Patologiczny hazard
Epidemiologia

Patologiczny hazard, dotykający około 1,2% dorosłej populacji globalnie, stanowi poważne wyzwanie zdrowia publicznego, z wyraźnym wzrostem problemów hazardowych wśród osób regularnie uprawiających hazard (wzrost z 12,7% w 2014 do 25,6% w 2023 roku). Zaburzenie to charakteryzuje się wysokim współwystępowaniem z innymi zaburzeniami psychicznymi, w tym zaburzeniami nastroju, lękowymi, uzależnieniami oraz zwiększonym ryzykiem samobójstwa (15-krotnie wyższe w porównaniu z populacją ogólną). Szczególnie narażone grupy to osoby starsze, młodzież, studenci, sportowcy i weterani. Istotnym czynnikiem ryzyka jest stosowanie leków dopaminergicznych, takich jak pramipeksol, ropinirol oraz aripiprazol, zwłaszcza u pacjentów z chorobą Parkinsona i zaburzeniami psychotycznymi. Wzrost dostępności hazardu online, zwłaszcza po legalizacji zakładów sportowych w USA (decyzja Murphy v. NCAA, 2018), koreluje ze wzrostem poszukiwania pomocy w związku z uzależnieniem od hazardu (wzrost o 23%, do 6,5-7,3 mln wyszukiwań). Monitoring i nadzór epidemiologiczny, realizowany przez wyspecjalizowane instytucje (np. OPGS w Massachusetts, Centrum Doskonałości w Maryland), są kluczowe dla identyfikacji czynników ryzyka, oceny rozpowszechnienia i skuteczności interwencji.

  1. Patologiczny hazard: Epidemiologia i monitoring
    1. Globalny zasięg patologicznego hazardu
    2. Czynniki ryzyka i współwystępowanie z innymi zaburzeniami
    3. Zmiany w rozpowszechnieniu patologicznego hazardu
    4. Skutki wprowadzenia legalnego hazardu
  2. Systemy monitoringu i nadzoru nad patologicznym hazardem
    1. Krajowe systemy monitoringu
    2. Międzynarodowe wysiłki w zakresie monitoringu
    3. Wyzwania w monitoringu patologicznego hazardu
    4. Znaczenie monitoringu dla zdrowia publicznego
  3. Konsekwencje zdrowotne i społeczne patologicznego hazardu
    1. Konsekwencje zdrowotne
    2. Konsekwencje społeczne i ekonomiczne
    3. Wpływ na otoczenie
  4. Postępy w badaniach nad patologicznym hazardem
    1. Badania neurobiologiczne
    2. Badania farmakologiczne
    3. Badania nad przebiegiem zaburzenia
  5. Implikacje dla zdrowia publicznego i polityki
    1. Potrzeba uniwersalnych podejść do zdrowia publicznego
    2. Wczesne wykrywanie i interwencja
    3. Potrzeba dalszych badań
    4. Kolejne rozdziały

Patologiczny hazard: Epidemiologia i monitoring

Patologiczny hazard (ang. compulsive gambling, gambling disorder) stanowi istotny problem zdrowia publicznego, który dotyka miliony osób na całym świecie. W ostatnich latach, wraz z rozwojem dostępności możliwości uprawiania hazardu, w tym hazardu online, problem ten zyskuje coraz większe znaczenie w kontekście zdrowia publicznego. W tym artykule skupimy się na epidemiologii patologicznego hazardu oraz systemach monitoringu i nadzoru nad tym zjawiskiem.12

Globalny zasięg patologicznego hazardu

Badania epidemiologiczne wskazują, że problem patologicznego hazardu dotyka znaczącą część populacji na całym świecie. Według Światowej Organizacji Zdrowia (WHO), około 1,2% światowej populacji osób dorosłych cierpi z powodu zaburzeń hazardowych. Szacuje się, że około 5,5% kobiet i 11,9% mężczyzn na całym świecie doświadcza pewnego poziomu szkód związanych z hazardem.1

Metaanaliza badań empirycznych z lat 2016-2022 wykazała, że rozpowszechnienie hazardu o umiarkowanym ryzyku/zagrożeniu wynosi 2,43%, a patologicznego hazardu/problemowego hazardu wynosi 1,29% wśród populacji dorosłych. Te wskaźniki różnią się znacząco w zależności od kraju i regionu, co podkreśla potrzebę uwzględnienia różnic kulturowych i kontekstowych w badaniach nad patologicznym hazardem.12

W Stanach Zjednoczonych według różnych źródeł, problem patologicznego hazardu dotyczy od 0,6% do 3% populacji, co przekłada się na około 2-6 milionów Amerykanów. Krajowa Rada ds. Problematycznego Hazardu (NCPG) szacuje, że około 5 milionów Amerykanów spełnia kryteria kompulsywnego hazardu, jednak tylko około 8% z tych osób kiedykolwiek szuka pomocy.123

Czynniki ryzyka i współwystępowanie z innymi zaburzeniami

Patologiczny hazard charakteryzuje się wysokim poziomem współwystępowania z innymi zaburzeniami psychicznymi. Badanie z 2008 roku wykazało, że osoby z zaburzeniami psychicznymi są 17 razy bardziej narażone na rozwój problemów hazardowych. Osoby z zaburzeniami hazardowymi często cierpią również na zaburzenia nastroju, zaburzenia lękowe, zaburzenia związane z używaniem substancji psychoaktywnych lub zaburzenia osobowości.12

Badania wskazują również na silny związek między patologicznym hazardem a tendencjami samobójczymi. Badanie przeprowadzone w Szwecji wykazało, że osoby z zaburzeniami hazardowymi są 15 razy bardziej narażone na śmierć przez samobójstwo niż populacja ogólna.1

Wśród grup szczególnie narażonych na rozwój patologicznego hazardu znajdują się:1

  • Osoby starsze
  • Młodzież i młodzi dorośli
  • Studenci
  • Sportowcy
  • Weterani

Badania wykazały również, że patologiczny hazard może być konsekwencją stosowania leków dopaminergicznych, szczególnie tych używanych w leczeniu chorób neurologicznych, takich jak pramipeksol i ropinirol, a także potencjalnie aripiprazol, atypowy lek przeciwpsychotyczny. Pacjenci z chorobą Parkinsona, zespołem niespokojnych nóg oraz innymi schorzeniami leczonymi agonistami dopaminy, a także pacjenci leczeni z powodu zaburzeń psychotycznych, stanowią grupy szczególnie narażone na rozwój zaburzeń hazardowych.123

Zmiany w rozpowszechnieniu patologicznego hazardu

Obserwuje się zmieniające się trendy w rozpowszechnieniu patologicznego hazardu, co częściowo wynika z rosnącej dostępności możliwości uprawiania hazardu, w tym poprzez platformy online. Badania przeprowadzone przez Uniwersytet Massachusetts Amherst wykazały, że wśród osób uprawiających hazard co miesiąc, odsetek tych doświadczających problemów hazardowych wzrósł z 12,7% w 2014 roku do 20,9% w 2022 roku i 25,6% w 2023 roku.12

Jednocześnie, badania populacyjne przeprowadzone przed i po wprowadzeniu kasyn w Massachusetts wykazały stały poziom problemowego hazardu na poziomie 2%. To sugeruje, że wzrost problemów hazardowych może być szczególnie widoczny wśród osób regularnie uprawiających hazard, podczas gdy ogólna populacja może nie doświadczać takiego samego wzrostu.12

Najnowsze badanie online wykazało również wzrost odsetka osób uprawiających hazard co miesiąc, które uważają, że szkody związane z hazardem przewyższają korzyści, oraz że uzależnienie od hazardu jest najważniejszym negatywnym skutkiem kasyn. To wskazuje na rosnącą świadomość ryzyka związanego z hazardem.12

Skutki wprowadzenia legalnego hazardu

Wprowadzenie legalnego hazardu, w tym zakładów sportowych, może mieć znaczący wpływ na rozpowszechnienie patologicznego hazardu. Badanie opublikowane w JAMA Internal Medicine, prowadzone przez badaczy z Uniwersytetu Kalifornijskiego w San Diego, wykazało dramatyczny wzrost zakładów sportowych i poszukiwania pomocy w związku z uzależnieniem od hazardu od czasu przełomowej decyzji Sądu Najwyższego w sprawie Murphy v. NCAA w 2018 roku, która otworzyła drogę do legalizacji zakładów sportowych w różnych stanach.1

Równolegle ze wzrostem liczby bukmacherów, wyszukiwania internetowe dotyczące pomocy w związku z uzależnieniem od hazardu, takie jak „czy jestem uzależniony od hazardu”, wzrosły łącznie o 23% w skali kraju od czasu decyzji Murphy v. NCAA do czerwca 2024 roku. Odpowiada to około 6,5-7,3 milionom wyszukiwań dotyczących pomocy w związku z uzależnieniem od hazardu w skali kraju, z maksymalną liczbą 180 000 wyszukiwań miesięcznie.1

Badanie wykazało również, że bukmacherzy online mieli znacznie większy wpływ na poszukiwanie pomocy w związku z uzależnieniem od hazardu niż tradycyjne bukmacherzy stacjonarne. To sugeruje, że zwiększona dostępność hazardu online może przyczyniać się do wzrostu problemów związanych z hazardem.1

Systemy monitoringu i nadzoru nad patologicznym hazardem

Ze względu na rosnące rozpowszechnienie patologicznego hazardu, coraz większe znaczenie zyskują systemy monitoringu i nadzoru epidemiologicznego tego zjawiska. Monitoring i nadzór są kluczowymi elementami zdrowia publicznego, które kierują wysiłkami i strategiami w zakresie zapobiegania i łagodzenia szkód.1

Krajowe systemy monitoringu

W wielu krajach istnieją wyspecjalizowane instytucje i programy zajmujące się monitorowaniem rozpowszechnienia patologicznego hazardu oraz zbieraniem danych na ten temat. W Stanach Zjednoczonych różne stany prowadzą własne programy badawcze i nadzorcze.1

Przykładem może być Departament Zdrowia Publicznego stanu Massachusetts (DPH), który poprzez Biuro Usług ds. Problematycznego Hazardu (OPGS) zobowiązał się do promowania optymalnego zdrowia i dobrostanu wszystkich mieszkańców oraz zapewnienia im zdrowych i sprawiedliwych społeczności do pracy i życia. OPGS opracowało Ramy Działania Opartego na Danych, które zapewniają, że dane dotyczące problematycznego hazardu są wiarygodne, sprawiedliwe, dostępne i możliwe do wykorzystania, co prowadzi do optymalnej reakcji zdrowia publicznego na problematyczny hazard.1

Ramy Działania Opartego na Danych OPGS obejmują:1

  • Monitoring i nadzór: Badanie danych z monitoringu i nadzoru zdrowia publicznego w celu scharakteryzowania i opisania problemu, identyfikacji czynników ryzyka i czynników ochronnych oraz eksploracji sił napędowych (przyczyn źródłowych)
  • Wykorzystanie ciągłych informacji zwrotnych od społeczności do informowania o przyszłych wysiłkach w zakresie monitoringu i nadzoru, programowania i polityki

W stanie Maryland funkcjonuje Centrum Doskonałości ds. Problematycznego Hazardu w Maryland, które prowadzi Program Badawczy dotyczący Hazardu. Program ten realizuje dwa główne projekty związane z nadzorem: Free State Data Warehouse oraz Badanie Rozpowszechnienia.1

Free State Data Warehouse to starannie utrzymywany magazyn danych, wdrożony w celu wspierania oceny wpływu hazardu na zdrowie publiczne w stanie Maryland. Prawo Maryland wymaga, aby Departament Zdrowia i Higieny Psychicznej (DHMH) regularnie oceniał rozpowszechnienie problematycznego hazardu w stanie. Początkowa ocena została przeprowadzona we wrześniu 2010 roku. Wraz z utworzeniem Maryland Center of Excellence on Problem Gambling i integracją Research Program on Gambling z Centrum, odpowiedzialność za przeprowadzenie ogólnostanowego badania rozpowszechnienia hazardu spoczywa teraz na Research Program on Gambling.1

Międzynarodowe wysiłki w zakresie monitoringu

Światowa Organizacja Zdrowia (WHO) uznaje negatywne skutki hazardu dla zdrowia i podkreśla potrzebę ścisłego monitorowania i skutecznego regulowania operacji, produktów i działań hazardowych. WHO przyznaje, że potrzebne są wielosektorowe działania w celu zmniejszenia szkód związanych z hazardem, aby zmniejszyć potencjał hazardu do hamowania postępu w realizacji Celów Zrównoważonego Rozwoju.1

Globalne rozpowszechnienie patologicznego hazardu jest trudne do precyzyjnego określenia ze względu na różnice metodologiczne w badaniach oraz różnice kulturowe i kontekstowe. Jednak standaryzowane globalne szacunki szkód związanych z hazardem sugerują, że 1,2% światowej populacji osób dorosłych cierpi z powodu zaburzeń hazardowych.1

Raport opublikowany w czasopiśmie Lancet Public Health przez międzynarodową komisję składającą się z 22 ekspertów w dziedzinie zdrowia i polityki ostrzega przed ryzykiem związanym z hazardem w erze łatwego dostępu online. Raport badał nowe przepisy dotyczące hazardu między 2018 a 2023 rokiem w 80 jurysdykcjach, w tym w większości stanów USA, i zalecał, aby rządy priorytetowo traktowały zdrowie podczas tworzenia przepisów dotyczących hazardu, zamiast koncentrować się na pieniądzach podatkowych, które te działalności mogłyby przynieść.12

Wyzwania w monitoringu patologicznego hazardu

Monitoring i nadzór nad patologicznym hazardem napotykają na różne wyzwania, w tym:12

  • Problemy z metodologią badań, w tym kwestie związane z próbkowaniem i pomiarem
  • Dostępność danych i trudności w ich gromadzeniu
  • Zaprzeczenie i efekty reaktywne, które mogą zniekształcać wyniki badań
  • Względy etyczne związane z badaniem wrażliwych populacji
  • Odpowiedniość różnych metod gromadzenia danych

Istnieje również brak systematycznego procesu edukacji, badań przesiewowych i leczenia patologicznych hazardzistów. Edukacja świadczeniodawców i społeczności na temat głębi tego problemu jest kluczowa w identyfikacji pacjentów, którzy są problematycznymi lub patologicznymi hazardzistami, oraz w pomocy programom leczenia.1

Znaczenie monitoringu dla zdrowia publicznego

Monitoring i nadzór epidemiologiczny nad patologicznym hazardem mają kluczowe znaczenie dla zdrowia publicznego z kilku powodów:12

  • Pomagają określić epidemiologię, czynniki ryzyka oraz strategie zapobiegania i leczenia zaburzeń hazardowych
  • Umożliwiają monitorowanie rozpowszechnienia zaburzeń hazardowych i ocenę wpływu polityk i interwencji
  • Informują o planowaniu usług i leczeniu
  • Wspierają wysiłki na rzecz wczesnego wykrywania i interwencji

W przypadku Nigerii, która ma drugi co do wielkości rynek zakładów sportowych online w Afryce, podkreślono potrzebę ogólnokrajowego badania w celu określenia epidemiologii, czynników ryzyka, strategii zapobiegawczych i leczniczych w przypadku zaburzeń hazardowych. Wskazano, że kamieniem węgielnym natychmiastowych i długoterminowych wysiłków na rzecz kontroli zaburzeń hazardowych jest nadzór epidemiologiczny.12

Konsekwencje zdrowotne i społeczne patologicznego hazardu

Patologiczny hazard powoduje szereg negatywnych konsekwencji zdrowotnych i społecznych, które wykraczają poza samą osobę uprawiającą hazard i dotykają również jej rodziny, bliskich i szerszej społeczności.11

Konsekwencje zdrowotne

Patologiczny hazard jest związany z różnymi problemami zdrowotnymi, w tym:123

  • Stres finansowy
  • Problemy ze zdrowiem psychicznym, w tym depresja i zaburzenia lękowe
  • Podwyższone ryzyko samobójstwa
  • Schorzenia wywoływane przez stres, takie jak nadciśnienie, wrzody trawienne i migreny
  • Współwystępowanie z innymi zaburzeniami psychicznymi i uzależnieniami

Badanie przeprowadzone w Szwecji wykazało, że osoby z zaburzeniami hazardowymi mogą być również bardziej narażone na długotrwałe zwolnienia chorobowe. Badacze z Karolinska Institutet odkryli, że osoby z uzależnieniem od hazardu miały o 89% wyższe ryzyko przebywania na długotrwałym zwolnieniu chorobowym, co oznacza ponad 90 dni w roku w trakcie roku, w którym zdiagnozowano uzależnienie.12

Konsekwencje społeczne i ekonomiczne

Patologiczny hazard ma również znaczące konsekwencje społeczne i ekonomiczne, w tym:123

  • Rozpad związków i rodzin
  • Przemoc domowa
  • Problemy finansowe, w tym nadmierne zadłużenie i bankructwo
  • Problemy z zatrudnieniem
  • Dążenia kryminalne

Szacunki dodatkowych kosztów szkodliwego hazardu (bezpośredni koszt finansowy dla rządu plus społeczna wartość wpływu na zdrowie) w Anglii wynoszą od 1,05 do 1,77 miliarda funtów. Jednak oczekuje się, że rzeczywiste koszty są wyższe, ponieważ brak dowodów uniemożliwił oszacowanie kosztów wszystkich rodzajów szkód lub szerszych szkód dla jednostek lub społeczeństwa.1

Wpływ na otoczenie

Patologiczny hazard wpływa nie tylko na osobę uprawiającą hazard, ale także na jej otoczenie. Szacuje się, że na każdą osobę uprawiającą hazard na wysokim poziomie ryzyka, średnio sześć innych osób (zwykle osoby nieuprawiające hazardu) jest dotkniętych negatywnymi konsekwencjami.1

Profil demograficzny hazardzistów wydaje się zmieniać wraz ze wzrostem ryzyka hazardu, przy czym szkodliwy hazard jest związany z osobami bezrobotnymi i wśród osób mieszkających na bardziej zubożałych obszarach. Sugeruje to, że szkodliwy hazard jest związany z nierównościami zdrowotnymi.1

Postępy w badaniach nad patologicznym hazardem

Badania nad patologicznym hazardem ewoluują, dostarczając nowych spostrzeżeń na temat przyczyn, przebiegu i leczenia tego zaburzenia. Ośrodki badawcze, takie jak Yale Medicine, które jest liderem w badaniach nad leczeniem zaburzeń hazardowych, z jednym z dwóch Centrów Doskonałości w badaniach nad hazardem w kraju finansowanych przez Krajowe Centrum Odpowiedzialnego Hazardu, prowadzą przełomowe badania.12

Badania neurobiologiczne

Centrum Doskonałości w Badaniach nad Hazardem Yale, kierowane przez psychiatrę Yale Medicine, dr. Marca Potenzę, przeprowadziło pierwsze badania obrazowania mózgu u osób z problemami hazardowymi. Badania te wykazały, że mózg działa podobnie podczas przetwarzania nagrody pieniężnej u osób z zaburzeniami hazardowymi, jak u osób z zaburzeniami związanymi z objadaniem się, używaniem alkoholu i używaniem tytoniu.1

Badania wykazały również, że patologiczny hazard charakteryzuje się znaczącymi zaburzeniami w zakresie kontroli impulsów. Metaanaliza wskazała na podwyższoną impulsywność w różnych domenach poznawczych w przypadku zaburzeń hazardowych, w tym w zakresie hamowania motorycznego i uwagi, dyskontowania i podejmowania decyzji.12

Badania farmakologiczne

Badania wykazały związek między stosowaniem leków dopaminergicznych a zwiększonym ryzykiem rozwoju zaburzeń hazardowych. Liczne badania na dużych populacjach potwierdziły związek między zaburzeniami hazardowymi a leczeniem lewodopą, ale jeszcze wyraźniej między zaburzeniami hazardowymi a agonistami dopaminy pramipeksolem i ropinirolem. Te dwa leki są selektywne dla receptora D3, co mogłoby wyjaśniać ich wysokie ryzyko zwiększania wskaźników zaburzeń hazardowych w porównaniu z innymi agonistami dopaminy lub lewodopą.12

Innym lekiem związanym ze wzrostem wskaźników zaburzeń hazardowych jest atypowy lek przeciwpsychotyczny aripiprazol. Proponowany mechanizm działania aripiprazolu to jego stabilizujący wpływ na poziomy dopaminy, działający jako częściowy agonista. Podczas gdy większość dowodów na rolę aripiprazolu w zaburzeniach hazardowych opierała się na bardziej anegdotycznych prezentacjach przypadków, ostatnie badania kliniczne i rejestrowe na dużą skalę wykazały statystyczny związek między leczeniem aripiprazolem a zaburzeniami hazardowymi.12

Badania nad przebiegiem zaburzenia

Patologiczny hazard zazwyczaj rozpoczyna się we wczesnej młodości u mężczyzn i później w życiu u kobiet. Niektóre osoby uzależniają się od pierwszego zakładu, ale dla większości przebieg jest bardziej podstępny. Lata uprawiania hazardu towarzyskiego mogą być poprzedzone nagłym początkiem, który może być wywołany większą ekspozycją na hazard lub jakimś czynnikiem stresującym. Wzorzec może być regularny lub epizodyczny, a przebieg zaburzenia jest często przewlekły.1

Badania nad rozwojem zaburzeń hazardowych wskazują również na rolę urazów mózgu w zwiększaniu ryzyka problemowego hazardu wśród młodzieży. Badanie przeprowadzone w Kanadzie wykazało, że uczniowie z historią traumatycznego urazu mózgu (TBI) mieli 2 razy większe szanse na problem hazardowy w porównaniu do tych bez TBI, po uwzględnieniu ryzykownego picia alkoholu i myśli samobójczych.12

Implikacje dla zdrowia publicznego i polityki

Rosnące rozpowszechnienie patologicznego hazardu ma istotne implikacje dla zdrowia publicznego i polityki. Eksperci podkreślają potrzebę lepszego monitorowania i nadzoru nad hazardem, szczególnie w kontekście rosnącej dostępności hazardu online.12

Potrzeba uniwersalnych podejść do zdrowia publicznego

WHO uznaje, że uniwersalne, populacyjne podejścia do zdrowia publicznego są niezbędne do zapobiegania szkodom związanym z hazardem. Komercjalizacja hazardu w wielu krajach, która napędza również jego normalizację, zwiększa częstość występowania szkód związanych z hazardem.12

Eksperci zalecają, aby rządy priorytetowo traktowały zdrowie podczas tworzenia przepisów dotyczących hazardu, zamiast koncentrować się na pieniądzach podatkowych, które te działalności mogłyby przynieść. Raport wzywa również do zwiększonego nadzoru w celu ochrony dzieci i konsumentów, zarówno na poziomie krajowym, jak i międzynarodowym, przed niebezpiecznym wpływem hazardu.1

Wczesne wykrywanie i interwencja

Badania przeprowadzone w Massachusetts wykazały, że odsetek wydatków na hazard pochodzących od hazardzistów z grupy ryzyka wzrósł z 51% w 2013 roku do 68% w 2021 roku. Ten wzrost sugeruje, że cel minimalizacji i łagodzenia szkód związanych z hazardem musi się przesunąć w kierunku wcześniejszego identyfikowania potencjalnych hazardzistów potrzebujących pomocy.1

Badacze z Karolinska Institutet podkreślają potrzebę wcześniejszego wykrywania problemów hazardowych w opiece zdrowotnej i w miejscach pracy oraz zwiększenia dostępu do pomocy dla osób dotkniętych, aby mogły one wcześniej przerwać negatywne trajektorie. Uzależnienie od hazardu może pozostać niezauważone, a problemy mogą stać się rozległe, zanim zostaną zauważone i zdiagnozowane w opiece zdrowotnej.1

Potrzeba dalszych badań

Pomimo postępów w badaniach nad patologicznym hazardem, nadal istnieje potrzeba dalszych badań w wielu obszarach. Rosnąca wiedza w tej dziedzinie wymaga dalszych badań w projektach przedklinicznych, klinicznych i epidemiologicznych.1

Kolejnym krokiem w badaniach jest dalsze rozwijanie metod wcześniejszego wykrywania uzależnienia od hazardu i edukowanie pracowników służby zdrowia na temat tego problemu. Ponieważ uzależnienie od hazardu jest często problemem długoterminowym, ważne będzie również śledzenie osób przez jeszcze dłuższy okres, na przykład do dziesięciu lat, aby dowiedzieć się więcej o długoterminowych konsekwencjach dla osób dotkniętych i ich otoczenia.1

Obecna metaanaliza podkreśla różnice w rozpowszechnieniu patologicznego hazardu w różnych krajach, uwzględniając różnice między poziomami ryzyka i nasilenia. Ta praca ma na celu zapewnienie punktu wyjścia dla decydentów i naukowców do uzupełnienia luk w badaniach nad hazardem, szczególnie w niektórych krajach, gdzie brak badań w tej dziedzinie jest oczywisty, oraz do zbadania skuteczności polityk wdrożonych w celu łagodzenia szkód związanych z hazardem.1

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 19.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Prevalence of Problem Gambling: A Meta-analysis of Recent Empirical Research (2016-2022) – PubMed
    https://pubmed.ncbi.nlm.nih.gov/36586057/
    Gambling is widely considered a socially acceptable form of recreation. However, for a small minority of individuals, it can become both addictive and problematic with severe adverse consequences. The aim of this systematic review and meta-analysis is to provide an overview of prevalence studies published between 2016 and the first quarter of 2022 and an updated estimate of problem gambling in the general adult population. […] This study found a prevalence of moderate risk/at risk gambling to be 2.43% and of problem/pathological gambling to be 1.29% in the adult population. […] The present meta-analysis highlights the variations of prevalence across different countries, giving due consideration to the differences between levels of risk and severity. This work intends to provide a starting point for policymakers and academics to fill the gaps on gambling research-more specifically in some countries where the lack of research in this field is evident-and to study the effectiveness of policies implemented to mitigate gambling harm.
  • #1
    https://www.who.int/news-room/fact-sheets/detail/gambling
    Standardized global estimation of gambling harms has been limited, but estimates suggest that 1.2% of the worlds adult population has a gambling disorder. […] Gambling can lead to serious harms to health. These include financial stress, relationship breakdown, family violence, mental illness and suicide. […] Around 5.5% of women and 11.9% of men globally experience some level of harm from gambling. […] A Swedish study estimated that those with a gambling disorder were 15 times more likely to die by suicide than the general population. […] For every person who gambles at high-risk levels, an average of six others (usually non-gamblers) are affected. […] The commercialization of gambling in many countries which also drives normalization is increasing the incidence of gambling harm.
  • #1 Problem gambling – Wikipedia
    https://en.wikipedia.org/wiki/Problem_gambling
    Pathological gambling is similar to many other impulse-control disorders such as kleptomania. […] According to evidence from both community- and clinic-based studies, individuals who are pathological gamblers are highly likely to exhibit other psychiatric problems concurrently, including substance use disorders, mood and anxiety disorders, or personality disorders. […] The World Health Organization has also classified gambling a disease. […] In Mexico there could be between one and three million people addicted to gambling. […] In the United States, the percentage of pathological gamblers was 0.6 percent, and the percentage of problem gamblers was 2.3 percent in 2008. […] Approximately 6 million American adults are addicted to gambling.
  • #1 Gambling Disorder > Fact Sheets > Yale Medicine
    https://www.yalemedicine.org/conditions/gambling-disorder
    Excessive gambling can drain finances, ruin personal and professional relationships, and harm the gamblers mental health. Gambling disorder affects about 1% of Americans who cant stop, despite the consequences. […] Yale Medicine is a leader in gambling disorder treatment research, with one of two Centers of Excellence in gambling research in the nation financed by the National Center for Responsible Gaming located at Yale. […] A 2008 study showed that people with psychiatric disorders are 17 times more likely to develop gambling problems. […] Most adults who gamble do not have a gambling disorder, but those who do can face very serious problems. […] People who, over a 12-month period meet four of these nine criteria devised by the American Psychiatric Association, are considered to have a gambling disorder:
  • #1 Problem Gambling – Wyoming Department of Health
    https://health.wyo.gov/behavioralhealth/mhsa/problem-gambling/
    Gambling addiction affects 6-9 million Americans, or 2-3% of the population. […] Problem gambling is a public health issue that impacts relationships, families, businesses, and communities. […] Problem gambling does not discriminate based on age, gender, religion, social status or education. Anyone can develop a gambling problem. […] Groups at high risk include seniors, adolescents, college students, athletes, and veterans.
  • #1 Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9825131/
    Problematic gambling has been suggested to be a possible consequence of dopaminergic medications used mainly in neurological conditions, i.e. pramipexole and ropinirole, and possibly by one antipsychotic compound, aripiprazole. […] Patients with Parkinsons disease, restless legs syndrome and other conditions potentially treated with dopamine agonists, as well as patients treated for psychotic disorders, are vulnerable patient groups with theoretically increased risk of developing gambling disorder (GD), for example due to higher rates of mental ill-health in these groups. […] The aim of the present paper is to review the epidemiological, clinical, and neurobiological evidence of the association between dopaminergic medications and GD, and to describe risk groups and treatment options. […] Gambling disorder (GD), previously referred to as pathological gambling, is a condition defined both in the psychiatric diagnostic manual of the American Psychiatric Association, the DSM-5 and in the World Health Organizations diagnostic manual, the ICD-11.
  • #1 Problem Gambling May Be on the Rise Among Monthly Gamblers in Massachusetts, Online Surveys Suggest : School of Public Health & Health Sciences : UMass AmherstUMass Collegiate MSchool of Public Health & Health SciencesXFind us on FacebookFind us on YouTub
    https://www.umass.edu/public-health-sciences/news/problem-gambling-may-be-rise
    In the latest of three online gambling surveys conducted by the University of Massachusetts Amherst, monthly gamblers in Massachusetts reported an increase in gambling intensity and gambling harms. In addition, their attitudes toward gambling have grown more negative. […] Among monthly gamblers in the online surveys, those experiencing gambling problems jumped from 12.7% in 2014 to 20.9% in 2022 to 25.6% in 2023. This compares to a 2% prevalence of problem gambling that held steady in general population surveys conducted before and after casinos were introduced in Massachusetts. […] „While the online panels were not representative of the population, they were very informative in regards to people with gambling difficulties. It’s very helpful from a surveillance and monitoring perspective.”
  • #1 Problem Gambling May Be on the Rise Among Monthly Gamblers in Massachusetts, Online Surveys Suggest : School of Public Health & Health Sciences : UMass AmherstUMass Collegiate MSchool of Public Health & Health SciencesXFind us on FacebookFind us on YouTub
    https://www.umass.edu/public-health-sciences/news/problem-gambling-may-be-rise
    The latest online survey also showed increases in the proportion of monthly gamblers who believe both that the harm of gambling outweighs the benefits and that gambling addiction is the most important negative impact of casinos. […] „I think it’s definitely a cause for concern about what the population impacts of sports betting are going to be because these indicators from the monthly gamblers in the online panel are not going in a direction that says there’s going to be less gambling harm in Massachusetts in the future.”
  • #1 Study Reveals Surge in Gambling Addiction Following Legalization of Sports Betting
    https://today.ucsd.edu/story/study-reveals-surge-in-gambling-addiction-following-legalization-of-sports-betting
    A new study, published in JAMA Internal Medicine and led by researchers from the University of California San Diego Qualcomm Institute and School of Medicine, reveals a dramatic increase in sports betting and gambling addiction help-seeking since the landmark Murphy v. NCAA Supreme Court decision in 2018 paved the way for states to legalize sports betting. […] Despite gambling addiction as a recognized disorder in the Diagnostic and Statistical Manual of Mental Disorders, it remains largely overlooked in healthcare and public health with no formal ongoing surveillance, said Kevin Yang, M.D., a third-year resident physician in the Department of Psychiatry. Without systematic surveillance, we are flying blind while millions bet on sports. […] Parallel with the growth in sportsbooks, internet searches for help with gambling addiction, such as am I addicted to gambling, have cumulatively increased 23% nationally since Murphy v. NCAA through June 2024. This corresponds with approximately 6.5 to 7.3 million searches for gambling addiction help-seeking nationally, with 180,000 monthly searches at its peak.
  • #1 Study Reveals Surge in Gambling Addiction Following Legalization of Sports Betting
    https://today.ucsd.edu/story/study-reveals-surge-in-gambling-addiction-following-legalization-of-sports-betting
    The study found that online sportsbooks had a substantially greater impact on gambling addiction help-seeking than traditional brick-and-mortar sportsbooks. […] The expansion of legalized sports betting to always be at arms reach has outpaced our ability to understand and address its public health consequences, said Nimit Desai, a third-year medical student. Our findings are a wake-up call for policymakers, healthcare professionals and public health advocates to act now.
  • #1 Data and Surveillance: Equity in Action | Mass.gov
    https://www.mass.gov/resource/data-and-surveillance-equity-in-action
    The Massachusetts Department of Public Health (DPH), Office of Problem Gambling Services (OPGS) is committed to promoting the optimal health and well-being of all residents in the Commonwealth and to ensuring they are provided with healthy and equitable communities to work and live in. Problem gambling has a high level of co-morbidity to other health issues and disproportionality impacts people and communities of color. Epidemiology is a key component of public health that guides public health efforts and strategies to prevent and mitigate harms. The OPGS Data to Action Framework ensures that problem gambling data is reliable, equitable, accessible, and actionable leading to an optimal public health response to problem gambling in the Commonwealth. […] The OPGS Data to Action Framework consists of: Monitoring and Surveillance: Examining public health monitoring and surveillance data to characterize and describe the issue, identify risk and protective factors, and explore driving forces (root causes). […] Using ongoing community feedback to inform future monitoring and surveillance efforts, programming, and policy.
  • #1
    https://www.medschool.umaryland.edu/md-gambling/projects/
    Maryland Center of Excellence on Problem Gambling – Research Program on Gambling […] The Research Program conducts two major projects related to surveillance, the Free State Data Warehouse and the Prevalence Study. […] The Free State Data Warehouse is a curated warehouse of data implemented to support assessment of the public health impact of gambling in the State of Maryland. […] Maryland law requires the Department of Health and Mental Hygiene (DHMH) to assess the problem gambling prevalence in the state at regular intervals. The initial assessment was conducted in September 2010. […] With the formation of the Maryland Center of Excellence on Problem Gambling and integration of the Research Program on Gambling into the Center, the responsibility for conduct of the statewide prevalence of gambling study now rests with the Research Program on Gambling.
  • #1
    https://www.who.int/news-room/fact-sheets/detail/gambling
    Universal, population-wide public health approaches are required to prevent gambling harm. […] WHO recognizes negative effects of gambling on health. Multisectoral action to reduce gambling harm is required to reduce the potential for gambling to impede progress on SDGs. […] WHO acknowledges the need for Member States to closely monitor and effectively regulate gambling operations, products and activities.
  • #1 Gambling addiction a 'threat to public health,’ report warns
    https://www.usatoday.com/story/news/health/2024/10/25/gambling-addiction-threat-public-health/75828027007/
    Gambling has reached new levels worldwide. […] A new report by an international commission of 22 health and policy experts warns of gamblings risks in the era of easy online access. […] Our conclusion is clear: gambling poses a threat to public health, said the report published Thursday in the Lancet Public Health journal. […] Gambling disorder affects nearly 16% of adults and more than 26% of adolescents who use online casinos or slot machine games, the report estimated. […] In addition to causing significant financial losses, gambling can increase a person’s risk for suicide and domestic violence, the report noted. […] The report examined new gambling laws between 2018 and 2023 across 80 jurisdictions, including most U.S. states. […] Monitoring is needed, she told USA TODAY. „There is really very, very little done to monitor the impacts of gambling expansion.”
  • #1
    https://link.springer.com/article/10.1007/BF01019753
    As legalized gambling opportunities increase, the performance of research on pathological gambling assumes greater importance. […] Unfortunately, the only systematic study of the incidence/prevalence of pathological gambling which has yielded widely publicized and frequently cited results appears to possess several methodological problems. […] Thus, this paper critiques this study and discusses methodological issues relevant to any epidemiological research effort. […] In addition to sampling and measurement concerns, issues such as data accessibility, denial and related reactive effects, ethical considerations, and the appropriateness of various data collection methods are discussed to promote the conduct of sound pathological gambling research.
  • #1 Overview of gambling disorder – UpToDate
    https://www.uptodate.com/contents/overview-of-gambling-disorder
    Gambling disorder (pathologic gambling) and problem gambling affects up to 15 million Americans and are common in young people. The number of people with gambling problems is increasing. The societal impact of pathological gambling and problem gambling is therefore also increasing, with related issues involving employment, personal relationships, financial solvency, and criminal pursuits. […] No systematic process of educating, screening, and treating pathologic gamblers is currently in place. Provider and community education about the depth of this problem is crucial in identifying patients who are problem or pathologic gamblers and in helping treatment programs work. Primary prevention of this condition using educational programs that target at-risk youth and adults might help establish a decrease in problem gambling and a culture of controlled, responsible gambling behaviors among adults and their children. […] This topic discusses the epidemiology, diagnosis, and treatment of gambling disorder.
  • #1
    https://journals.lww.com/apmd/fulltext/2022/19010/the_need_for_a_nationwide_epidemiological_study_on.8.aspx
    There is a need for a nationwide study to determine the epidemiology, risk factors, preventive, and treatment strategies for GD in Nigeria. […] The cornerstone of immediate and long-term efforts to control GD in Nigeria is epidemiological surveillance. […] For GD control and prevention in Nigeria, creating an effective epidemiological surveillance system is necessary. […] Monitoring of uncontrolled sports betting activities and associated mental disorders should be a public health priority in Nigeria, mainly because of the country’s young population and increasing sports fans, especially of football. […] Given the body of evidence on the relationship between gambling and disease and mortality indicators, the Nigerian government should prioritize gambling surveillance as a top public health concern. […] There is a lack of comprehensive information regarding the epidemiology, prevention, and treatment of GD in Nigeria. […] To avoid negative implications in the future, the rate of sports betting activities in Nigeria should be restricted and monitored.
  • #1
    https://journals.lww.com/apmd/fulltext/2022/19010/the_need_for_a_nationwide_epidemiological_study_on.8.aspx
    There is a lack of detailed information on the epidemiology, prevention, and treatment of gambling disorder (GD) in Nigeria, a country that has the second-largest online sports gaming market in Africa. […] A nationwide surveillance is necessary to determine the epidemiology, risk factors, and prevention and treatment measures for GD in Nigeria. […] The prevalence of gambling-related issues in Nigeria may be triggered by the ease of access, dissemination, and promotion of gambling activities, mostly during popular sports events. […] The incidence of pathological sports gambling is on the rise in Nigeria. […] The Nigerian government should endeavor to improve the mental health-care quality and standards in the country and ensure stringent regulation of online gambling activities. […] The rise in online gambling has triggered an increase in gambling-related harm in Nigeria, and this has serious implications for the mental health system in the country.
  • #1
    https://www.gov.uk/government/publications/gambling-related-harms-evidence-review/gambling-related-harms-evidence-review-summary–2
    The UK has one of the biggest gambling markets in the world, generating a profit of 14.2 billion in 2020. Previous research has shown that harms associated with gambling are wide-ranging. These include not only harms to the individual gambler but their families, close associates and wider society. There have been growing calls by the public health community, people with lived experience and parliamentarians that a population-level approach is needed to tackle this public health issue. However, there was a need to fully understand the extent to which gambling is a public health issue, for whom it is a problem and the extent of the possible harms. […] […] In 2018, 24.5 million people in England gambled (54% of the adult population, or 40% when you exclude the National Lottery). […] […] Based on 2018 HSE data, we estimated that 0.5% of the population reached the threshold to be considered experiencing problem gambling, and this proportion has remained relatively consistent since 2012. We also estimated that 3.8% of the population are classified as gambling at elevated risks, differentiated into low risk and moderate risk gambling. This means they might experience some level of negative consequences due to their gambling. […]
  • #1 Gambling addiction may increase the risk of long-term sick leave | Karolinska Institutet
    https://news.ki.se/gambling-addiction-may-increase-the-risk-of-long-term-sick-leave
    Gambling addiction can increase the risk of long-term sick leave for several years, according to a new study published in Psychological Medicine. Researchers from Karolinska Institutet behind the study point to the need to detect people with gambling addiction in time to avoid financial and health problems. […] Gambling addiction is a psychiatric condition characterized by prolonged and problematic gambling that leads to negative financial, health and social consequences. 1.3 percent of the Swedish population, corresponding to 105,000 Swedes, have gambling problems or an increased risk of gambling problems, but the number of unreported cases is believed to be much higher. […] The research team, with expertise in addiction, gambling, epidemiology, and sickness absence, used several linked national registers to study 2,830 working-age individuals between 19 and 62 who had been diagnosed with gambling addiction and examined their sickness absence over six years. They then compared these data to an equivalent group of 28,300 people without a gambling addiction diagnosis.
  • #1
    https://www.gov.uk/government/publications/gambling-related-harms-evidence-review/gambling-related-harms-evidence-review-summary–2
    The socio-demographic profile of gamblers appears to change as gambling risk increases, with harmful gambling associated with people who are unemployed and among people living in more deprived areas. This suggests harmful gambling is related to health inequalities. […] […] We identified 39 reviews examining possible risk factors for gambling and harmful gambling. […] […] We identified 53 studies describing a range of harms that had resulted from gambling. Most of the studies had focused on harms to the gambler, although some had also examined the harms to affected others. There was limited evidence examining harms to society. […] […] The excess costs of harmful gambling (direct financial cost to government plus societal value of health impacts) were estimated to be between 1.05 and 1.77 billion for England. But we expect that the true costs are higher because the lack of evidence meant that it was not possible to cost all types of harms or the wider harms to individuals or society. […]
  • #1 Gambling Disorder > Fact Sheets > Yale Medicine
    https://www.yalemedicine.org/conditions/gambling-disorder
    There are three main forms of interventions: […] Yales Center of Excellence in Gambling Research, one of two such centers in the nation, is supported by the National Center for Responsible Gaming and conducts groundbreaking research into gambling disorder. […] The Center, directed by Yale Medicine psychiatrist Marc Potenza, MD, PhD, has conducted the first brain imaging studies on people with gambling problems. These have found that the brain acts similarly during monetary reward processing in individuals with gambling disorder as it does in people with binge-eating, alcohol-use and tobacco-use disorders.
  • #1 Impulsivity in Gambling Disorder and problem gambling: a meta-analysis | Neuropsychopharmacology
    https://www.nature.com/articles/s41386-019-0393-9
    Gambling Disorder is a prevalent psychiatric condition often linked to dysfunction of cognitive domains regulating impulsive behavior. […] This meta-analysis indicates heightened impulsivity across a range of cognitive domains in Gambling Disorder. […] Gambling Disorder was associated with significant impairments in motor and attentional inhibition, discounting, and decision-making tasks. […] For problem gambling, only decision-making had sufficient data for meta-analysis, yielding significant impairment versus controls; however, study quality was relatively low. […] It is also not yet established from meta-analysis whether impulsive cognitive dysfunction extends to people with some degree of disordered gambling falling short of the full diagnosis (termed at-risk or problem gambling).
  • #1 Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9825131/
    The correlation between dopaminergic drugs and increased rates of GD is beginning to be an established consensus. […] Along with hypersexuality, compulsive shopping and binge eating, GD is the most common manifestation of an impaired impulse control due to dopamine replacement therapy in Parkinsons disease. […] Multiple studies with large populations have confirmed an association between GD and levodopa treatment, but even more clearly between GD and the dopamine agonists pramipexole and ropinirole. […] These two drugs are selective for the D3 receptor, which could explain their high risk of increasing GD rates compared to other dopamine agonists or levodopa. […] Another drug associated with an increase in GD rates is the atypical antipsychotic aripiprazole. […] Even for this drug, an association with GD has been established in large-scale studies.
  • #1 Pathological Gambling (312.21) | Abnormal Psychology
    https://courses.lumenlearning.com/atd-herkimer-abnormalpsych/chapter/pathological-gambling-312-21/
    Pathological gambling usually begins in early adolescence in males and later in life in females. A few individuals are hooked with their first bet, but for most the course is more insidious. Years of social gambling may be followed by an abrupt onset that may be precipitated by greater exposure to gambling or to some stressor. The pattern may be regular or episodic, and the course of the disorder is often chronic.
  • #1 Traumatic brain injuries and problem gambling in youth: Evidence from a population-based study of secondary students in Ontario, Canada | PLOS One
    https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239661
    Traumatic brain injury (TBI) is associated with risk-taking, impulsivity, psychological distress, substance abuse, and violent crime. Previous studies have also linked problem gambling to TBI, but these studies have not controlled for possible confounding variables such as mental health problems and hazardous drinking which are also linked to TBI. This study examines the relationship between problem gambling and TBI among adolescents. […] This study provides further data to suggest a link between TBI and problem gambling. However, research is needed on the causal relationship between these variables and the potential implications for treatment and prevention. […] The current study examined the association between TBI and problem gambling in a population-based sample of secondary school students from Ontario, Canada. To our knowledge, this study is the first to examine the association between problem gambling, hazardous drinking, suicidal ideation, and TBI in a population-based study of youth.
  • #1 Gambling addiction a 'threat to public health,’ report warns
    https://www.usatoday.com/story/news/health/2024/10/25/gambling-addiction-threat-public-health/75828027007/
    Researchers recommended governments prioritize health when they craft laws about gambling rather than the tax money the businesses could bring. […] The report also called for increased oversight to protect children and consumers, nationally and internationally, from the dangerous impact of gambling.
  • #1 Massachusetts Population Survey Shows No Increase in Problem Gambling Following Introduction of Casinos : School of Public Health & Health Sciences : UMass AmherstUMass Collegiate MSchool of Public Health & Health SciencesXFind us on FacebookFind us on Yo
    https://www.umass.edu/public-health-sciences/news/no-increase-problem-gambling
    Problem gamblers are defined as those who experience significant impaired control over their gambling and negative consequences as a result. At-risk gamblers are those whose behaviors place them at greater risk of experiencing a gambling problem, such as persistently betting more than planned, spending more time gambling than intended and borrowing money to gamble. […] One area of concern was revealed by the latest survey: the proportion of gambling expenditures that came from at-risk gamblers increased from 51% in 2013 to 68% in 2021. […] That increase suggests that the target for minimizing and mitigating gambling harm needs to shift to identify potential gamblers in need earlier, Volberg says.
  • #1 Gambling addiction may increase the risk of long-term sick leave | Karolinska Institutet
    https://news.ki.se/gambling-addiction-may-increase-the-risk-of-long-term-sick-leave
    The researchers found that people with gambling addiction had an 89 percent higher risk of being on long-term sick leave, which means more than 90 days per year during the year they were diagnosed. […] According to the researchers, the results are important because there is a lack of knowledge about the consequences of gambling addiction over time and how they can affect the individual in terms of health and workability, and ultimately financial stability and participation in society through work. […] The study shows that we need to detect gambling problems at an earlier stage in health care and at workplaces and increase access to help for affected people so that they can break negative trajectories earlier. Gambling addiction risks going unnoticed, and the problems can become extensive before they are noticed and diagnosed in health care, something that this study shows.
  • #1 Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9825131/
    The proposed mechanism of action for aripiprazole is its stabilizing effect on dopamine levels, acting as a partial agonist. […] While most of the evidence of a role of aripiprazole in GD has relied on more anecdotal case presentations, recent large-scale clinical and register studies have demonstrated a statistical association between aripiprazole medication and GD. […] The emerging knowledge in the area calls for further research in preclinical, clinical, and epidemiological study designs.
  • #1 Gambling addiction may increase the risk of long-term sick leave | Karolinska Institutet
    https://news.ki.se/gambling-addiction-may-increase-the-risk-of-long-term-sick-leave
    The next step in the research is to continue to develop methods for earlier detection of gambling addiction and to educate healthcare professionals about the problem. As gambling addiction is often a long-term problem, it will also be important to follow people over an even longer period, for example up to ten years, to find out more about the long-term consequences for those affected and their environment.
  • #2
    https://www.who.int/news-room/fact-sheets/detail/gambling
    Standardized global estimation of gambling harms has been limited, but estimates suggest that 1.2% of the worlds adult population has a gambling disorder. […] Gambling can lead to serious harms to health. These include financial stress, relationship breakdown, family violence, mental illness and suicide. […] Around 5.5% of women and 11.9% of men globally experience some level of harm from gambling. […] A Swedish study estimated that those with a gambling disorder were 15 times more likely to die by suicide than the general population. […] For every person who gambles at high-risk levels, an average of six others (usually non-gamblers) are affected. […] The commercialization of gambling in many countries which also drives normalization is increasing the incidence of gambling harm.
  • #2 Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9825131/
    Problematic gambling, including both a sub-diagnostic problematic behavior and the more severe clinical picture of a GD, has been reported to occur in up to 6% of the adult population in some settings, whereas the corresponding figures are well below 1% in other settings. […] Meanwhile, prevalence rates of GD vary around 1%. […] The concept of problematic gambling is poorly defined, but often used in broader epidemiological studies where face-to-face diagnostic assessments are difficult. […] GD is today defined in the DSM-5 as the fulfilment of four out of nine criteria describing several measures of tolerance, withdrawal, chasing losses behavior, and different measures of harm. […] GD typically causes substantial psycho-social problems, and financial problems including over-indebtedness.
  • #2 Gambling – Rutgers Addiction Research Center (RARC)
    https://www.addiction.rutgers.edu/about-addiction/facts-and-figures/gambling/
    The National Council on Problem Gambling (NCPG) estimates that approximately 5 million Americans meet the criteria for compulsive gambling. However, only around 8 percent of these individuals will ever seek help for their problem. […] Gambling addiction is a significant public health concern characterized by increasing preoccupation with gambling, a need to bet more money more frequently, restlessness or irritability when attempting to stop, chasing losses, and loss of control manifested by continuation of the gambling behavior in spite of mounting, serious, negative consequences. […] The American Psychiatric Association defines gambling disorder as: Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress that meets at least four of nine criteria.
  • #2 Problem gambling – Wikipedia
    https://en.wikipedia.org/wiki/Problem_gambling
    Repetitive gambling despite demonstrable harm and adverse consequences […] Problem gambling may be diagnosed as a mental disorder according to DSM-5 if certain diagnostic criteria are met. […] The DSM-5 has re-classified the condition as an addictive disorder, with those affected exhibiting many similarities to those with substance addictions. […] Pathological gambling is a common disorder associated with social and family costs. […] Mayo Clinic specialists and other studies state that compulsive gambling may result from biological, genetic, and environmental factors such as mental health disorders (the presence of substance use disorders, personality disorders, emotional states). […] Evidence indicates that pathological gambling is an addiction similar to chemical addiction. […] The findings in one review indicated that behavioral disorders such as problem gambling and substance use disorder are closely linked; sensitization theory indicates that these disorders are marked by a compulsive drive towards unhealthy behaviors and an inability to control against them.
  • #2 Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9825131/
    Gambling for money is also the first non-substance-related addictive behavior that has been found to develop as a consequence of dopaminergic medications, likely through specific brain circuits affecting addictive behavior. […] The order in which comorbid disorders appear may differ in different subgroups of the population, and health services are suggested to screen for gambling problems in patients with mental health conditions, and vice versa for mental health problems in patients with known GD. […] Given the susceptibility of patients with schizophrenia to develop GD, attention has been raised to one of the newer-generation atypical antipsychotic compounds, i.e. the dopamine modulator aripiprazole, which differs from the traditional anti-dopaminergic profile or traditional antipsychotics.
  • #2 Problem gambling may be on the rise among monthly gamblers in Massachusetts, online surveys suggest | EurekAlert!
    https://www.eurekalert.org/news-releases/1056186
    In the latest of three online gambling surveys conducted by the University of Massachusetts Amherst, monthly gamblers in Massachusetts reported an increase in gambling intensity and gambling harms. […] Among monthly gamblers in the online surveys, those experiencing gambling problems jumped from 12.7% in 2014 to 20.9% in 2022 to 25.6% in 2023. This compares to a 2% prevalence of problem gambling that held steady in general population surveys conducted before and after casinos were introduced in Massachusetts. […] Its very helpful from a surveillance and monitoring perspective. […] The latest online survey also showed increases in the proportion of monthly gamblers who believe both that the harm of gambling outweighs the benefits and that gambling addiction is the most important negative impact of casinos. […] I think its definitely a cause for concern about what the population impacts of sports betting are going to be because these indicators from the monthly gamblers in the online panel are not going in a direction that says theres going to be less gambling harm in Massachusetts in the future.
  • #2 Massachusetts Population Survey Shows No Increase in Problem Gambling Following Introduction of Casinos : School of Public Health & Health Sciences : UMass AmherstUMass Collegiate MSchool of Public Health & Health SciencesXFind us on FacebookFind us on Yo
    https://www.umass.edu/public-health-sciences/news/no-increase-problem-gambling
    The prevalence of problem and at-risk gambling has not significantly changed since casinos were introduced in Massachusetts beginning in 2015, according to the first statewide population survey that compares gambling behavior and attitudes before and after the opening of three casinos in the commonwealth. […] Volberg notes the pre-casino survey found a high level of overall participation (73.1%) in different types of gambling among Massachusetts residents, including 21.5% who traveled to resorts in Connecticut and other states with a casino industry. […] Volberg also attributed the steady rate of problem gamblers (2% in 2013 and 1.4% in 2021) and at-risk gamblers (8.4% in 2013 and 8.5% in 2021) to Massachusetts’ robust problem gambling prevention programs – GameSense, PlayMyWay and voluntary self-exclusion.
  • #2 Gambling addiction a 'threat to public health,’ report warns
    https://www.usatoday.com/story/news/health/2024/10/25/gambling-addiction-threat-public-health/75828027007/
    Researchers recommended governments prioritize health when they craft laws about gambling rather than the tax money the businesses could bring. […] The report also called for increased oversight to protect children and consumers, nationally and internationally, from the dangerous impact of gambling.
  • #2 Science has a gambling problem
    https://www.nature.com/articles/d41586-018-01051-z
    Pathological gambling is thought to affect as many people as autism and schizophrenia. […] The world of gambling research is too small and underfunded. The paucity of data available to inform policymakers and the medical profession is shocking. […] Much more needs to be understood about the elements of diverse online and offline gambling activities for example, display strategies on screens that mislead users on the chances of winning and the epidemiology of who is most vulnerable and so most likely to be seduced by the lure of addiction. […] There is little empirical evidence as to whether such strategies work. […] Problem gambling does cause health problems, however, not only through self-neglect, but perhaps also as a result of its extraordinarily high level of comorbidity with other psychiatric conditions; psychiatrists have started to investigate whether gambling in itself could precipitate a psychotic incident in someone who was previously in a subclinical state. […] Each government needs to make a call and assign the problem of pathological gambling to an appropriate agency or ministry.
  • #2 Profile of cases accessing gambling treatment in Ireland using national treatment surveillance data 2008 to 2019. – Drugs and Alcohol
    https://www.drugsandalcohol.ie/35098/
    Home Profile of cases accessing gambling treatment in Ireland using national treatment surveillance data 2008 to 2019. […] An identifiable proportion of individuals who gamble experience significant problems as a consequence of gambling. Globally, problem gambling prevalence is estimated at between 0.1% and 5.8%. […] This is the first Irish national study using routinely gathered health surveillance data to describe treated problem gambling. Results will inform service policy and planning. […] Monitoring and surveillance can play a crucial role in measuring the successful efforts and help inform planning and treatment. The findings may have implications for treatment pathways.
  • #2
    https://journals.lww.com/apmd/fulltext/2022/19010/the_need_for_a_nationwide_epidemiological_study_on.8.aspx
    There is a need for a nationwide study to determine the epidemiology, risk factors, preventive, and treatment strategies for GD in Nigeria. […] The cornerstone of immediate and long-term efforts to control GD in Nigeria is epidemiological surveillance. […] For GD control and prevention in Nigeria, creating an effective epidemiological surveillance system is necessary. […] Monitoring of uncontrolled sports betting activities and associated mental disorders should be a public health priority in Nigeria, mainly because of the country’s young population and increasing sports fans, especially of football. […] Given the body of evidence on the relationship between gambling and disease and mortality indicators, the Nigerian government should prioritize gambling surveillance as a top public health concern. […] There is a lack of comprehensive information regarding the epidemiology, prevention, and treatment of GD in Nigeria. […] To avoid negative implications in the future, the rate of sports betting activities in Nigeria should be restricted and monitored.
  • #2 Gambling addiction may increase the risk of long-term sick leave | Karolinska Institutet
    https://news.ki.se/gambling-addiction-may-increase-the-risk-of-long-term-sick-leave
    The researchers found that people with gambling addiction had an 89 percent higher risk of being on long-term sick leave, which means more than 90 days per year during the year they were diagnosed. […] According to the researchers, the results are important because there is a lack of knowledge about the consequences of gambling addiction over time and how they can affect the individual in terms of health and workability, and ultimately financial stability and participation in society through work. […] The study shows that we need to detect gambling problems at an earlier stage in health care and at workplaces and increase access to help for affected people so that they can break negative trajectories earlier. Gambling addiction risks going unnoticed, and the problems can become extensive before they are noticed and diagnosed in health care, something that this study shows.
  • #2 Overview of gambling disorder – UpToDate
    https://www.uptodate.com/contents/overview-of-gambling-disorder
    Gambling disorder (pathologic gambling) and problem gambling affects up to 15 million Americans and are common in young people. The number of people with gambling problems is increasing. The societal impact of pathological gambling and problem gambling is therefore also increasing, with related issues involving employment, personal relationships, financial solvency, and criminal pursuits. […] No systematic process of educating, screening, and treating pathologic gamblers is currently in place. Provider and community education about the depth of this problem is crucial in identifying patients who are problem or pathologic gamblers and in helping treatment programs work. Primary prevention of this condition using educational programs that target at-risk youth and adults might help establish a decrease in problem gambling and a culture of controlled, responsible gambling behaviors among adults and their children. […] This topic discusses the epidemiology, diagnosis, and treatment of gambling disorder.
  • #2 Gambling Disorder > Fact Sheets > Yale Medicine
    https://www.yalemedicine.org/conditions/gambling-disorder
    There are three main forms of interventions: […] Yales Center of Excellence in Gambling Research, one of two such centers in the nation, is supported by the National Center for Responsible Gaming and conducts groundbreaking research into gambling disorder. […] The Center, directed by Yale Medicine psychiatrist Marc Potenza, MD, PhD, has conducted the first brain imaging studies on people with gambling problems. These have found that the brain acts similarly during monetary reward processing in individuals with gambling disorder as it does in people with binge-eating, alcohol-use and tobacco-use disorders.
  • #2 Impulsivity in Gambling Disorder and problem gambling: a meta-analysis | Neuropsychopharmacology
    https://www.nature.com/articles/s41386-019-0393-9
    The aim of this paper was to conduct a comprehensive meta-analysis of the range of cognitive domains relevant to impulsivity in Gambling Disorder, including examination of key moderators. […] This study undertook a comprehensive meta-analysis of cognitive findings germane to impulsivity in Gambling Disorder, and in problem gambling (individuals fulfilling some but not necessarily all diagnostic criteria for Gambling Disorder), versus controls. […] The main finding was that Gambling Disorder was associated, in meta-analysis, with elevated impulsivity on motor inhibition, attentional inhibition, discounting, and decision-making tasks. […] Thus, in fully established Gambling Disorder, impulsivity is evident across the full swathe of relevant cognitive tasks. […] This analysis provides the first meta-analytic support for the existence of impulsivity in Gambling Disorder across cognitive domains, in keeping with neurobiological models implicating impulsivity and dysregulation of related frontostriatal brain pathways in the pathophysiology of disordered gambling. […] The finding of decision-making deficits in at-risk gamblers here using the Iowa Gambling Task, and in a prior data study using a different task indicates this is a particularly promising domain for identifying vulnerability markers in this setting.
  • #2
    https://link.springer.com/article/10.1007/s40290-022-00453-9
    Multiple studies with large populations have confirmed an association between GD and levodopa treatment, but even more clearly between GD and the dopamine agonists pramipexole and ropinirole. […] Another drug associated with an increase in GD rates is the atypical antipsychotic aripiprazole. […] Patients exposed to dopamine-regulating antipsychotic drugs are likely to have a statistical risk increase of gambling problems due to their psychiatric comorbidities, over and above the potential medication effect and other socio-demographic parameters also leading to a statistically heightened risk of developing gambling problems.
  • #2 Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9825131/
    The proposed mechanism of action for aripiprazole is its stabilizing effect on dopamine levels, acting as a partial agonist. […] While most of the evidence of a role of aripiprazole in GD has relied on more anecdotal case presentations, recent large-scale clinical and register studies have demonstrated a statistical association between aripiprazole medication and GD. […] The emerging knowledge in the area calls for further research in preclinical, clinical, and epidemiological study designs.
  • #2 Traumatic brain injuries and problem gambling in youth: Evidence from a population-based study of secondary students in Ontario, Canada | PLOS One
    https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239661
    The primary objective of this study was to examine the association between TBI and problem gambling among a population-based sample of secondary school students from Ontario, Canada. Consistent with recent research among adults, we found that students with a history of TBI had 2 times the odds of a gambling problem compared to those without TBI, after controlling for hazardous drinking and suicidality. These findings provide additional support for an association between TBI and gambling problems, and extend this observation to the adolescent population. […] The association between TBI and problem gambling may also help to explain why some problem gamblers have difficulties in responding to treatment due to previously un-recognized neuro-cognitive and social deficits caused by prior TBI.
  • #2
    https://www.who.int/news-room/fact-sheets/detail/gambling
    Universal, population-wide public health approaches are required to prevent gambling harm. […] WHO recognizes negative effects of gambling on health. Multisectoral action to reduce gambling harm is required to reduce the potential for gambling to impede progress on SDGs. […] WHO acknowledges the need for Member States to closely monitor and effectively regulate gambling operations, products and activities.
  • #3 Gambling Addiction: Resources, Statistics, and Hotlines | University of Nevada, Reno
    https://onlinedegrees.unr.edu/blog/gambling-addiction-resources/
    According to the National Council on Problem Gaming, 2 million adults in the U.S. meet severe gambling criteria in a given year. The council reports that another 4 to 6 million American adults have mild or moderate problems. The threat of gambling addiction doesnt discriminate or target, which makes it a particularly troublesome issue, as gambling addiction can affect people of all ages, sexes and socioeconomic groups. […] Gambling disorder, sometimes referred to as compulsive gambling, is the lone behavioral addiction found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) from the American Psychological Association (APA). According to the APA, gambling disorder involves repeated, problem gambling behavior. The behavior leads to problems for the individual, families, and society. Adults and adolescents with gambling disorders have trouble controlling their gambling. They will continue even when it causes significant problems.
  • #3 Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9825131/
    The correlation between dopaminergic drugs and increased rates of GD is beginning to be an established consensus. […] Along with hypersexuality, compulsive shopping and binge eating, GD is the most common manifestation of an impaired impulse control due to dopamine replacement therapy in Parkinsons disease. […] Multiple studies with large populations have confirmed an association between GD and levodopa treatment, but even more clearly between GD and the dopamine agonists pramipexole and ropinirole. […] These two drugs are selective for the D3 receptor, which could explain their high risk of increasing GD rates compared to other dopamine agonists or levodopa. […] Another drug associated with an increase in GD rates is the atypical antipsychotic aripiprazole. […] Even for this drug, an association with GD has been established in large-scale studies.
  • #3 Pathological Gambling (312.21) | Abnormal Psychology
    https://courses.lumenlearning.com/atd-herkimer-abnormalpsych/chapter/pathological-gambling-312-21/
    Pathological gambling (PG) involves being unable to resist the impulse to gamble. […] Compulsive gamblers often find themselves lying to their family members and friends to hide the severity of their problem. […] Compulsive gamblers are more prone to medical conditions that are brought about by stress such as hypertension, peptic ulcers, and migraine headaches. […] Compulsive gambling can be confused with bipolar disorder, which sometimes accompanies compulsive gambling. […] Pathological gambling typically begins in adolescence for boys and later in life for girls. […] As gambling facilities become more prevalent, so do PG rates. In fact, 2 million Americans are considered to be pathological gamblers, with another 3 million considered being problematic gamblers, and 15 million more considered to be at risk. There is a 4% prevalence rate in America. Prevalence rates in other countries vary. Worldwide rates range from 2% to 6%.
  • #3
    https://www.gov.uk/government/publications/gambling-related-harms-evidence-review/gambling-related-harms-evidence-review-summary–2
    The UK has one of the biggest gambling markets in the world, generating a profit of 14.2 billion in 2020. Previous research has shown that harms associated with gambling are wide-ranging. These include not only harms to the individual gambler but their families, close associates and wider society. There have been growing calls by the public health community, people with lived experience and parliamentarians that a population-level approach is needed to tackle this public health issue. However, there was a need to fully understand the extent to which gambling is a public health issue, for whom it is a problem and the extent of the possible harms. […] […] In 2018, 24.5 million people in England gambled (54% of the adult population, or 40% when you exclude the National Lottery). […] […] Based on 2018 HSE data, we estimated that 0.5% of the population reached the threshold to be considered experiencing problem gambling, and this proportion has remained relatively consistent since 2012. We also estimated that 3.8% of the population are classified as gambling at elevated risks, differentiated into low risk and moderate risk gambling. This means they might experience some level of negative consequences due to their gambling. […]

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