By David Joel Miller.
This week, March 3-9, is National Problem Gambling Week.
Problem Gambling is currently described as Pathological Gambling in the Diagnostic and Statistical Manual of Mental Disorders (DSM-TR-4.) Pathological Gambling is one of a group of disorders that currently are considered “impulse control disorders.”
Pathological Gambling is one of a group of disorders that currently are considered “impulse control disorders.”
In the DSM-5 this is named Gambling Disorder (F63.0) Essentially the same features.
Other impulse control problems not classified as an addictive disorder.
Other impulse control problems are intermittent explosive disorder, kleptomania, pyromania, and trichotillomania. Intermittent explosive disorder gets treated by far the most, but many more people need to get treated for pathological or problem gambling than are currently receiving help.
In California, this week-long effort to make people aware of the difficulties people may have with problem gambling is spearheaded by the California Department of Drug and Alcohol Programs via their Office of Problem Gambling. In a few other states Gambling issues are treated by separately trained and licensed counselors.
One reason for the interest in problem gambling among drug and alcohol counselors is the tendency for clients in early substance abuse or addiction recoveries to “switch addictions” and now off drugs and alcohol, to develop a new problem with compulsive or pathological gambling.
The similarities between addictive disorders and pathological gambling are so large that it was proposed that Pathological Gambling be moved to the addictive disorders rather than the impulse control disorders when the new DSM-5 comes out. We will need to look at that again in the future when the DSM-5 is available.
One of the controversies among treatment professionals is about the choice between trying to control an issue like drug use or gambling and the need to stop doing that activity completely.
If we view drinking excessively or pathological gambling as an addiction then we would expect the client to need to totally abstain. If it is an impulse control issue then we might reasonably try to teach the client to control the impulses and drink or gamble in moderation.
Most people who self-describe as addicts or alcoholics will tell you that control is an illusion. For them, the only answer is complete abstinence.
One reason for the conflict is that funding for treatment often comes from the people who make the most profit from the activity. The alcoholic beverage manufacturers would like counselors to teach people to drink responsibly not tell them to stop drinking altogether. The same issue occurs when problem gambling programs are funded by casinos.
So if you are one of those people who are able to control your drinking or gambling and for whom it is mostly just a source of entertainment, then problem gambling week is not of much interest to you.
But if you are one of those people who has lost the ability to control your gambling or your drinking consider getting help. If you live with someone who has a Pathological gambling problem, consider getting help for yourself as well as for them.
The web address for the California initiative is www.problemgambling.ca.gov
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books