Gambling as a form of recreational activity has been pursued for millennia, but its harmful effects when undertaken in a reckless and irresponsible manner are only now being fully considered. When gambling crosses from a fun occasional pastime into a behavioural addiction, it can manifest as a chronic mental health condition. The need for a proper understanding of the risks involved has grown urgently with the vast proliferation of forms of gambling and its increased accessibility due to the widespread penetration of the internet.

Devastating online craze 

Online gambling can easily escalate into a compulsion which harms not only the player but also their family, friends and society at large. One alarming recent example to hit the headlines was the teenager in Henan province who frittered away his father’s life savings after becoming addicted to a lottery game on the short video app, Kuaishou. The game cost 100 yuan a go, with the enticement of bagging 20,000 yuan. The boy only bet small amounts at first, a few hundred yuan at a time, but over three months the amounts grew exponentially until nothing was left of the 200,000 yuan (about HK$200,500) his father had in the bank.

Understandably devastated by his son’s actions, the father appeared on a television programme in a bid to undo the loss. It was revealed that the 15-year-old was able to access his father’s bank account as it shared the same password as the Kuaishou app, plus the ‘teenager mode’ on the app which limits daily usage was easy to turn off.  

Families destroyed 

Consider the awful case of Tony O’Reilly from the Republic of Ireland whose marriage and life fell apart after his gambling addiction unravelled. Initially, he tasted some success, betting correctly on the exact score of a 1998 World Cup match between the Netherlands and Argentina and who would score the first goal (Patrick Kluivert). This whetted his appetite, and he began to bet regularly on football and horse racing as a fun recreational activity. Once he secured an online account, though, compulsive behaviour took hold. His betting was conducted in secret and became increasingly reckless and desperate. 

Theft to feed the habit

By the time of his wedding, he was effectively broke, but one last gamble paid off when a horse at the Epsom Derby came from nowhere to win. New costs and new risks then arose after the couple had a baby, and he started stealing from his employer to pay off his debts. His continual thieving amounted to a whopping EUR 1.75 million (HK$14.63 million) binge, and he went on the run when the auditors arrived.

But O’Reilly could not hide forever; he ended up doing time for his crimes and losing everything – his job, his marriage and his home. But one bright spot from a tale of woe is that he became a gambling addiction counsellor and now lectures in schools and clubs about the dangers of betting. 

Forms of gambling

Addictive gambling behaviour has been described over the years as compulsive gambling or pathological gambling, though today it is more commonly called problem gambling. It is classified as a mental disorder if certain diagnostic criteria are met. It should be noted that there are many forms of gambling, and not all of them are prone to addictive behaviour. They mainly fall under four categories: gaming, betting, lotteries and speculation. 

Gaming is the exchange of money on the outcome of a game, which could be cards, fruit machines and other slot machines, video-poker machines and casino games such as baccarat and roulette. Betting is staking money on the outcome of a future event, such as horse races or football matches. Lotteries are the distribution of money by ‘lot’ or number and can take the form of scratch cards, bingo, sweepstakes and raffles (for physical or cash prizes) as well as lotteries. Speculation is gambling on business, insurance or stock markets. 

What is known for certain is that different types of gambling present different levels of risks of leading to problem gambling. Two factors are thought to play a major part here – the opportunity to place single large bets (such as in horse racing or casinos) or frequent small bets over relatively short periods (such as in fruit machines or online gambling), where the interval between play may be less than 20 seconds. 

Phases of addiction

However, luck never lasts and the losing phase then kicks in, with gamblers starting to lose more money than they can afford in an attempt to chase their losses. During this phase gamblers may become secretive, start borrowing unsustainably and neglect home life. The third and final desperation phase sees the gambler caught in a never-ending cycle of chasing losses and bigger and bigger debts. It is at this stage, studies have suggested, that some 60% of compulsive gamblers will commit a non-violent crime such as theft, passing dud cheques, shoplifting and embezzlement or misappropriation of company funds. 

Telltale signs

Ultimately, problem gambling is often accompanied by numerous behavioural, psychological, financial and health signs. The gambler may stop doing things they previously enjoyed, or experience changes in patterns of sleep, eating or sex. They may start to frequently borrow money or ask for salary advances. Unpaid bills will be an issue, as well as cashing in savings and insurance plans prematurely. 

Telltale health signs include headaches, stomach and bowel problems, and excessive eating or complete loss of appetite. Conflicts with other people may arise and misuse of alcohol or other drugs may develop. As well as lying, secretive and irritable behaviour, the problem gambler may develop suicidal thoughts.

Treatment and recovery

Treatment interventions include psychological therapies, medications and self-help initiatives. Scientific research has highlighted how antidepressants may be effective in reducing the symptoms of pathological gambling, even if the person evidences minimal symptoms of depression or anxiety. Cognitive behavioural therapy has shown to be effective after six to 12 months following intervention. Many countries around the world operate self-help groups so gamblers can help each other to recover.