Playing a slot machine

5 Things to Know About Problem Gambling

March 13, 2018

In light of Problem Gambling Awareness Month, we asked Dr. Mayumi Okuda, psychiatrist and Director of the Columbia Gambling Disorders Clinic, to share 5 things that everyone should know about problem gambling.

1. A gambling addiction can result in debilitating consequences.

Gambling represents a harmless form of entertainment for most people, but it has the capacity to become dysfunctional in a subset of the population. Gambling disorder has been reconceptualized within substance-related and addictive disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which defines diagnoses used by psychiatrists, psychologists, social workers, and mental health counselors alike, as a “non-substance related disorder.” This was based on emerging parallels with substance use disorders.

The negative consequences of gambling addiction can be severe and include financial debt or bankruptcy, family dissolution, depression, and suicide. Gambling activity is not limited to casino games, but also includes scratch-off games and lotteries, sports betting including fantasy sports, and betting on the stock market, among others.

2. Individuals who also struggle with mental health problems are at a higher risk to develop a gambling addiction.

People with a history of mental health problems including anxiety, mood and psychotic disorders, are more vulnerable to develop a gambling disorder. Those with a previous or current substance use disorder are at a particularly high risk, with selected studies reporting prevalence rates between 7% and 39% among substance users.

3. Problematic gambling can be detected in as few as 2 questions.

A brief, highly sensitive and specific screening tool, consisting of 2 questions is available:

  • "Have you ever had to lie to people important to you about how much you gambled?
  •  "Have you ever felt a need to bet more money?"

A positive answer to either question suggests further assessment using a variety of more detailed questionnaires and interviewing to explore the extent of one’s gambling activities and severity of any negative consequences.

4. Some medications have been associated with development of gambling addiction.

Behavioral addictions including gambling addiction have been seen to develop in up to 17% of patients taking dopamine agonists used for the treatment of Parkinson’s Disease and restless leg syndrome. There is also a recent FDA warning for aripiprazole (Abilify®). Patients taking any of these medications should be regularly screened for behavioral addictions including gambling addiction.

5. There are effective treatments for gambling addiction.

Cognitive behavioral therapy (CBT) and motivational interviewing (MI) have been proven effective in several large, randomized controlled trials. The Columbia Gambling Disorders Clinic at the New York State Psychiatric Institute, funded by the New York State Office of Alcohol and Substance Abuse Services (OASAS), provides treatment free of charge to people with a problem gambling and to their concerned significant others. For more information about treatment in the New York City area, visit the Columbia Gambling Disorders Clinic website, call 646-774-8096, or e-mail


If you think you or someone you care about may have a gambling problem or addiction, please take a moment to complete this brief assessment. Treatment is available. For more information, visit the Columbia Gambling Disorders Clinic website, call 646-774-8096, or e-mail