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Problem Gambling

Understand problem gambling and find treatment.

Both online and in person, it’s easier than ever to bet on sports; play the lottery, bingo, poker, and slots; and risk money for the chance to win at other games and contests.

Many people who gamble can make the occasional wager and then stop — whether they’ve won, lost, or broke even. However, some people develop a need to gamble that is hard to control, leading to varying degrees of personal and financial problems. In the most severe cases, people may develop a clinical condition called gambling disorder.

It’s common for people with a gambling problem to develop other behavioral health conditions, including substance misuse and substance use disorder (SUD).

If you are experiencing gambling problems and substance misuse, you are not alone. Recovery is possible.

Link between gambling and substance use

Much like substance use, gambling behaviors can impact different people in different ways. Experts rate the levels of harm from gambling along a continuum.

Not all gambling behavior is inherently problematic. People who gamble only recreationally may experience no or very few negative effects. However, people who exhibit even mild problem gambling may experience many negative effects, including to their health, finances, and relationships. People can move back and forth along this continuum.

In severe cases, a clinician may diagnose someone with gambling disorder. This is when a person has difficulty controlling their gambling, even when it has harmful consequences.

Gambling problems are often linked with drug and alcohol misuse. Misusing alcohol or other drugs can cause medical, financial, and social problems. When this behavior is recurring and prolonged, a clinician may diagnose a substance use disorder (SUD), a mental health condition characterized by the repeated use of one or more substances. SUDs harm people’s health, social functioning, and ability to reduce or stop their substance use. Learn more about substance misuse.

Statistics: Gambling and substance use

Millions of Americans experience harm from gambling or substance misuse. Although statistics vary, it’s estimated that between 1% and 4.6% of American adults have gambling disorder or exhibit problem gambling and 16.5% of Americans age 12 and older have an SUD.

Gambling and substance use disorders often co-occur. People with a gambling problem or disorder have higher rates of substance use, substance misuse, and SUD diagnoses. According to one study, 22.5% of people diagnosed with gambling disorder were also diagnosed with an SUD. In another study, people with a gambling problem or disorder had higher rates of alcohol use disorder (28%) and other SUDs (17%).

The reverse is also true. One study estimated that although the overall rate of problem gambling is 4.6%, it is:

  • 17% among those who misuse or are dependent on alcohol.
  • 14% among people who are dependent on tobacco.
  • 33% among people who misuse or are dependent on marijuana.

Signs and symptoms

For someone to be clinically diagnosed with gambling disorder, they must have had at least four of these nine symptoms in the past year:

  • Needing to gamble with more money to achieve the desired excitement (i.e., higher tolerance for risk).
  • Repeated unsuccessful attempts to control, cut back, or stop gambling.
  • Symptoms of withdrawal when trying to control gambling (e.g., becoming irritated or restless).
  • Life problems as a consequence of gambling, including damage to personal or work relationships.
  • Fixation marked by preoccupying thoughts of gambling (e.g., how to pay for gambling).
  • Gambling in response to stress or other negative situations.
  • Gambling in an attempt to recover losses.
  • Being untruthful about gambling or losses.
  • Requiring a bailout to reverse gambling losses.

Many of these symptoms are also present in people with an SUD diagnosis. People who are dependent on alcohol or other drugs may experience increased tolerance, loss of control, withdrawal symptoms, fixation, and life problems as a result of substance use. 

Other risk factors and causes 

Additional risk factors for problem gambling include: 

Criminal justice involvement. It’s well documented that people who misuse substances and have drug-related convictions make up a large portion of the U.S. prison and jail population. Some researchers estimate that 65% of incarcerated people have misused substances or have an SUD. But justice involvement is also linked with gambling: Studies show at least one-third of incarcerated people gamble. Most people who have gambling disorder and are in prison or jail report that their incarceration was related to a gambling offense.

Early age of onset. People exposed to gambling as youths or young adults may be more at risk. Over time, this could have a disproportionate effect on certain minority groups; one study found that 10% of Black, Native American, and Hispanic youths gambled on a daily basis, compared with just 4% of white and 5% of Asian youths.

Early big wins. People new to betting who have an early big win are more likely to develop later problems with gambling.

Frequent gambling and certain types of games. People who gamble frequently and who gamble on high-risk games of chance (e.g., betting on sports while they’re being played, playing bingo, and buying scratch cards) may be more at risk.

Male gender. Young men who are single and live alone or who have been married for less than five years are more likely to develop problem gambling. Males have a higher rate of problem gambling (6.8%) than females (2.5%), according to a 2015 study. However, other evidence suggests that problem gambling among females is on the rise, along with an associated risk of developing an SUD.

History of mental illness. As many as 96% of people with gambling disorder meet the criteria for another psychiatric disorder, including mood, anxiety, and substance use disorders.

Influence of family, friends, and media. Promotions of gambling by friends, family members, and the media, including in advertisements, contribute to the development of problem gambling.

Certain personality traits. People who are competitive, are restless, or are easily bored may also develop problems with gambling.

Lower socioeconomic status. Reviews of studies more consistently show higher rates of problem gambling among people with lower levels of education, employment, and financial stability.

Other populations who may develop a gambling problem include casino workers and people diagnosed with Parkinson’s disease.

How to get help for gambling issues 

Are you or someone you know at risk for problem gambling? 

Anyone who has a history of drug or alcohol misuse, has a substance use disorder, or has received treatment for a related mental health condition should take caution. A history of substance misuse increases your risk of developing gambling disorder. 

For free, confidential support for problem gambling, you can contact the National Problem Gambling Helpline 24 hours a day, seven days a week: 

Complications and effects

Untreated gambling and substance use disorders can cause lasting damage to people’s health and well-being and even lead to death. 

Both gambling disorder and SUDs can cause:

  • Problems at school and work, including loss of employment. 
  • Family and relationship problems.
  • Financial distress.
  • Involvement in the legal or criminal justice system. 
  • Poor general health and heightened risk for suicide.

SUDs can cause additional issues, such as increased risk of infectious disease, accidental injury, or death from an overdose.

Pathways of recovery

Recovery from problem gambling and substance misuse is possible. Here are some resources and treatment options that can help with either or both issues.

Community-based support 

Some people seek help for a gambling problem or for substance misuse from peers in recovery. Free support group meetings — for example, Alcoholics Anonymous, Gamblers Anonymous, and Self-Management and Recovery Training (SMART) — can be found in almost every community.

Learn more about support groups.


Therapeutic approaches — for example, cognitive behavioral therapy, motivational enhancement therapy, and motivational interviewing — have shown potential in helping people learn how to stop problem gambling and substance misuse.

Learn more about counseling.


People with both gambling and substance use disorders may require a more intensive treatment and rehabilitation program in order to recover.

A medical professional can begin the treatment process by taking a patient’s medical history and screening for gambling disorder, an SUD, and other issues. They then can help the patient determine an appropriate course of treatment.

Learn about rehab and find treatment for substance misuse.


The Food and Drug Administration (FDA) has approved several medications to manage symptoms of alcohol withdrawal or opioid use withdrawal. Although there are no FDA-approved medications for gambling disorder, some studies have shown that certain medications for substance use disorder (e.g., naltrexone) and mood disorders (e.g., lithium) may be effective in people with gambling disorder.

Learn about medication.

Other pathways of recovery 

Exercise intervention programs. Exercise is a healthy way to relieve or manage stress and improve mood. Physical activity can counteract or replace the negative feelings that might lead to gambling or substance use, and it can promote long-term recovery.

Guided self-help interventions. In this type of intervention, individuals use workbooks and other informational resources to reduce their gambling. This may be paired with support from a specialist.

Personalized feedback intervention. In this intervention, people report certain problem behaviors (e.g., problem gambling, substance misuse) to a health care professional or through a software program. They then receive feedback as to whether their behavior is similar to or different from the way most people behave. There is some evidence that people who see how their behavior compares with others’ take steps to be safer (e.g., by reducing the number of days they engage in gambling or substance misuse).

Recovery coaches. Certified recovery coaches, many of whom are themselves in recovery, can help people navigate life in recovery.

Prevention: Reduce the risk of problem gambling 

Take steps to prevent problem gambling and the onset of gambling disorder: 

  • Make a plan to gamble responsibly and stick to it.
  • Limit the amount of money and time spent on gambling.
  • Take breaks from gambling.
  • Don’t gamble while drinking or doing drugs or if you have a history of substance misuse.
  • Understand how gambling works and what your chances of winning are.
  • Don’t continue gambling to recoup money you lost.
  • Gamble only when you’re in a good mood.

Finding support 

Recovery is possible. Get free, confidential help, available 24 hours a day, seven days a week.

For help with problem gambling, contact the National Problem Gambling Helpline

For substance misuse support, contact SAMHSA’s National Helpline for information and referrals in English and Spanish:

Find Support Near You

This resource was produced collaboratively with a group of Education Development Center (EDC) subject matter experts who reviewed the content and provided their insights. Last reviewed July 2023.


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