Integrate Gambling Disorder Treatment Into SUD Treatment Settings

While treatment for gambling disorder is often classified as a specialized intervention, as Maureen “Mo” Michael, MS, LPC, ICGC-I, explained to Cape Cod Symposium attendees on Saturday, it can be integrated into a substance use disorder treatment setting.

Prior to her session at the Symposium in Hyannis, Massachusetts, Addiction Professional caught up with Michael for a brief interview over email to discuss how gambling disorder is defined and diagnosed, similarities and differences between gambling disorder and SUD, best practices for integrating gambling disorder treatment with SUD treatment, and a change in laws in many jurisdictions that could create a significant increase in the number of individuals seeking treatment for problem gambling.

Editor’s note: This interview has been edited for length and clarity.

Addiction Professional: How is gambling disorder defined, and how can practitioners assess for it among their patients?

Maureen Michael: Gambling disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as a substance use disorder. It is listed under “other substance use disorders.” A few of the criteria are the patient:

• Needs to gamble with increasing amounts of money in order to achieve the desired excitement
• Is restless or irritable when attempting to cut down or stop gambling
• Has made repeated unsuccessful efforts to control, cut back, or stop gambling

Practitioners can assess their patients using the South Oaks gambling screen.

AP: Are there similarities between gambling disorder and SUD? What are some differences between the 2?

MM: There are many similarities between gambling disorder and other substance use disorders. Behaviors, preoccupation and thoughts of using and/or gambling, and chasing of a high are similar. Tolerance goes with both; chemical changes happen to the brain with both.

The main difference between the 2 is the belief that the person with the gambling disorder has the belief that they have control of the outcome. A person with gambling disorder needs a greater amount of money than other substance use disorders.

AP: What are some best practices for integrating gambling disorder treatment into existing SUD treatment plans?

MM: Assessing is the first step into integrating gambling disorder treatment. Psychoeducation for all patients regarding gambling disorder and how patients with SUD are at a higher risk of developing a gambling problem. 

AP: Is there anything else you would like to mention that we have not touched on?

MM: With the legalization of sports betting in more than half of the US, the substance use industry should be prepared for an increase in patients presenting with gambling disorder. 

Reference:

Michael M. Integrating gambling disorder treatment into SUD treatment. Presented at the Cape Cod Symposium on Addictive Disorders. Sept. 8-11, 2022. Hyannis, Massachusetts.