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Robin Campbell, LMFT, PHD Gambling can start as entertainment, but it can turn into problematic gambling that affects health, money, work, and relationships.
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Clinical Editorial Team
Gambling can start as entertainment, but it can turn into problematic gambling that affects health, money, work, and relationships. The American Psychiatric Association classifies gambling disorder as an addictive disorder, similar to drug addiction and alcohol use disorder. With more access to sports betting and online gambling, sports bettors and young people face greater exposure to risky behaviors. Research shows a strong link between gambling and substance use disorder. Co-occurring substance use, mental disorders, mood disorders, personality disorders, ADHD, and obsessive compulsive disorder can raise the risk. This blog explains hidden signs, negative consequences, and why integrated treatment may help.
Gambling and substance use are both linked to impulsive behaviors, which are associated with changes in brain regions responsible for self-control. These activities can affect the same reward and impulse-control systems in the brain. A person may drink, use drugs, or gamble to escape stress, chase excitement, or numb emotional pain. Over time, both behaviors can increase cravings, secrecy, risky choices, and financial or relationship strain.
Alcohol or drug use can also lower judgment, which may lead to longer gambling sessions or larger bets. Gambling losses can then trigger shame, anxiety, or depression, which may push a person back toward substance use.
Co-occurring disorder treatment addresses substance use, mental health symptoms, and behavioral addictions at the same time. For gambling and substance use, this means treating gambling urges, alcohol or drug use, cravings, and emotional triggers in one care plan. This approach helps people see how each issue fuels the other. Gambling losses may trigger drinking or drug use, while substance use may increase impulsive bets and risky choices. Treating both together can improve stability, reduce relapse risk, and support long-term recovery.
Dual diagnosis programs are built for people dealing with more than one condition. Treating only gambling or only substance use can leave the other issue active.
Specialized care helps manage triggers, cravings, and mental health symptoms together. This leads to better outcomes and stronger relapse prevention.
Dual addiction can stay hidden because gambling does not show physical signs like drug or alcohol use. Many people also hide financial problems, losses, or substance use. Shame, secrecy, and denial can delay help. A person may focus on one issue while the other continues to grow. The diagnostic and statistical manual, fifth edition, notes that some people develop gambling disorder from impulse control disorders, where sports wagering, losing money gambling, and other risky behaviors tied to desired excitement can affect an individual’s life, especially with psychiatric conditions like attention deficit hyperactivity disorder or nicotine dependence, which may shape treatment approaches.
Gambling can create fast shifts in stress, excitement, hope, and regret. A person may drink alcohol to calm nerves, use stimulants to stay awake during long sessions, or use marijuana to numb anxiety after losses. Wins can also trigger substance use because they may lead to celebration, overconfidence, and more risk-taking. Losses can trigger shame, panic, or depression, which may push a person to use drugs or alcohol for short-term relief. Over time, the brain may connect gambling and substance use as part of the same reward cycle.
Substance use can change judgment, impulse control, and risk perception. Alcohol can make a person bet more money, stay longer at a casino, chase losses, or ignore limits they set before drinking. Cocaine and meth can increase energy, confidence, and urgency, which may lead to faster bets, bigger risks, and longer gambling sessions.
Marijuana can affect focus, memory, and time awareness, so a person may lose track of spending or keep playing longer than planned. Opioids, benzodiazepines, and sleep medications can dull fear, guilt, and stress, which may make losses feel less serious in the moment. When substance use and gambling happen together, the person may start linking both behaviors with escape, reward, and short-term relief.
Problem gambling and substance use can lead to serious financial problems. These may include debt, unpaid bills, loss of savings, or selling assets.
Legal risks may include theft, fraud, or charges related to substance use. These consequences can increase stress and make recovery harder.
Gambling disorder and substance use often occur together. National epidemiologic surveys and national centers report strong overlap, with gambling disorder affecting up to 28% to 50% of people with substance use disorders, about 4% of people in substance use treatment, and nearly 7% of psychiatric inpatients. Pathological gambling can affect any age group, but early gambling exposure may increase later risk. Recent research, including gambling studies, systematic review, longitudinal study, and meta analysis data, shows that sports gamblers who start gambling at a younger age may have higher gambling involvement, higher past year prevalence rate, and greater risk of feeling distressed without responsible gaming support from multiple stakeholders.
Gambling and substance use can overlap with depression, anxiety disorders, PTSD, bipolar disorder, ADHD, panic disorder, and obsessive compulsive symptoms. Some people gamble or use substances to escape stress, racing thoughts, trauma memories, or low mood. These conditions can increase impulsive behavior and make recovery harder. Integrated care can treat the addiction pattern and the mental health symptoms together.
Shame can make a person hide gambling losses, substance use, debt, or relapse. Secrecy can delay help until the problem affects work, money, health, and relationships.
Many people stay silent because they fear judgment. Honest support can reduce isolation and help a person take the next step.
Dual addiction can damage trust through hidden spending, missed promises, lying, or repeated relapse. Family members may feel hurt, anxious, angry, or unsure what to believe.
Recovery often includes rebuilding trust through honesty, structure, and consistent action. Family support can help, but boundaries are also important.
Integrated treatment addresses gambling, substance use, and mental health symptoms in one plan. This matters because each issue can trigger the other.
Treating them together helps reduce relapse risk. It also gives people stronger coping tools for cravings, stress, shame, and financial triggers.
Therapy most commonly involves cognitive behavioral therapy (CBT), which focuses on changing maladaptive thought patterns and behaviors associated with gambling addiction. Other options include motivational interviewing (MI), which helps individuals address ambivalence about stopping gambling and substance use, as well as group therapy, family therapy, relapse prevention counseling, and financial behavior planning. These approaches help people spot patterns, challenge urges, and make safer choices.
There are currently no FDA-approved medications specifically for treating gambling disorder, but some medications may help manage co-occurring conditions like depression or anxiety. Therapy can also address stress, grief, trauma, and negative thought patterns. Support groups such as Alcoholics Anonymous (AA) and Gamblers Anonymous (GA) provide peer support and anonymity for individuals in recovery. This support helps people replace gambling and substance use with healthier coping skills.
Relapse prevention helps people prepare for cravings, urges, high-risk places, and emotional triggers. A plan may include blocking gambling access, avoiding substance cues, limiting cash access, and building sober support. People also learn what to do after a slip. Fast honesty and support can keep a setback from becoming a full relapse.
Family support can help recovery by adding structure, encouragement, and accountability. Loved ones can learn how to support progress without enabling gambling or substance use.
Family involvement may include therapy, boundary setting, financial safeguards, and relapse planning. This can help rebuild trust over time.
Seek help when gambling or substance use feels hard to control. Warning signs include debt, secrecy, cravings, missed responsibilities, failed attempts to stop, or using alcohol or drugs while gambling. Help is also important if anxiety, depression, trauma, mood swings, or suicidal thoughts are present. Early treatment can reduce harm and support safer recovery.
Many insurance plans cover substance use and mental health treatment, but benefits depend on the plan, diagnosis, provider, and level of care. Coverage may include assessment, outpatient care, IOP, PHP, therapy, and dual diagnosis treatment. Verifying benefits before treatment helps families understand costs, coverage, and available care options.
Gambling and substance use disorder can lead to negative consequences, repeated unsuccessful efforts to stop, psychological distress, illegal activities, and losing important opportunities. These related conditions often grow when negative mood, drug use disorder, alcohol use disorder, or co occurring substance use goes untreated. Integrated care can address gambling affects, substance use, mental disorders, and psychiatric disorders in one plan. With the right support, people can reduce risky behaviors, rebuild trust, and move toward lasting recovery.
At New Hope Healthcare, as an in-network provider we work with most insurance plans, such as:
If you or a loved one are struggling with mental health challenges or substance abuse, seeking treatment and emotional support is crucial. Consulting a doctor can provide the necessary support and guidance for your teen. Reach out to New Hope Healthcare today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Effective medication management is a crucial part of the treatment process to ensure safety and success. Give us a call at 866-799-0806.
Visit SAMHSA for more information.
It means a person struggles with both problem gambling and drug or alcohol use.
Signs include secrecy, debt, mood swings, missed duties, and increased substance use.
It treats both issues together and lowers relapse risk.
Yes. Stress, losses, and shame can trigger drug or alcohol use.
People with gambling problems often have higher rates of substance use.
CBT, group therapy, and relapse prevention can support recovery.
](https://dictionary.apa.org/gambling-disorder)
](https://www.ncpgambling.org/problem-gambling/)
](https://pmc.ncbi.nlm.nih.gov/articles/PMC10628029/)
](https://pmc.ncbi.nlm.nih.gov/articles/PMC7044589/)
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