblers are increasing faster than men. Teenagers, particularly college students, are also falling into gambling at an alarming rate.

The number of casinos continues to grow, lotteries are everywhere and there are now hundreds of internet sites where one can gamble their money away. Sadly, appivapp the gambling industry targets those with low incomes and the elderly. These are the people who can afford the least to lose their money. There are however, elements that increase the likelihood that the person will develop a gambling addiction. Risk factors for developing pathological gambling include schizophrenia, mood problems, antisocial personality disorder, and alcohol or cocaine addiction (1).

Individuals who are problem pathological gamblers experience intense pleasure when gambling. In fact, MRI studies have demonstrated that, when problem pathological gamblers gamble, they release dopamine into the pleasure center of the brain similar to what happens when cocaine addicts use cocaine. There is no doubt that this addictive behavior is motivated in part through the pleasure center of the brain. Broader brain circuits are also involved in mediating addiction, including the amygdala, hippocampus, and frontal cortex-all parts of the brain’s memory systems (2).

The intensity of this pleasure response depends on the level of addiction to the gambling act itself. In general, the individuals who gamble feel an intense need to change mood, and gambling is how they do it. The disease is seductive and clever. Nearly all gamblers have a period where they enjoy the activity and usually there is the “big win.” This can “set the hook” for active disease. After the “big win,” gambling activity usually increases and, eventually, the gambler is chasing his or her losses. The last stage of problem pathological gambling is total financial ruin. Most men who are gamblers are action seekers. The majority of women who are gamblers are “escape seekers.” This means that female gamblers gamble to escape unpleasant moods. The time required for a gambler to progress to a problem pathological gambler depends on the person. The disease does progress and all gamblers lose more money than they win. Diagnosis is easy. If gambling is causing a problem in a person’s life, they are a problem or pathological gambler. Signs and symptoms of problem pathological gambling are tricky to see. The person is usually in debt. The average debt for a male is usually $55,000 to $90,000 and for a woman $15,000 to $20,000. The individual will often need to borrow money and will often have a “lucky” shirt, tie or some other item that they believe brings them luck while gambling. “Magical Thinking” is not uncommon with problem pathological gamblers.

Individuals who are problem pathological gamblers can experience significant withdrawal and cravings. Their symptoms may include extreme emotional states, anxiety, agitation, restlessness and other unpleasant symptoms. Male gamblers commonly crave the excitement or action of the gambling experience. Female gamblers often seek escape from unpleasant situations. Problem pathological gamblers will frequently engage in “mind betting” when they are not actively gambling. PPG will have withdrawal symptoms or cravings indefinitely. These usually decrease over time but they may return for no reason. It is important that the problem pathological gambler avoid “slippery” people, places and things. The gambling world is an entire culture of its own. The gambler must separate himself or herself from this culture of activities.

PPG can have a host of harmful side effects ranging from financial ruin, incarceration, destruction of personal relationships and job loss to psychiatric illness and even suicide. It is hard to put a price tag on the harmful side effects of gambling. The financial ruin not only destroys families but college educations and futures. Problem pathological gamblers are also at increased risk to abuse alcohol or drugs.

It is estimated that at least 65% of all problem pathological gamblers engage in criminal acts. The motive is always the same… trying to get their hands on money they can use to gamble. Nearly all gamblers have borrowed money from family members of friends. They will also embezzle funds from the work place if possible. PPG is a common cause of white-collar crime. The legal difficulties of the problem pathological gambler depend on the seriousness of the crime. The big problems come when the gambler continues to offend. It is difficult to know when the gambler is active. No drug screen or physical exam can detect gambling. A good sign or symptom would be that the gambler lies regularly when they are in active disease.

Current treatment for PPG is sorely lacking. Another problem with this disease is that it often goes undiagnosed. Many state agencies and the gambling industry supposedly put money aside to treat the problem pathological gambler. Sadly, any type of treatment is usually difficult to find and expensive. There is no specific medication for PPG. Medical treatment for this disease is usually inconsistent and short-term. Treatment for the problem pathological gambler usually focuses on any mood disorder. Inpatient treatment for PPG is a luxury. Treatment for this disease is usually outpatient. Alternative treatment for PPG provides a viable option for managing this addiction. The use of herbal treatments and supplements has been helpful in the treatment of withdrawal, detox and cravings for PPG.

Behavior and cognitive therapy are valuable tools in a recovery program from addiction. Problem pathological gamblers commonly attend Gamblers Anonymous (GA). The format is similar to other 12-Step meetings such as AA, CA, NA, SA and OA.