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Pagano A, Le T, Fong T, Reid R, Delucchi K, Guydish J. Gambling, tobacco use, and health among individuals in substance use disorder treatment. Am J Addict 2023; 32:563-573. [PMID: 37543853 DOI: 10.1111/ajad.13458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/23/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Gambling is highly comorbid with disordered use of tobacco and other drugs, and may increase relapse risk among substance use disorder (SUD) patients. We investigated associations between gambling and tobacco use behaviors among SUD patients to inform clinical care. METHODS Patients (N = 651, 170 female) from 25 residential SUD treatment programs in California completed surveys about tobacco use, health, and gambling. Using multivariate regression, we examined associations between gambling, tobacco use behaviors, and mental and physical health. RESULTS Past-year gamblers were more likely than non-gamblers to be current smokers (adjusted odds ratio [AOR] = 1.44, 95% confidence interval [CI] = 1.03, 2.01). Smokers who gambled had higher mean Heaviness of Smoking Index (HSI) scores (mean difference = +0.32, 95% CI = 0.04, 0.60), and more often reported smokeless tobacco use (AOR = 1.73, 95% CI = 1.16, 2.58), compared to non-gambling smokers. Past-year problem gamblers were more likely than all others (non-gamblers and non-problem gamblers) to be current smokers (AOR = 1.44, 95% CI = 1.08, 1.90) and to report high psychosocial stress (AOR = 1.87, 95% CI = 1.34, 2.61). Smokers with problem gambling also had higher HSI scores (mean difference = +0.54, 95% CI = 0.14, 0.95) compared to smokers without problem gambling. DISCUSSION AND CONCLUSIONS Gambling and problem gambling were associated with tobacco use and heavier smoking. SUD patients with gambling comorbidity may be heavier smokers and may need concurrent treatment for tobacco use and problem gambling. SCIENTIFIC SIGNIFICANCE This study provides novel data regarding gambling and tobacco use behaviors among SUD patients.
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Affiliation(s)
- Anna Pagano
- Institute for Health Policy Studies, University of California, San Francisco, California, USA
| | - Thao Le
- Institute for Health Policy Studies, University of California, San Francisco, California, USA
| | - Timothy Fong
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Rory Reid
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Kevin Delucchi
- UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA
| | - Joseph Guydish
- Institute for Health Policy Studies, University of California, San Francisco, California, USA
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Sussman S, Galimov A, Ayala N, Sinclair DL. Web-based Evidence on the Treatment of Behavioral Addictions in United States Model Treatment Centers. Eval Health Prof 2023; 46:23-29. [PMID: 36189854 DOI: 10.1177/01632787221130543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Behavioral addictions are highly comorbid with substance use disorders, presenting in as many as 54% of service users receiving substance use treatment. Few studies have examined whether treatment centers are attentive to such other addictions, which may undermine treatment. This study examined the mention and treatment of behavioral addictions on United States treatment center websites. The 2021 Newsweek America's Best Addiction Treatment Centers website was utilized to examine the mention and treatment of behavioral addictions in 300 leading treatment centers across 25 states in the United States. Of 289 active websites, only 61 (21.1%) treatment centers mentioned anything about behavioral addictions. The highest prevalence was for gambling (n = 38), sex (n = 22), food/eating (n = 21), and internet gaming (n = 12). A total of 49 treatment centers reported treating those addictions. The most prevalent treatments involved 12-step programming (n = 18), cognitive behavioral therapy (CBT; n = 16), individual counseling (n = 16), and group therapy (n = 15). Little formalized importance via websites was provided regarding the mention or treatment of behavioral addictions at treatment centers. A greater emphasis on concurrent and substitute behavioral addictions is needed to improve the quality of life and lower the possibility of relapse among those persons in addictions treatment.
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Affiliation(s)
- Steve Sussman
- Departments of Population and Public Health Sciences, and Psychology, and School of Social Work, 12223University of Southern California, Los Angeles, CA, USA
| | - Artur Galimov
- Departments of Population and Public Health Sciences, and Psychology, and School of Social Work, 12223University of Southern California, Los Angeles, CA, USA
| | - Nayeli Ayala
- Departments of Population and Public Health Sciences, and Psychology, and School of Social Work, 12223University of Southern California, Los Angeles, CA, USA
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Leino T, Torsheim T, Griffiths MD, Pallesen S. The relationship between substance use disorder and gambling disorder: A nationwide longitudinal health registry study. Scand J Public Health 2023; 51:28-34. [PMID: 34590511 PMCID: PMC9900184 DOI: 10.1177/14034948211042249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Aim: This study aimed to examine the co-morbidity and temporal relationship between substance abuse disorders (SUDs) and gambling disorder (GD). Method: Cross-tabulated census data were retrieved from the Norwegian Patient Registry. The data included the number of patients by year of first-time incidence of GD and/or SUD diagnoses, age and sex from 2008 to 2017. Results: Approximately 22.5% of GD patients were also diagnosed with SUD, whereas 0.7% of SUD patients were also diagnosed with GD. Among GD patients, males had a greater risk of SUD in the same year compared to females, whereas the risk of SUD a year or more after the onset of GD was greater among females compared to males. Among SUD patients, males had a greater risk of GD in all age categories and across all time periods except among those aged 40-66 years. The risk of GD three to four years after the onset of SUD among those aged 40-66 years was similar between SUD males and females. Discussion: The overall co-morbidity of SUD and GD was low. However, the risk of the other addictive disorder was contingent upon the nature of the first disorder. The risk of SUD among GDs over time was greater among females compared to males. Conclusions: The risk of the other addictive disorder appears to be contingent upon the first addictive disorder. There are sex differences in the risk trajectories of the other addictive disorder over time between GD patients and SUD patients.
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Affiliation(s)
- Tony Leino
- Department of Psychosocial Science,
University of Bergen, Norway,Tony Leino, Department of Psychosocial
Sciences, University of Bergen, Christiesgate 12, 5015 Bergen, Norway. E-mail:
| | | | - Mark D. Griffiths
- International Gaming Research Unit,
Psychology Department, Nottingham Trent University, UK
| | - Ståle Pallesen
- Department of Psychosocial Science,
University of Bergen, Norway,Norwegian Competence Center for Sleep
Disorders, University of Bergen, Norway,Optentia Research Focus Area,
North-West University, Vanderbijlpark Campus, South Africa
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Changes in secondary outcomes associated with brief interventions for problem gambling in methadone patients. Addict Behav 2021; 120:106953. [PMID: 34022757 DOI: 10.1016/j.addbeh.2021.106953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 03/23/2021] [Accepted: 04/09/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Patients in methadone maintenance treatment (MMT) with problem gambling (PG) experience worse psychosocial outcomes than their non-PG counterparts. Interventions targeting PG in MMT may enhance psychosocial functioning beyond gambling reduction and abstinence. The present study was a secondary data analysis that examined the trajectories of non-gambling outcomes of three brief PG interventions (i.e., brief psychoeducation, brief advice, motivational enhancement therapy plus cognitive-behavioral therapy [MET + CBT]) among MMT patients. METHODS Participants (N = 109) were engaged in substance use disorder treatment, met criteria for PG, and had a current or lifetime history of MMT. Latent growth curve models examined outcome trajectories of psychiatric, medical, legal, employment, and social problems, as well as psychological distress and quality of life. Follow-up analyses examined clinically significant change. RESULTS MET + CBT patients reported lower medical problems at baseline and over time than the brief interventions. There was no evidence of differences between interventions on the other outcomes. Psychiatric problems and psychological distress decreased over time for the entire sample, regardless of the PG intervention. About 24% and 13% of the sample demonstrated clinically significant improvements in psychological distress from baseline to 5 months, and 5 months to 12 months, respectively. Nearly 21% of the sample showed clinically significant improvements in psychiatric problems from 5 months to 12 months. Among all patients, men and those with more severe opioid dependence symptoms demonstrated the greatest psychological improvements. CONCLUSIONS Many patients in MMT with PG experience improvements in psychological problems, including long-term improvement, regardless of the PG intervention offered.
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Frisone F, Settineri S, Sicari PF, Merlo EM. Gambling in adolescence: a narrative review of the last 20 years. J Addict Dis 2020; 38:438-457. [PMID: 32634072 DOI: 10.1080/10550887.2020.1782557] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Gambling has increasingly become a problem in adolescence over the last 20 years. Previous research has failed to identify exactly the level of involvement of adolescents in gambling, yet a relevant presence of addictive behaviors was noticed. OBJECTIVE This narrative review highlights the implications of adolescent gambling, taking into consideration the main risk and protection factors aimed at limiting gambling activity, as well as the main links with the impulse-control disorder, addiction, and behavioral addiction. METHODS The review process was conducted through Medline, Scopus, Web of Science and Google Scholar search engines. The considered keywords were "Gambling" AND "Adolescence," "Behavioral addiction," AND "Adolescence." The articles related to gambling and adolescence in the last 20 years were included in compliance with inclusion and exclusion criteria, to perform a consistent analysis of the phenomenon and the related maintenance factors. RESULTS Starting from 1067 articles, 107 were selected to denote the main thematic areas involved in the gambling problem. The online search was completed on December 13, 2019. CONCLUSIONS The narrative review of literature can facilitate the analysis of gambling problems in adolescence, as the main studies in the last 20 years showed the complexity of the problem, the links between addiction, and the most effective methods of prevention and treatment.
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Affiliation(s)
- Fabio Frisone
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Messina, Italy.,International Research Center for Theoretical and Applied Cognitive Sciences (CRISCAT), University of Messina, Messina, Italy
| | - Salvatore Settineri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Professor Federica Sicari
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Messina, Italy
| | - Emanuele Maria Merlo
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Messina, Italy.,International Research Center for Theoretical and Applied Cognitive Sciences (CRISCAT), University of Messina, Messina, Italy
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Rosen LA, Weinstock J, Peter SC. A Randomized Clinical Trial Exploring Gambling Attitudes, Barriers to Treatment, and Efficacy of a Brief Motivational Intervention Among Ex-Offenders with Disordered Gambling. J Forensic Sci 2020; 65:1646-1655. [PMID: 32539157 DOI: 10.1111/1556-4029.14476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 02/03/2023]
Abstract
Correctional populations are disproportionately burdened by disordered gambling; yet, problem awareness is minimal among both offenders and professionals within the criminal justice system. The aims of the current study were twofold: (i) to examine gambling attitudes and problem awareness among ex-offenders, and (ii) to determine the efficacy of a brief online gambling intervention for ex-offenders. Participants (N = 126) were ex-offenders on probation and parole. Gambling attitudes, attitudes toward treatment, and disorder gambling status were assessed. Disordered gamblers (n = 102) were randomly assigned to (i) a brief intervention plus referral to treatment or (ii) referral to treatment only, and these individuals were re-assessed at a 30-day follow-up. Lifetime disordered gambling was highly prevalent (86%) in the ex-offender sample, and providing information regarding disordered gambler status and referral to treatment was effective in decreasing gambling attitudes, as well as gambling severity and frequency. The current study has direct implications for treatment and intervention efforts among ex-offenders with disordered gambling and yields a greater understanding of attitudes toward gambling among ex-offenders.
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Affiliation(s)
- Laura April Rosen
- Department of Psychology, Saint Louis University, 3700 Lindell Blvd., Morrissey Hall, St. Louis, MO
| | - Jeremiah Weinstock
- Department of Psychology, Saint Louis University, 3700 Lindell Blvd., Morrissey Hall, St. Louis, MO
| | - Samuel Cody Peter
- Department of Psychology, The University of Memphis, 400 Innovation Dr., Memphis, TN, 38111
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Langan K, Wall M, Potts W, Himelhoch S. Prevalence and potential predictors of gambling disorder among people living with HIV. AIDS Care 2018; 31:421-426. [PMID: 30019914 DOI: 10.1080/09540121.2018.1499858] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Specific subsets of the adult population are at an increased risk of problem gambling behaviors. Previous research among these subsets has found increased rates of disordered gambling among those with drug use, alcohol use, mood, anxiety, and personality disorders. To what extent this may apply to the HIV population, known to have a high burden of co-occurring substance use and mental disorders, is not known The current study also examined the effectiveness of The Brief Biosocial Gambling Screen (BBGS) for the diagnosis of gambling disorder. This study examined the prevalence of gambling behaviors and disordered gambling in patients enrolled in an urban HIV clinic. 100 people living with HIV (PLWH) were assessed on gambling behaviors, impulsivity, and criterion on disordered gambling. Screening for gambling disorder using the BBGS was compared to the American Psychiatric Association DSM-5 criterion. The mean age was 53, 44% were female, 60% completed high school or above, and 80% self-identified as unemployed/disabled. 13% met four or more criteria for gambling disorder according to DSM-5 criteria. Participants that met criteria were more likely to report marijuana (p = .044) and heroin (p = .002) use, and greater impulsivity (p < 0.00001) when compared to participants who did not meet criteria. The BBGS was able to effectively screen individuals for disordered gambling with a sensitivity of 100%, specificity of 90.8%, positive predictive value of 56.2%, and a negative predictive value of 100%. These results suggest that urban HIV clinics may need to consider actively screening for gambling disorders, and referring to appropriate counseling and treatment for those who screen positive.
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Affiliation(s)
- Kristen Langan
- a Department of Psychiatry, University of Maryland School of Medicine , Baltimore , MD , USA
| | - Megan Wall
- a Department of Psychiatry, University of Maryland School of Medicine , Baltimore , MD , USA
| | - Wendy Potts
- a Department of Psychiatry, University of Maryland School of Medicine , Baltimore , MD , USA
| | - Seth Himelhoch
- a Department of Psychiatry, University of Maryland School of Medicine , Baltimore , MD , USA
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The Economic Burden of Pathological Gambling and Co-occurring Mental Health and Substance Use Disorders. J Addict Med 2018; 12:53-60. [DOI: 10.1097/adm.0000000000000363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Weinstock J, April LM, Kallmi S. Is subclinical gambling really subclinical? Addict Behav 2017; 73:185-191. [PMID: 28531824 DOI: 10.1016/j.addbeh.2017.05.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/08/2017] [Accepted: 05/13/2017] [Indexed: 01/01/2023]
Abstract
Gambling disorder and substance use disorders (SUD) overlap in terms of etiology and diagnostic constructs (e.g., preoccupation, loss of control), yet diagnostic thresholds for the disorders are different. Currently, endorsing 2-3 gambling disorder criteria does not warrant a diagnosis while endorsing 2-3 SUD criteria does. The aim of this study was to examine whether subclinical gamblers (i.e., endorsing 2-3 gambling disorder criteria) experience psychosocial dysfunction equivalent to individuals who are diagnosed with mild severity SUD (i.e., 2-3 SUD criteria) and whether this level of dysfunction is significantly different from individuals with no psychopathology. Data are from the first wave of Quinte Longitudinal Study, a large epidemiological sample (N=4121). Psychometrically supported measures assessed for psychosocial functioning and the presence of Axis-I psychiatric disorders. Cross-sectional analysis examined 7 domains of psychosocial functioning using ANCOVA, which allowed for the inclusion of covariates, to test for difference between subclinical gamblers and individuals with no psychopathology and individuals with mild severity SUD. Equivalency testing compared subclinical gamblers in relation to mild severity SUD. Subclinical gamblers reported significantly poorer psychosocial functioning in relation to individuals endorsing no current psychopathology. Subclinical gamblers were also equivalent to and not significantly different from individuals with mild severity SUD. Subclinical gamblers experience similar psychosocial impairment to those individuals who endorse mild severity SUD, and this significantly differed from healthy individuals. The threshold for diagnosis of gambling disorder therefore warrants re-examination.
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Rash CJ, Weinstock J, Van Patten R. A review of gambling disorder and substance use disorders. Subst Abuse Rehabil 2016; 7:3-13. [PMID: 27051333 PMCID: PMC4803266 DOI: 10.2147/sar.s83460] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder was recategorized from the "Impulse Control Disorder" section to the newly expanded "Substance-related and Addictive Disorders" section. With this move, gambling disorder has become the first recognized nonsubstance behavioral addiction, implying many shared features between gambling disorder and substance use disorders. This review examines these similarities, as well as differences, between gambling and substance-related disorders. Diagnostic criteria, comorbidity, genetic and physiological underpinnings, and treatment approaches are discussed.
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Affiliation(s)
- Carla J Rash
- Calhoun Cardiology Center – Behavioral Health, UConn Health, Farmington, CT, USA
| | | | - Ryan Van Patten
- Department of Psychology, Saint Louis University, St Louis, MO, USA
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Wieczorek Ł, Dąbrowska K. Zaburzenia hazardowe – rozpowszechnienie, oferta terapeutyczna, dostępność leczenia i predyktory podjęcia leczenia. Przegląd literatury. ALCOHOLISM AND DRUG ADDICTION 2015. [DOI: 10.1016/j.alkona.2015.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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