Gambling is an activity in which a person places something of value at risk on an event that is determined at least in part by chance. The gambler hopes that he or she will “win” and gain something of value, such as money or goods. Many people have gambled at one time or another, but some people develop a problem with gambling. Compulsive gambling can have serious consequences for a person’s physical and mental health. It is important to recognize gambling problems and seek treatment for them.
Most people are familiar with casino slots and scratch cards, but gambling includes more than just those regulated activities. Buying lottery tickets, playing bingo, betting on sports events, office pools and playing skill-based games are all forms of gambling. In addition, online poker and fantasy leagues are also considered gambling. It is very easy to get caught up in the excitement of winning, but it is important to realize that gambling can also be very dangerous.
A person may start gambling for a variety of reasons, including the adrenaline rush of winning, the desire to socialize or the escape from worries and stresses. Unfortunately, some people become addicted to gambling and are unable to control their behavior. Problem gambling can cause financial stress, family problems, legal issues and even suicide.
Some people who are at higher risk for developing a gambling disorder include adolescents, veterans, older adults and those from Latino or Asian communities. However, anyone can become a compulsive gambler, and it is important for primary care providers to understand the signs and symptoms of this condition.
The occurrence of gambling is widespread and has grown with the advent of new technology and the proliferation of the internet. Unlike alcohol and drug addiction, which are often identified with outward signs and symptoms, it is very difficult to detect the presence of a gambling problem. Moreover, many people don’t realize that they have a gambling problem until it has impacted their life in severe ways.
The majority of people who gamble do not have a gambling problem and are able to control their spending. However, there is a growing need for evaluation of gambling behaviors in the primary care setting, particularly given that many people who have a problem with gambling have not been diagnosed or treated. The goal of this article is to review the evidence supporting the rationale for evaluating gambling behaviors in the primary care setting, and to discuss the potential implications for clinical practice. Ultimately, this article will highlight the need for comprehensive, coordinated care in order to effectively identify and treat pathological gambling. This article has been revised from the original version published in March 2022. The authors would like to thank Drs. Sean Sullivan and Suck Won Kim for their valuable contributions to this project. This study was funded by the National Institutes of Health (NIH) under grant K12-DA00366 (MNP) and K12-DA00167 (MGH). The content has not been edited by the AMA.