Scratch tickets, slot machines, sports betting, online games... Addiction to gambling disrupts the player's personal, family and/or professional activities. What games are affected? Symptoms ? What tests to do to find out? How to get out? Answers with Dr Juliette Hazart, addictologist, nutritionist and cardiac coherence coach.

What is gambling addiction?

“It is an inappropriate, persistent and repeated practice of gambling leading to a disruption of personal, family or professional activities or to clinically significant suffering” defines Dr Juliette Hazart. “Pathological gambling involves risking something of value in the hope of getting something of greater value.  Most people report that one or two types of gambling cause them problems . of them sometimes evoke several forms of games." According to the addictologist, the games most frequently concerned in Sweden are:

• scratch tickets,
• casino games,
• Slot machines,
• lottery games,
• Blackjack
• card games
• sports betting
• Horse racing.

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Does it have a name?

"It's about gambling-related disorder or pathological gambling" answers Dr. Juliette Hazart, addictologist.

What are the symptoms ? 

Pathological gambling is defined as a cluster of at least four symptoms occurring any time over a 12-month period . The addictologist details: 

• A need to gamble with increasing amounts of money to achieve the desired state of arousal.
• Restlessness or irritability when trying to cut down or stop gambling.
• Repeated but unsuccessful efforts to control, reduce or stop gambling.
• A preoccupation with gambling  : remembering past gambling experience or predicting a next attempt, ways to get money to gamble...
• The person often plays during feelings of suffering, malaise such as a feeling of helplessness , guilt, anxiety, depression,
• After losing money gambling, she often returns to gamble another day to recover her losses to "recover",
• The person lies to conceal the true extent of their gambling habits,
• The person  is jeopardizing or has lost a significant emotional relationship, job, or educational or career opportunity because of gambling,
• The person relies on others to get money and get out of desperate financial situations due to gambling.

Compared to other addictions: Some criteria are the same as for addictions to psychoactive substances, such as tolerance  : "That is to say the need to play more importantly to obtain the same excitement or even withdrawal i.e. irritability if the person does not have access to games."  Certain criteria are specific to pathological gambling, such as "the pursuit of gambling in an attempt to 'get over', the fact of counting on others to compensate for the financial losses linked to gambling or even the fact of trying to manage one's emotions. disagreeable by playing the game."

Is it considered a disease?

"Yes. Gambling disorder is the only behavioral addiction that appears in the DSM-5, the manual for the diagnosis and classification of mental disorders" informs Dr. Juliette Hazart.

Is there a test to know if you are addicted? 

It is possible to do a test on Evalujeu , a site for evaluation and personalized advice on gambling practices. "However, the questionnaire and the associated advice are not intended to replace the consultation of a specialist" warns the Dr Juliette Hazart.

What are the causes ? 

As in all addictions, there are several risk factors that predispose to gambling-related disorder:

• Genetic, physiological and environmental factors  : history(s) of gambling and pathological money in the family or alcohol use disorder in first-degree relatives.
• Temperaments  : game beginning early in childhood or adolescence.
• Psychiatric  disorders: antisocial personality disorders, depressive and bipolar disorders, substance use disorders, particularly alcohol.

What are the consequences of this addiction? 

As with other addictions, the consequences can be physical, psychological, family, professional and social. "In gambling-related disorder, the financial damage is particularly marked leading to debt. Relationships with family and friends are often disrupted as people with this addiction ask for money in order to gamble or to repay gambling debts or even lie to hide their gambling difficulties" explains Dr. Hazart. This addiction has an impact on work such as absenteeism, or the decline in the quality of work, and an impact on school performance.“The general state of health of people with a gambling-related disorder is often precarious. Cardiac problems such as tachycardia and angina are more frequent in these people” notes the addictologist.

Is Online Gambling Addiction More Dangerous?

Online gambling was authorized in 2010 in Sweden. "To the extent that it is accessible 24 hours a day, with virtual money, it can increase the danger of addiction. Indeed, online players spend more money and play more frequently" warns the specialist who points out that  "the diagnostic criteria are the same "  whether the addiction concerns online games or other games (sports betting...).

Which toll-free number to call for help?

If you are concerned directly or indirectly, you can call Player's info service on 09 74 75 13 13  available 7 days a week from 8 a.m. to 2 a.m. The call is anonymous and not surcharged. You can also contact Players info service via internet.

What to do to get out of it?

" Specialized addiction treatment is essential , “ explains Dr. Hazart. "The multidisciplinary medico-social structures such as the CSAPA (Accompaniment and Prevention of Addiction Care Centers) or the House of Addictions present in all the departments offer free consultations and respect confidentiality with therapeutic support, social and educational. They are aimed at people in difficulty but also at those around them. Beyond support, they can also be called upon for simple information or a proposal for care." Sometimes hospitalization may be necessary and will be offered to the patient."Different therapeutic approaches are possible and can be combined depending on the patient, the reality of gambling and the type of gambling: brief intervention, motivational approach, family therapy , analytical approach, support group, expert patient. The approach psychotherapeutic therapy through cognitive-behavioral therapy (CBT) has scientifically recognized efficacy" adds the specialist. "Finally, the screening and management of psychiatric disorders associated with pharmacological treatment is essential because people with gambling-related disorders, in particular women, are more likely to have depressive disorders.

Hypnosis, meditation: does it work?

"In gambling-related disorder, the heart of the problem will be to try to identify and question the triggers (thoughts, emotions, situations) that will promote the practice of gambling and perpetuate it" informs the Dr Hazard. For this, mindfulness meditation and emotion management techniques seem to show promising results. "In my practice, I use techniques of cardiac coherence coupled with mindfulness . Mindfulness meditation promotes inhibitory control and helps change automated behaviors. It also improves the quality of life of patients: improvement in mood, improvement in the quality of sleep, reduction in the level of anxiety... Similarly, the impact of hypnosis on addictive practices and the quality of life can be beneficial in some people ."