Pilot Study of Problem Gambling in Specialized Substance Use Disorder Treatment—High Lifetime Prevalence of Problem Gambling in Opioid Maintenance Treatment Patients

Anders Håkansson,Johanna Ek

doi:10.4236/ojpsych.2018.83020

Abstract

Problem gambling is over-represented in patients treated for substance use disorders, but substance-specific prevalence of problem gambling is rarely reported. In specialized addiction treatment facilities for opioid maintenance treatment and for alcohol and prescription drug dependence, respectively, 129 patients were screened for problem gambling using the NODS-CLiP. The lifetime prevalence of problem gambling was markedly higher in opioid maintenance treatment (61 percent) than in alcohol and prescription drug dependence treatment (11 percent, p < 0.001). When controlling for gender and age, problem gambling remained significantly associated with opioid maintenance treatment. The present study demonstrated a very high prevalence of lifetime problem gambling in opioid maintenance treatment patients. This calls for active screening for problem gambling in substance use disorder patients, and mainly in treatment for opioid dependence.

Highlights

The link between disordered gambling and substance use disorders, as defined in diagnostic systems such as in the DSM-5 or preceding diagnostic manuals [1], is well established in the literature [2]-[7]
The present study aimed to address the prevalence of lifetime problem gambling in two specialized substance use disorder treatment facilities, treating alcohol and prescription drug use disorders, and opioid dependence, respectively
Patients were included from two types of settings in three cities, which address distinct types of substance use disorders; 1) an out-patient facility of the Malmö Addiction Centre (MAC), Sweden, treating substance use disorders related to alcohol or to the misuse of prescription drugs, typically opioid analgesics or sedatives such as benzodiazepines or similar pharmaceuticals, and 2) an out-patient department for opioid maintenance treatment (OMT) located in two units, in Lund and Helsingborg, respectively

Summary

Introduction

The link between disordered gambling and substance use disorders, as defined in diagnostic systems such as in the DSM-5 or preceding diagnostic manuals [1], is well established in the literature [2]-[7]. Substance use disorders have been described to represent some of the most prevalent co-morbidities; a meta-analysis reported that 21 percent and seven percent of pathological gambling patients may meet criteria of a current alcohol use disorder and drug use disorder, respectively [4]. An increased prevalence of problem gambling has been demonstrated in samples of substance use disorder patients; a review and meta-analysis by Cowlishaw and co-workers demonstrated comorbidity with pathological gambling or the wider concept of problem gambling in 14 and 23 percent of substance users, respectively. Across types of substance use disorders and across study methodologies, in a review paper from 2014 [3], the prevalence of problem gambling ranged from less than 10 percent to around 50 percent, i.e. constantly well above prevalence rates reported from the general population [3]. In a more recent study from a methadone maintenance facility, as many as 46 percent of patients fulfilled criteria of past-year gambling disorder [8]

Methods

Results

Conclusion