On the Massachusetts Department of Health and Human Services website, there are four stories about gambling addiction. The common thread among those who shared their stories is this: Gambling addiction doesn’t happen in a vacuum.
“If someone in recovery asks me about gambling, I would tell them that when you have an addictive personality, it’s just like doing drugs,” one anonymous addict called “Duane” wrote. “You’re getting in debt, maxing out your cards, doing the same thing and getting the same results, every time. And honestly, I can’t even say that you can go out and gamble and not end up hooked on drugs again. Because that’s the way it was for me – it all went together.”
That connection hasn’t gone unnoticed by researchers, some of whom in recent years have begun to find that some drugs used to treat anxiety, depression, and most recently diabetes can have a positive effect on those with gambling disorder and other addictions. According to a June story in Scientific American, the drug Ozempic, developed to treat diabetes, also helps tamp down cravings for nicotine, alcohol, gambling, and other compulsive behaviors.
But Ozempic and other medications that could potentially help aren’t approved by the FDA to treat gambling disorder.
“With respect to medications, there are no medications that have FDA approval for gambling disorder,” Marc Potenza, professor of psychiatry, child study, and neurobiology at the Yale University School of Medicine, told US Bets. “People with gambling disorder often have other issues. And those medications for those do have FDA indications.
“You treat the co-occurring issues and then you often catch the gambling disorder scenario.”
Potenza is also the director of the Problem Gambling Clinic and the Center of Excellence in Gambling Research at Yale. When studying gambling disorder, researchers include many forms of gambling from online casino to sports betting to in-person gambling.
Drugs + therapy = best treatment option
Potenza was among researchers who published a 2020 paper that revisited results of 19 trials that tested how effective “pharmacotherapies” are in treating gambling disorder. The research revealed that multiple classes of drugs, including agonists, like Ozempic, and opioid antagonists are among those that can help to curb cravings. Opioid antagonists include naltrexone and nalmefene. Naloxone, marketed as Narcan, is the nasal spray used by first responders to immediately reverse an opiate overdose. Mood stabilizers, such as lithium, have mixed success.
The evidence is growing that ozempic can help with addictions like alcoholism and gambling. https://t.co/9ystGfxdog
— Anne Connelly (@Anne_Connelly) October 12, 2023
“Given what we knew about gambling disorder, we thought if we targeted people with co-occurring concerns, perhaps we would see a more robust response,” Potenza said. “People with gambling disorder, it’s not just one homogenous group, it’s heterogenous. We hypothesized that this type of medication would be helpful for people with gambling disorder.”
In the study, researchers wrote that drug therapy should be combined with psychotherapy for the best results, and that “although no medications have a formal indication for [gambling disorder], pharmacological treatments may be effective at reducing gambling frequency and urges to gamble.”
The fact that researchers are now identifying medications that can help, however, doesn’t mean that patients will be prescribed such medications, unless they have at least one other issue that the drug is approved to treat. So while the findings are good news for those within the problem gambling community, those in a position to help are still stymied, and it’s not likely that pharmacological treatment for gambling disorder will become the norm anytime soon, according to Potenza.
The FDA has not shown a major interest in gambling disorder, which doesn’t “fall within the domain” of any one major federal research institute, Potenza said.
Or, put more succinctly, addiction to gambling “is the only public health area in the United States where the federal government is completely uninvolved,” National Council on Problem Gambling Executive Director Keith Whyte told Sports Handle earlier this year.
Some drugs can make gambling addiction worse
In the gambling landscape, many stakeholders take addiction seriously and have ramped up responsible gambling programs in recent years in trying to prevent addiction. Most legal sports betting states earmark a portion of their tax revenue for responsible and problem gambling initiatives.
As with many illnesses that affect only a sliver of the population, however, problem gambling gets little to no federal funding and is studied in a limited fashion.
It was only when the Diagnostic and Statistic Manual of Mental Disorders came out with its fifth edition in 2013 that gambling disorder was formally recognized as an addiction by the medical community. It is the first non-substance-related addiction to be included in the DSM, which means it is now recognized by insurance companies and treatment is often covered.
Around 145,000 people live with Parkinson’s in the UK.
Impulsive and compulsive behaviours are possible side effects of some Parkinson’s medication, including the desire to gamble.
— GamCare (@GamCare) April 11, 2023
While Potenza and his group have identified some drugs that could help curb the urge to gamble, there are also medications that would seem to have no relationship to gambling or addiction that could increase a patient’s desire to play.
According to a report from Kindbridge published earlier this year, dopamine agonists, antipsychotics, and stimulants can increase the urge to gamble in some patients. So, for example, if a patient with Parkinson’s Disease or ADHD is prescribed medicine that helps with symptoms of those conditions, it could lead to an increase in gambling.
These medications “can lead to an exaggerated response to rewards and an increased risk of developing disordered gambling behaviors,” according to the Kindbridge story.
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