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the medical treatment of addictions, these services could play an important role in
tackling adult gambling disorder,’ said the RCPsych report, with the basic service
infrastructure and staff already in place. ‘Incorporating gambling disorder within this
structure provides a method to meet a critical and growing need, and one which not
only needs to be seriously considered by the government, but also acted on.’
Derek Irwin, a psychotherapist and counselling services manager at GamCare,
which currently offers counselling through a partnership with 18 local agencies,
says his organisation would definitely ‘support the same access for services related
to gambling addiction’ as for drugs and alcohol. ‘Even though gambling as an
addiction does not exhibit physical or health symptoms in the same way, the
behavioural process is similar to other addictions and the consequences are often
just as serious,’ he tells
DDN
.
‘The NHS is committed to treating people with other forms of addiction, but
not gambling, and so the onus is on the third sector to provide the services
necessary to support those who suffer as a consequence of their gambling
behaviour,’ says Marc Etches, chief executive of the Responsible Gambling Trust
(RGT), a charity which exists to help ‘minimise gambling-related harm’ via
voluntary donations from the gambling industry – around £6m per year.
From March 2013 to March 2014, 80 per cent of this money was spent on
treatment, he points out, including the cost of running GamCare’s National
Gambling Helpline. However, there is ‘scope to spend more on support for people
with gambling problems and the RGT has plans to do so – but I’ve little doubt that
nationwide provision of additional support through the NHS, including training for
GPs on how to spot and treat gambling addiction, would greatly help problem
gamblers’, he states.
So could gambling be incorporated into the existing treatment sector, as
RPsych’s report advocates? ‘Working with addictions in a treatment context would
utilise similar skills, but training regarding gambling-related problems would be
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Gambling
essential in order to deal with this specific problem,’ says Irwin.
The report acknowledges additional resources would need to be identified –
and ring-fenced – with the most significant cost likely to be training existing staff,
and potentially employing more. Much could also be achieved by improving non-
specialist care, however, with RCPsych calling for better screening for problem
gambling by GPs and other professionals and the use of low-cost brief
interventions to try to stop people moving from being ‘at risk’ to developing a full
disorder, particularly with clients who are unsuited to – or unwilling to access –
more intensive treatment.
Screening and brief interventions are indeed ‘useful and important’ says Irwin,
as people ‘would benefit from early intervention just like any other problem or
condition’.
Meanwhile, the RGT’s funding plan for 2014-15 has set aside £4.3m for the
provision of services to treat problem gambling, stresses Etches. ‘This includes
£2.4m for GamCare to provide treatment services, either directly or via its network
of partners, to gamblers and others adversely affected by gambling via free and
confidential counselling, one-to-one or in groups, face-to-face and online.’ The RGT
has also made grants to CNWL to fund CBT-based counselling at the National
Problem Gambling Clinic, he points out, as well as residential services at the
Gordon Moody Association and GamCare’s National Gambling Helpline. ‘There is
no national, publicly funded alternative to these services,’ he states.
And what about RPsych’s warning that without dramatically upscaled action
now there could be a whole new generation of problem gamblers? ‘It depends how
you look at problems causally,’ says Irwin. ‘A parallel could be made with
legislation, advertising and availability around alcohol. It is the case, we feel, that
other problems and issues lead to addictive behaviours, so addressing these other
issues would be our priority. Of course, legislation and advertising need always to
be monitored, but it’s not the solution.’
DDN
Gambling: the hidden addiction at www.rcpsych.ac.uk
A losing bet? Alcohol and gambling: investigating parallels and shared solutions
at www.alcoholconcern.org.uk
A major London conference on 13 November will look at the level of gambling-
related problems in the UK, the links with drug and alcohol misuse, and opportunities
for the treatment sector. For more information on
Weighing up the odds
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FROM BETS TO DEBTS
John explains how six years into recovering from drug and
alcohol addiction, he stumbled into a gambling habit
IT STARTED THREE YEARS AGO with scratch cards, first £5 ones, then £10.
Then I discovered roulette in the bookies – I’d only gone into the use the
toilet and saw someone winning. The first time I played I won £2,500 and
thought ‘I could do that again’.
When the bookies wasn’t open I’d buy scratch cards or go into pubs
looking for the £500 jackpot machine. Then I began driving to motorway
services to look for more machines. I won £28,000 in one day on roulette
machines.
I’d have a ritual that gave me the same buzz as drug paraphernalia. I’d
set out the scratch cards in order of value, and save scratching the amount
off the winning boxes till last.
It was making me dishonest. I had £15,000 in the glove compartment of
my car because I couldn’t tell my wife. Then I couldn’t sleep. I couldn’t pay the
rent – I couldn’t even pay my mobile phone. I’d used my credit card to the limit
and had two bank loans. My wife confronted me and I denied it – but she
knew. I saw the pain in her eyes and thought, ‘I really have to sort this out.’
As I was working at a treatment centre, I had access to one-to-one
counselling. I also went to Gamblers Anonymous, using the 12 steps to
make financial amends. I tackled my debts and used an app to block
gambling sites on my computer. Up till then I’d gambled on the dogs,
football, horses, roulette and scratch cards, but GA made me realise ‘you
win to lose’.
It’s difficult to avoid because it’s legal and people think ‘it’s only the
lottery fund’.
The TV ads bombard you all the time – Barbara Windsor, Ray Winstone.
It’s hard to get away from it.
‘Often people with alcohol
problems participate in
unhealthy gambling, and vice
versa... One in six of those
interviewed for the report
who had sought help for
alcohol misuse also admitted
to problems with gambling.’