Chapter 54 - Alcohol and Gambling Addiction

Abstract

Drinking alcohol is connected to gambling; alcohol abuse in many occasions precedes the development of a gambling disorder, contributes to prolonging a gambling disorder, and entices a risky behavior in gamblers. In many cases, alcohol addiction is in comorbidity with gambling disorder with comorbidity being more prevalent in men. The alcohol addiction rate in gamblers is around 73%, and alcoholics are 5–6 times under greater risk of developing a gambling disorder, and the severity of gambling disorder is directly related to the amount of alcohol consumed and the age when the drinking began. Alcoholism is prevalent in pathological gamblers. Possible mutual variables which contribute to pathogenesis of these disorders are: genetic vulnerability, dysregulation of the dopamine reward system, conduct disorder in childhood, prenatal alcohol exposure and mother’s alcohol abuse later during childhood, impulsive and compulsive behaviors, and a deficit in emotion regulations. Structural and functional disorders in the prefrontal cortex in relation to executive function disorders are also an important factor in the development and maintenance of alcohol addiction and gambling disorders. Comorbidity between gambling disorders and alcoholism is related to bad treatment response, and currently treatment possibilities are limited to modified treatment modalities which are already being used in the treatment of alcohol addiction, such as motivation interview, cognitive behavioral therapy, and relapse prevention. Pharmacotherapeutic approaches have not provided positive results.