Truth, Alternative Facts, Narrative, and Science: What Is Happening to Responsible Gambling and Gambling Disorder?

Update on Gambling Disorder

Gambling disorder (GD) is estimated to be experienced by about 0.5% of the adult population in the United States. The etiology of GD is complex and includes genetic and environmental factors. Specific populations appear particularly vulnerable to GD. GD often goes unrecognized and untreated. GD often co-occurs with other conditions, particularly psychiatric disorders. Behavioral interventions are supported in the treatment of GD. No medications have a formal indication for the GD, although clinical trials suggest some may be helpful. Noninvasive neuromodulation is being explored as a possible treatment. Improved identification, prevention, and treatment of GD are warranted.

Moving Away from Individual Responsibility: A Comment

In this comment, we suggest there has been a crusade among some gambling stakeholders to move the field away from personal responsibility influences and toward social setting effects. This perspective disproportionally attributes gambling-related negative consequences to the social setting rather than the gambler. We argue that personal responsibility is a pivotal issue during the emotional maturation of healthy adults and remains essential to understanding intemperate gambling. This comment explores this movement away from personal responsibility and briefly discusses some of the iatrogenic consequences that this position might create in a clinical setting.

Personal choice is a nuanced concept - Lessons learned from the gambling field. •

This thoughtful framework to minimize the harm associated with emerging technologies by encouraging collaborations among stakeholders would benefit from adopting the WHO precautionary principle in order to keep public health issues at the core of discussions. It would also be helpful to acknowledge and make transparent the differences in stakeholder priorities, the power differentials among stakeholders, and the importance of institutional duty of care.