Review shows treatments effective for problem gamblers

Experts say more needs to be done to minimise gambling-related harm.

Problem gambling remains a persistent and burdensome global mental health condition that creates negative social and economic impacts for the gambler, their family and friends, and the wider community.

In Ballarat, nearly $58 million was lost to electronic gaming machines in 2018/19, with the losses easing more recently because of venue closures due to the COVID pandemic. But with sports betting and internet gambling growing each year, experts say more needs to be done to minimise gambling-related harm, which can include financial loss, relationship breakdowns, violence, psychological distress, reduced health and wellbeing, and suicide.

Professor of Health Promotion and Associate Deputy Vice-Chancellor in Research and Innovation, Professor Shane Thomas, initiated a study with a research team that was recently published in the prestigious Cochrane Database of Systematic Reviews, the world’s leading evidence treatment review journal, reviewing the treatment of problem gambling with pharmacological agents. The publication is a sister review to Professor Thomas’ team’s previous Cochrane review on psychological treatments for problem gambling released a decade ago.

That review has played a key part in developing the National Health and Medical Research Council (NHMRC) clinical guideline which has guided treatment for problem gambling in Australia and many other countries. The new pharmacological treatment review is informing the UK National Institute for Clinical Excellence’s new guideline on problem gambling treatment which is due for release this year.

Professor Thomas says the research reviewed in the two Cochrane studies shows that contemporary evidence-based treatments can make a significant impact on the reduction and amelioration of the condition for many people.

“Gambling is a significant problem for the community, but this research shows that there are proven treatments that can fix the problem for many people with this condition,” Professor Thomas said.

“However, a significant challenge is that some problem gamblers do not seek treatment. There seem to be two main reasons for this. One is the stigma or shame associated with having an addiction, which leads to a reluctance to seek treatment. Another is that some problem gamblers believe that they will fail in their treatment program. But the research data shows that actually the prospects of treatment success are really quite good.

“For people with gambling addiction, our research shows that treatment for that group can, on average, halve their spend and halve their hours spent gambling. So while the treatment is effective for many, some hold the view that addiction is something that you never recover from, so why should they enrol for treatment?”

Professor Thomas says both the Cochrane systematic reviews show that psychological and pharmacological treatments are effective in treating many problem gamblers and are significantly more effective than no treatment at all.

He is hopeful of working with community health groups to develop research and high-quality intervention, a collaboration that would include training health professionals to carry out the treatments. This would also allow researchers to learn more about the issue in the region.

Professor Thomas’ two main research areas – chronic illness and behavioural addictions – have a significant impact on the health and wellbeing of people in Australia and around the world. Both will rely on shifts in the behaviour of individuals and larger populations for progress to be made. Professor Thomas says his recent work on chronic illness is built upon the same learnings and principles from this program.

“Our work in China with genomics, digital health and contemporary behaviour change principles – newly added to our core behaviour change program – enable early risk assessment and timely primary, secondary and tertiary prevention in diabetes, heart health and mental health,” he said.

“Globally, chronic illnesses account for 90 per cent of disease burden. In Australia, half of the community currently have a chronic illness and one quarter have two or more such illnesses. There is much work to do, but the work is very promising.

“For problem gamblers, this is a story about not losing hope. Many can recover from this condition, and there is a lot of interesting local and international research in this area. For those who have this problem and their families, please be assured that many teams globally are working assiduously on developing effective prevention and treatments and programs to deliver them.

“Please also be assured that there are government-funded services dedicated to assisting problem gamblers and their families that can be readily accessed. An internet search on problem gambling help services will list a range of options. Many local family and community health services also run programs.”

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