Many mental health disorders are thought of by the general public as stand-alone problems, however it has been shown that alcohol abuse and gambling addictions often occur together. When two disorders occur together, they are called “co-occurring disorders” or “dual diagnosis disorders”. One study found that individuals who gamble are two to ten times more likely to do so if they have a substance abuse disorder (e.g. Steinberg, Kosten, Rounsaville, 1992, in Potenza et al., 2002). Another study of 2,638 American adults (Welte et al, 2001) discovered that there was an extremely significant relationship between alcohol abuse and gambling. A recent study by Cowlihaw et al (2013) confirmed this, indicating that 14% of people with substance abuse difficulties also have pathological gambling addictions, and an additional 23% have sub-clinical gambling problems; this means that 37% have co-occurring substance abuse and gambling problems.
The focus of this post ison the affects of gambling and alcohol abuse . Both alcohol and gambling problems are addiction problems that often co-occur (Elia and Jacobs, 1993), implying that their etiology or causes could be similar. These similar causes may be in the form of way someone thinks (cognitive processes), they way they act (behavioural styles) or environmental causes (e.g., troubled relationships, losses, abuse, etc.). One theory is that self-regulatory resources are ineffective in those displaying addictive behaviors (e.g. Phillips and Ogeil, 2011). It has been shown that negative emotions, such as sadness, depression, anxiety and anger can lead to more risky behaviors. It has also been shown that these negative feeling states lead to greater cravings (Witkiewitz and Bowen, 2010). Therefore, when negative emotions occur they may result in morerisky behaviour in the forms of both gambling and alcohol abuse. It has also been well documented that depression can be highly comorbid with alcohol abuse (e.g. National Epidemiologic Survey on Alcohol and Related Conditions, 2001-2002) and so depressed people may be at a particularly high risk for both alcohol abuse and gambling problems.
Another theory of addiction is the Excessive Appetites Model of Addiction (Orford, 2001), which states that humans naturally have a range of appetites and desires which we wish to be fulfilled. In some situations that appetite can reach excess and become out of control, leading to an addictive behaviour pattern. The model proposes that there are many interacting components which lead to excessive addiction, such as more opportunities to indulge, thought processes involving a preoccupation with rewards , avoidance of negative emotions, etc. In this model, alcohol abuse and gambling addiction are the result of an excessive appetite for fulfilment of one’s desires.
The theories of addiction are not exhaustive; indeed, many others exist which have not been mentioned here. The importance of having theories of comorbid alcoholism and gambling difficulties cannot be underestimated, as they often lead to the most effective treatments. Cognitive Behavioural Therapy (CBT) is a comprehensive, well informed and empirically based treatment which has been shown to be effective for many mental health difficulties, and even some physical ailments. Because it is an eclectic approach which focuses both on maladaptive cognitions and unhelpful belief systems, and uses behavioural theories to understand problematic behaviors, it can be applied to a wide range of difficulties including alcohol abuse and gambling addiction.
For example, by focusing on the cognitive distortions associated with gambling, such as biased memories and illusions of control, and by reinforcing non-gambling behaviours and preventing relapse, CBT can quickly and effectively eliminate gambling behaviour. Petry et al (2006) studied the effects of CBT on 231 pathological gamblers, and found that CBT led to significantly greater improvements in all outcome measures, including days of gambling, and the amount of money gambling, compared to participants who did not have CBT. When alcohol addiction is also present, CBT can use guided discovery and behavioural experiments to show the client that their drinking behaviour is highly linked to their gambling behaviour. For instance, it might be found that drinking is a trigger for gambling. In this case, the CBT therapist might discuss scheduling alternative activities which do not involve alcohol, to eliminate both alcohol abuse and gambling behaviour (Petry, 2009).
Castellani et al (1996) have shown that patients who have both a substance abuse disorder and a gambling addiction have much poorer coping responses; CBT is extremely effective in helping clients develop better coping strategies, and so it may well be an ideal treatment for comorbid alcoholism and pathological gambling.
Because our treatment center relies on evidence based practices, our Substance Abuse Intensive Outpatient Program shares many common methods with other successful rehab programs. The foundations of our treatment program for substance abuse also rely on the principles of harm reduction, motivational interviewing, stages of change and cognitive behavioral therapy to promote recovery from alcohol abuse and drug treatment. In fact, our Intensive Outpatient Program in Memphis, TN that has been proven to be effective in the treatment of alcohol abuse and drug treatment in peer reviewed treatment outcome studies. Our treatment center provides services to those who need more treatment than one hour a week, but less than 24 hour care, by providing three hours of treatment per day, three to five days per week, in an intensive outpatient setting. If you or a loved one is showing signs of alcohol abuse or needs drug treatment rehab, they should be assessed by a trained mental health professional who can help design a treatment plan that can result in recovery. Treatment for substance abuse can be highly successful. Call us at 901-682-6136 to schedule an appointment.
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