Gambling and Alcoholism May Have Different Roots

Drinking is tied to anxiety while gamblers seek excitement, study suggests

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By Alan Mozes
HealthDay Reporter

MONDAY, Aug. 15, 2005 (HealthDay News) -- While drinking and gambling often go hand-in-hand, the two addictions are not identical, according to a team of Brazilian and Canadian researchers.

Men and women suffering from alcoholism tend to turn to alcohol to tamper down a range of negative emotions, including anxiety, the researchers found.

On the other hand, pathological gamblers appear to be in search of stimulation -- a transitory "high" to counter depressive feelings and a lack of positive life experiences.

"Personality factors had a significant impact in craving for both gambling and alcohol, but in different ways," said study author Dr. Hermano Tavares, of the Gambling Outpatient Unit in the faculty of medicine at the University of Sao Paulo in Brazil. "This may hint at priorities and new strategies in the treatment of both alcohol and gambling addiction."

Reporting in the August 2005 issue of Alcoholism: Clinical and Experimental Research, Tavares' team compared the emotions driving alcoholism and gambling.

The 49 pathological gamblers and 101 alcoholics in the study had all sought outpatient treatment for their addiction at a hospital in Calgary, Canada, between 2001 and 2002. All had undergone psychiatric examinations confirming a diagnosis of addiction.

Before participating in the study, patients abstained from either drinking or gambling for between five to 21 days to minimize withdrawal symptoms while their craving needs were assessed.

The researchers then conducted a series of tests and interviews to quantify the intensity and frequency of cravings for either alcohol or gambling. They also assessed levels of depression or anxiety.

Participants were also asked to record addiction-related thoughts. Finally, the researchers also gauged levels of three key "temperament" characteristics: an addict's desire to seek excitement; to avoid harm; and to continue behaviors that had brought rewards in the past -- even in the face of fatigue or frustration.

According to the researchers, pathological gamblers were more likely than alcoholics to seek excitement and behave more impulsively. Gamblers were also less likely than alcoholics to indulge in their habit for the sake of avoiding harm.

Gamblers were much more likely to experience intense cravings to resume their addiction compared to alcoholics, the researchers found. And gamblers with the least joyful lives were most likely to miss gambling when trying to quit.

While depression was present in both gambling and alcoholism, anxiety played a key role for alcoholics only.

The researchers determined that, as a motivator for drinking, anxiety appears to be for alcoholics what depression and the absence of positive stimulation is to pathological gamblers.

Further research is needed to verify this first-ever comparison of addiction personalities, the researchers said. And they cautioned that these findings represent general rules that might not apply to all patients.

Nonetheless, the findings could point to better, more patient-tailored addiction treatments.

Gamblers might benefit from depression counseling coupled with an attempt to pro-actively replace the "joy" derived from gambling with other, more healthy activities, the researchers said.

Alcoholics, on the other hand, might do better by being taught relaxation techniques that ease negative emotions and anxiety.

One expert expressed skepticism about the findings, however.

Alcoholism and pathological gambling share "a lot in common, even if there are differences," said Dr. Marc Galanter, director of the division of alcoholism and drug abuse in the department of psychiatry at New York University School of Medicine. "Sensation-seeking has often been associated with both alcoholism and gambling, and there are undoubtedly commonalities in neuro-transmissions that illustrate how these addictive behaviors are reinforced."

However, Galanter emphasized, patients should be treated on a case-by-case basis. "Individual differences clearly exist among different addicted people, whether they are gamblers or alcoholics," he noted, "and it is the individual that has to be approached in terms of their respective needs."

Linda Chamberlain, a psychologist and coordinator for the Center for Addiction and Substance Abuse at University of South Florida in Tampa, believes the roots of addiction are too complex to be captured in just one study.

She noted, for example, that prior research has indicated that while stimulation-seeking may be the driving force for men who gamble, women are more likely to gamble for escapism.

"In terms of the emotional draw for the gambler, it's going to be different, depending on gender and what types of games they're engaged in," said Chamberlain. "Some games are very high-risk and involve skill which makes them more stimulating, more competitive. For people who are playing slots or video-based games, where they're just interacting with the machine -- which is what the majority of women seek out -- there's a very low probability of skill coming into play. These games tend to be more a question of escape. So it depends on the person."

But Chamberlain also stressed that, regardless of differences in the way people become addicts, addiction takes a grim toll on their lives.

"Addicted people go crazy, they die, they try to get help," she said. "And the outcomes are very similar, regardless of how the person got engaged in the behavior -- in terms of the destruction of their values and the loss of important aspects of their lives including relationships, careers and their financial situation. Regardless, it's life-threatening."

More information

For more on gambling addiction, check out the Illinois Institute for Addiction Recovery. For more on alcoholism, check out the National Institute on Alcohol Abuse and Alcoholism.

SOURCES: Hermano Tavares, M.D., Ph.D, Gambling Outpatient Unit, faculty of medicine, University of Sao Paulo, Brazil; Marc Galanter, M.D., director, division of alcoholism and drug abuse, department of psychiatry, New York University School of Medicine, New York City; Linda Chamberlain, psychologist and coordinator, Center for Addiction and Substance Abuse, University of South Florida, Tampa; August 2005 Alcoholism: Clinical and Experimental Research

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