Abstract
Problem gambling, substance use disorders, and their cooccurrence are serious public health concerns. We conducted a comprehensive review of the literature to understand the present state of the evidence on these coaddictions. Our main focus was illicit drug use rather than misuse of legal substances. The review covers issues related to gambling as a hidden problem in the illicit drug use community; prevalence, problem gambling, and substance use disorders as kindred afflictions; problem gambling as an addiction similar to illicit drug use; risk factors and problems associated with comorbidity, and gender issues. We end with some suggestions for future research.
Highlights
The relation between illicit drug abuse and problem gambling remains understudied, with a preponderance of information generated from treatment samples
The review covers issues related to gambling as a hidden problem in the illicit drug use community; prevalence, problem gambling, and substance use disorders as kindred afflictions; problem gambling as an addiction similar to illicit drug use; risk factors and problems associated with comorbidity, and gender issues
Research on problem gambling itself suggests stark differences between gamblers seeking treatment and those identified in the general population: treatment populations are generally white, middleaged men while those in the general population are more likely than treatment populations to be women, minorities, and of lower education [1,2,3]
Summary
The relation between illicit drug abuse and problem gambling remains understudied, with a preponderance of information generated from treatment samples. Boas de Carvalho et al [18] found high problem gambling rates (10.8% problem and 18.9% pathological) among 74 (89% male) persons in treatment for substance use disorders (of whom 60.3% identified cocaine/crack as a major drug of abuse). It has been argued that problem gambling and substance use disorders are related because of underlying traits such as impulsivity [45,46,47], adding more weight to the notion of a unified disorder Still, such a conception is unlikely to apply to every case [25] since most information on comorbidity comes from treatment samples we may have exaggerated the associations given that persons with more than one disorder might be more inclined to seek help [12]. Crockford and ElGuebaly [4] suggest that since gambling and substance use often occur at the same locations, some cases of comorbidity may be situational rather than endemic to the disorders
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