The ability of the UK population surveys to capture the true nature of the extent of gambling related harm

The UK government is undergoing consultation to reform the UK 2005 Gambling Act. Gambling behaviour in the general population was measured via the British Gambling Prevalence Survey (BGPS), (1999, 2007, and 2010) [1], and since 2010, via the Health Survey England (HSE) and the Scottish Health Survey (SHeS) [2] and more recently by small telephone surveys carried out quarterly by the Gambling Commission (GC) [3]

Homelessness and gambling: a complex relationship

Homelessness and gambling: a complex relationshi

Gender Differences in Treatment-Seeking British Pathological Gamblers

Background and aim Gambling is a widespread recreational activity in the UK. A significant percentage of gamblers develop subclinical or clinically relevant problem gambling issues, but only a low percentage of them seek treatment. Although characteristics of pathological gamblers from treatment-seeking population have been examined in some research, only a few studies have explored the differences between females and males. This study aimed to examine the gender-related differences in demographics, gambling measures, and clinical variables in an outpatient sample of pathological gamblers seeking treatment. Methods A total of 1,178 treatment-seeking individuals with gambling disorder were assessed at the National Problem Gambling Clinic in London. Sociodemographic characteristics, clinical variables, and gambling behavior habits were obtained during the assessment evaluation. Of the total sample, 92.5% were males and 7.5% were females. Results Males were more likely to be younger, white, and employed than females. In addition, compared to women, men showed a lower PGSI score, an earlier age of onset of gambling behavior, a higher gambling involvement, and preferred specific forms gambling. Female gamblers were more anxious and depressed, while men were more likely to use alcohol and illicit drugs. Conclusions Our findings support the importance of gender differences in a treatment-seeking population of pathological gamblers both in sociodemographic characteristics, gambling behavior variables, and clinical variables. Males and females might benefit from group-specific treatment

The use of naltrexone in pathological and problem gambling: A UK case series

Background and aims To investigate the potential indications and adverse effects of using the opioid antagonist naltrexone to treat problem gamblers. Case presentation The files of the 1,192 patients who were referred to the National Problem Gambling Clinic between January 2015 and June 2016 were audited. Seventeen patients were considered appropriate for treatment with naltrexone, having attended and failed to respond to psychological therapies at the clinic. Fourteen patients were placed on a regimen of 50 mg/day naltrexone. Discussion Of the 14 patients who were treated with naltrexone, there were 10 for whom sufficient follow-up existed to analyze the treatment efficacy and side effects of naltrexone. Patients showed significant decreases in their craving to gamble and the majority (60%) were able to abstain completely from gambling in the treatment period, with a further 20% reducing their gambling to almost nothing. The reported side effects from the naltrexone included: loss of appetite, gastrointestinal pain, headaches, sedation, dizziness, and vivid dreams. Two patients with concurrent alcohol-use disorder relapsed during the treatment. One patient relapsed after the treatment period. Conclusions The study showed significant outcomes in reducing gambling cravings for the sample set. Given the design of the study as a case series, there was no control group, and a number of patients were on other psychotropic medications. We recommend care when prescribing to those suffering from concurrent alcohol-use disorder

Types of gambling and levels of harm: A UK study to assess severity of presentation in a treatment-seeking population

Background and aim Previous international research emphasized that some forms of gambling are more “addictive” than others. More recently, research has shown that we should shift our attention from the type of gambling activity to the level of involvement in a number of different gambling activities. The aim of our study was to verify whether a higher Problem Gambling Severity Index (PGSI) score was associated with particular gambling activities and evaluate the impact of involvement on gambling behavior. Methods A total of 736 treatment-seeking individuals with gambling disorder were assessed at the National Problem Gambling Clinic in London. First, the independent two-sample t-test and the Mann–Whitney test were used to verify if the PGSI score changed significantly according to the gambling activity at a bivariate level. Second, we conducted a cluster analysis and finally, we fitted a linear regression model in order to verify if some variables are useful to predict gambling addiction severity. Results The PGSI score was significantly higher for lower stakes gaming machine gamblers (1% significance level) and for fixed-odds betting terminal (FOBT) gamblers (5% significance level) at a bivariate level. Moreover, such finding was confirmed by cluster and linear regression analyses. Conclusions The results of this study indicated that gambling addiction severity was related to gambling involvement and, for a given level of gambling involvement, gambling addiction severity may vary according to gambling type, with a particularly significant increase for FOBT and gaming machine gambling

Should GPs routinely screen for gambling disorders?

There is limited data regarding disclosure of gambling problems by patients, and awareness of gambling related symptoms and treatment options amongst GPs. A recent UK study determined the extent of gambling problems among patients attending GP services, and reported a gambling disorder in 5% of patients. Whilst reinforcing the potential for GP practices to be used for disorder detection, the study did not specially measure GPs awareness of both gambling disorder symptoms, or established care pathways for those experiencing the disorder4. To this end, data was collected via an online survey from 85 UK GPs (34 female)., from across the UK Respondents had been a GP for an average of 14.67 years (s.d. 9.58, range 1-40 years)

Gambling problems, traumatic life events and the perpetration of violence

There have been suggestions that violence and victimisation are associated with gambling problems. However, despite the global expansion of the gambling industry, there have been very few studies investigating this phenomenon in the general population. The aim of this study was to examine the relationship between gambling problems and violence (as a victim and perpetrator), including IPV (Intimate partner violence) and traumatic life events in a nationally representative sample of men. Regression analysis revealed that problem/pathological gambling was associated with increased odds of the perpetration of violence, using a weapon, hitting a child and being injured in a violent incident. Moreover, pathological gambling was associated with increased odds of the perpetration of IPV and fighting whilst intoxicated. A comorbid alcohol dependence diagnosis further increased the likelihood of IPV perpetration. The findings also indicated that there was a significant relationship between problem gambling and victimisation including direct and indirect IPV, and other childhood and adulthood traumatic episodes (e.g. assault, injury, homelessness and relationship breakdown). The links between violence and gambling are not fully established, but it is possible that the strain and tension associated with problem gambling (exacerbated by a traumatic history and alcohol use in some cases) can lead to antagonism that is directed towards others, particularly those in immediate surroundings including spouses, partners and children. The current findings highlight the need for problem gambling treatment services to undertake routine screening for alcohol, violence, IPV and traumatic life events and to tailor treatment for clients who present with such issues