If you are struggling with compulsive gambling, you may be wondering what the best treatment plan is for you going forward. There are a few options, the most common being Gamblers Anonymous or outpatient counselling. However, there is also the option of attending a residential treatment center for gambling.
Gambling disorder, recognized by the American Psychiatric Association as the only behavioral addiction in the DSM-5, affects approximately 1-3% of adults in the United States.
The condition shares many similarities with substance use disorders in terms of brain function, symptom presentation, and treatment approaches.
Gambling Disorder: Signs and Symptoms
Before exploring treatment options, it's important to understand what distinguishes problem gambling from recreational gambling. According to the DSM-5 diagnostic criteria, gambling disorder is characterized by persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress.
Common signs and symptoms include:
- Needing to gamble with increasing amounts of money to achieve the desired excitement
- Feeling restless or irritable when attempting to cut down or stop gambling
- Making repeated unsuccessful efforts to control, cut back, or stop gambling
- Being preoccupied with gambling (reliving past experiences, planning future gambling, thinking of ways to get money)
- Often gambling when feeling distressed, anxious, guilty, or depressed
- "Chasing" losses and returning to gamble again to try to win back money
- Lying to conceal the extent of gambling involvement
- Jeopardizing or losing significant relationships, jobs, or educational opportunities due to gambling
Relying on others to provide money to relieve desperate financial situations caused by gambling
A diagnosis requires meeting four or more of these criteria within a 12-month period. The severity is classified as mild (4-5 criteria), moderate (6-7 criteria), or severe (8-9 criteria).
Compulsive Gambling Treatment Options
When coping with compulsive gambling, it can be hard to attend meetings, but some have success with Gamblers Anonymous, especially because it’s easy to access.
However, more dangerous habits could require a separation from your environment completely. Residential gambling treatment also includes other helpful programs, such as financial counseling.
Treatment for gambling disorder typically involves a combination of approaches tailored to your individual needs.
The National Council on Problem Gambling emphasizes that there isn't just one "best" way to treat problem gambling. Often, a mix of therapeutic approaches produces the best outcomes.
The main treatment recommendations include peer support groups, individual and group therapy, outpatient programs, intensive outpatient programs (IOP), and residential treatment.
Attending Gamblers Anonymous for Gambling Addiction
Gamblers Anonymous (GA) is a community of men and women struggling with compulsive gambling, where they can share their experiences with each other in a safe space with the common goal of quitting gambling. Anyone with a desire to stop gambling can attend a GA meeting at no cost.
GA follows a 12-step recovery program that encourages the gambler to take responsibility for their actions so that they can move forward in life without gambling.
GA is an excellent first step for those who are looking to connect with others who are going through the same struggles, and to gain more insight on how to combat a gambling addiction. The hope is that attendees form friendships and are able to support each other in their daily lives, outside of GA.
Unfortunately, in many cases, the occasional GA meeting is not enough to keep the gambler abstinent from gambling.
Alternative Peer Support Options
While Gamblers Anonymous is the most widely known peer support option, several alternatives exist for those who may prefer a different approach:
- SMART Recovery: A science-based, self-empowering program that uses cognitive behavioral techniques. SMART stands for "Self-Management and Recovery Training" and is popular among those who may not resonate with the spiritual aspects of traditional 12-step programs.
- Gam-Anon: A support group specifically designed for family members and loved ones of individuals struggling with gambling addiction. This program helps affected family members develop coping strategies and set healthy boundaries.
- Online Support Communities: Forums like GamTalk and Reddit communities provide anonymous spaces for people to share experiences and find solidarity with others facing similar challenges.
Is it Enough to Only Attend Gamblers Anonymous?
Every person is different and recovers in their own way and at their own pace, and some may find that they get enough help and support from GA alone. However, depending on where you live, you might not have access to in-person GA meetings.
Although some meetings are now being offered online, they are often infrequent, and it doesn’t necessarily provide the support or accountability that you need.
It’s important to note that addiction and shame go hand-in-hand. Many people find that if they relapse, they don’t want to return to GA meetings, for fear of feeling ashamed or judged by their peers. If a gambler chooses to isolate, their addiction could further escalate, and the vicious cycle continues.
Many people who gamble compulsively also have underlying mental health disorders, such as PTSD, depression, or anxiety. What you need is to get to the root of your gambling problem, and it will likely take more than GA to do that.
When a gambler attends counselling in addition to GA, this increases their likelihood of success, but this likelihood increases significantly more when the gambler attends a residential treatment center to address their gambling problem.
Research supports this observation: studies show that less than 10% of Gamblers Anonymous attendees become actively involved in the fellowship long-term, and overall abstinence rates through GA alone tend to be relatively low.
However, GA combined with professional treatment significantly improves outcomes. The most effective approach typically combines peer support with evidence-based therapies delivered by qualified professionals.
Medication Options for Gambling Disorder
While there are currently no FDA-approved medications specifically for gambling disorder, several medications have shown promise in clinical trials and may be prescribed off-label by physicians as part of a comprehensive treatment plan.
Opioid Antagonists (Naltrexone and Nalmefene)
Opioid antagonists have the strongest evidence for treating gambling disorder. These medications work by blocking the brain's reward pathways, reducing the pleasure and excitement associated with gambling.
Naltrexone, which is FDA-approved for treating alcohol and opioid dependence, has been shown to reduce gambling urges, gambling frequency, and the amount of money spent gambling. Clinical trials have demonstrated up to 50-60% reductions in gambling urges and significant decreases in gambling behavior. Naltrexone appears to be most effective for individuals with more intense gambling urges.
Nalmefene, a similar medication, has also shown efficacy in reducing gambling symptoms. A large analysis found that both naltrexone and nalmefene are effective first-line pharmacological options for gambling disorder, also improving quality of life alongside reduced gambling.
Antidepressants and Mood Stabilizers
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), may be helpful for individuals with gambling disorder who also experience depression or anxiety. While these medications don't directly target gambling urges, they can help manage co-occurring mental health conditions that often contribute to gambling behavior.
Mood stabilizers may be considered for individuals who exhibit impulsive behavior or have co-occurring bipolar disorder. As with any medication, the decision to use pharmacological treatment should be made in consultation with a qualified healthcare provider who can weigh the potential benefits against side effects.
Benefits of Attending a Residential Treatment Center
If you find that what you are learning from GA isn’t sticking with you and you continue to sink deeper into your gambling addiction, then it’s time to try something new. While attending a residential treatment center may seem extreme, that’s really not the case.
A gambling problem needs to be treated with the same urgency as any other health condition. Here are a few benefits to leaving your daily routine and attending a residential treatment center.
Residential treatment for problem gambling is typically recommended for individuals with severe gambling addiction, those with co-occurring mental health or substance use disorders, or those who have not responded well to outpatient treatment. The immersive nature of residential care provides intensive support during the critical early stages of recovery.
Connection
Addiction thrives on loneliness, and gambling can cause a person to become very isolated, especially with online gambling. Being a part of a community is essential for recovery - if you try to recover without help from anyone, you will most likely be unsuccessful.
When you come to treatment, you are surrounded by other individuals who are in the same boat as you. What we consistently hear from our clients post-departure from Algamus, is that one of their most meaningful experiences was the depth of relationships that they developed with others during the course of their treatment, and many leave as life-long friends.
You will also have the constant support of staff who are highly experienced in the reality of gambling addiction, and can empathize with what you’re going through.
New Environment & Routine
Getting away from what is familiar in your life may be the breath of fresh air that you need. This may help you identify what was triggering you in your daily life.
For example, if you tend to stop by the casino on the way home from work, taking some time away will allow you the time and space to break these unhealthy habits. You may be facing stress in your relationships or your job, and a new environment can give you a new perspective on how to better handle these situations.
Residential programs typically follow a structured daily schedule that includes individual therapy sessions, group therapy, educational workshops, and various therapeutic activities. This structure helps establish healthy routines and keeps you engaged in recovery work throughout the day, rather than having idle time that could lead to cravings or negative thought patterns.
Evaluation of Underlying Mental Health Disorders
Gambling is usually triggered by unpleasant emotions and the desire to escape from them. At a residential treatment center, there will be a strong focus on not only treating the gambling disorder, but any mental health disorders that lead to gambling.
Once the gambler learns ways to cope with their mental health disorders, this can significantly improve their ability to refrain from gambling.
Co-occurring disorders are extremely common among people with gambling addiction. Research shows high rates of depression, anxiety disorders, PTSD, bipolar disorder, ADHD, and substance use disorders among problem gamblers. In fact, gambling disorder has been shown to carry the highest suicide risk of any addictive disorder.
Studies indicate that roughly one in two problem gamblers will experience suicidal thoughts, and one in five will attempt suicide.
This underscores the critical importance of comprehensive mental health evaluation and treatment.
A thorough assessment at a residential treatment center can identify these co-occurring conditions and ensure they are addressed alongside the gambling disorder. This integrated approach to treatment significantly improves long-term outcomes.
Aftercare Support
At Algamus, we understand that recovery is a whole other story once you are back to your normal routine. Before leaving our facility, we work with our clients to form an individualized aftercare plan so that they aren’t left in the dark once they go back home.
We want to see our clients succeed, which is why we provide them with helpful resources, and check in with them periodically after their stay at Algamus.
Once a client has completed our program, we recommend that they continue to go to Gambler’s Anonymous and outpatient counselling for as long as they need.
Outpatient Treatment Programs
For many people, outpatient treatment provides an effective middle ground between self-help groups and residential care. Outpatient programs allow you to receive professional treatment while continuing to live at home and maintain your daily responsibilities.
Standard Outpatient Treatment
Standard outpatient treatment typically involves meeting with a therapist or counselor one or more times per week. Sessions focus on understanding the underlying causes of your gambling addiction, developing coping strategies, and working toward recovery goals. This option offers flexibility for those who cannot take time away from work or family responsibilities.
Intensive Outpatient Programs (IOP)
Intensive Outpatient Programs provide nine or more hours of structured programming per week, typically spread across three to five days. IOPs offer a higher level of care than standard outpatient treatment and may include individual therapy, group therapy, family sessions, and educational components.
This level of care is suitable for individuals who need more support than weekly therapy but cannot commit to residential treatment.
Relapse Prevention and Long-Term Recovery
Even with treatment, returning to gambling remains a risk, especially if you spend time with people who gamble or in gambling environments. Understanding how to prevent relapse is essential for maintaining long-term recovery.
Key strategies for preventing relapse:
- Stay focused on your primary goal: Not to gamble. Remind yourself that it's too risky to gamble at all - one bet typically leads to another.
- Identify and avoid triggers: Recognize situations that trigger gambling urges, such as certain locations, times of day, emotional states, or social situations. Develop specific plans for handling each trigger.
- Develop healthy replacement behaviors: Find new activities that provide excitement, social connection, or stress relief without gambling. Exercise, hobbies, and spending time with supportive friends can fill the void gambling once occupied.
- Maintain support systems: Continue attending support group meetings, therapy sessions, and check-ins with your aftercare program. Give yourself permission to ask for help when you need it.
- Have a relapse response plan: Know who to contact immediately if you feel the urge to gamble or if you do gamble. Contact your therapist, sponsor, or call the National Problem Gambling Helpline (1-800-522-4700) right away.
Taking the First Step Toward Recovery
If you or a loved one are looking to stop gambling and need support, reach out to us to speak to one of our certified gambling counsellors. We can help determine whether or not our gambling-specific treatment program would be a good fit for you, and provide other resources that can be of help to you.
Remember, gambling disorder is a treatable condition. With the right support, professional guidance, and commitment to recovery, you can regain control of your life and build a healthier future free from gambling.