The Relationship Between Addiction and Gambling: Understanding and Addressing Co-occurring Disorders

Gambling Addiction

As one of the most lucrative industries in the modern world, gambling has had profound effects on the lives of many. While the majority of gamblers enjoy the activity in moderation and without adverse consequences, a significant number of people develop problems related to gambling, including addiction. A growing body of research suggests that the relationship between gambling and substance addiction is complex and involves a wide range of factors. In this article, we explore the nature of addiction and its role in problem gambling, as well as how these co-occurring disorders can be addressed effectively.

The Nature of Addiction

Addiction is a chronic and often relapsing disorder characterized by compulsive substance use or behavior despite harmful consequences. The American Society of Addiction Medicine (ASAM) defines it as a primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations, reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Indeed, the line between recreational pastimes and addictive habits can blur when it comes to certain activities, like gambling. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the primary diagnostic tool for mental health professionals in the United States, has included gambling disorder as a behavioral addiction. With that said, it is important to recognize that, while many similar neural and cognitive processes underlie both substance and behavioral addictions, the specific factors driving addictive behavior can differ significantly from one individual to another.

Why Do Some Gamblers Develop Co-occurring Disorders?

A considerable body of research has demonstrated that many individuals who develop a gambling problem also suffer from other mental health disorders, such as substance abuse and mental disorders. A 2019 study published in the American Journal on Addictions found that 72.1% of pathological gamblers had a lifetime history of alcohol dependence, 38.1% had a history of drug dependence, and 60.4% had a history of nicotine dependence.

There are several reasons why co-occurring disorders are prevalent among problem gamblers. First, there is a common genetic vulnerability shared between gambling disorder and substance addiction. Research has found that about half of the risk for developing an addiction to gambling comes from genetic factors. The same is true for other addictions like alcohol and drug addiction. Notably, some individuals may be genetically predisposed to addiction in general, rather than just one specific type.

Another contributing factor is the presence of shared neurobiological mechanisms between gambling and substance addiction. Both forms of addiction involve changes in the brain’s reward system, which play a critical role in motivating behavior. In both cases, the repeated engagement in these behaviors increases tolerance, leading to the need for escalating doses of the substance or increasing bets in gambling to achieve the desired effects.

Moreover, pre-existing mental health disorders, such as depression or anxiety, may put individuals at a greater risk of developing addiction or problem gambling. These disorders can contribute to the development of maladaptive coping mechanisms, like substance abuse or gambling, to alleviate negative feelings.

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Addressing Co-occurring Disorders: A Holistic Approach

Treating co-occurring disorders, such as gambling and substance addiction, requires a comprehensive and integrated approach. In many cases, individuals presenting with a gambling problem may also benefit from substance addiction treatment and vice versa. A combination of evidence-based therapeutic interventions can be helpful, including cognitive-behavioral therapy (CBT), motivational interviewing, and psychoeducation, among others.

It is crucial that treatment providers address both the gambling and substance addiction, as well as any underlying mental health issues. Treatment plans should be personalized to the individual’s unique needs and circumstances. In addition, those in recovery may benefit from attending mutual support groups, like Gamblers Anonymous and Alcoholics Anonymous, which can provide ongoing support and encouragement.

Finally, prevention is key in addressing the problem of co-occurring disorders. Public health initiatives aimed at increasing awareness about gambling and substance addiction, as well as the risks associated with these behaviors, can help individuals make informed choices about their involvement in these activities. Furthermore, promoting responsible gambling practices and implementing policies that limit access to substances and gambling opportunities for vulnerable populations can also help to reduce the prevalence of these co-occurring disorders.


The relationship between addiction and gambling is complex and multifaceted. A growing body of research has highlighted the prevalence of co-occurring disorders among individuals who struggle with problem gambling. Addressing this issue requires a holistic and collaborative approach that takes into account both the addictive aspects of gambling and any underlying mental health disorders. Through increased awareness, effective treatment options, and targeted policy interventions, it is possible to mitigate the risks associated with these co-occurring disorders and promote healthier, safer communities.


– American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
– American Society of Addiction Medicine (ASAM). (2011). Definition of Addiction. Retrieved from
– Lorains, F. K., Cowlishaw, S., & Thomas, S. A. (2011). Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys. Addiction, 106(3), 491-498.
– Petry, N. M., Stinson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 66(5), 564-574.
– Slutske, W. S. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two US national surveys. American Journal of Psychiatry, 163(2), 297-302.

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