Problem gambling: what can help?

In a blog for people who think they may have a problem controlling their gambling, or who are concerned about someone who does, GP Robert Walton looks at recent Cochrane evidence on what might help.

Take home points


Had a flutter recently and lost? Then did you get straight back on and try to win it back?  Then did you lose again?

If your gambling is out of control you’re not alone.  According to a YouGov survey more than a million people in the UK have problem gambling.  As a general practitioner working in the NHS over several decades, I have seen at first hand the harm that gambling causes both to gamblers themselves and to their families.

Heavy financial losses leading to serious debt are sometimes the very first outward sign of a problem that has lain hidden for years.  The YouGov survey found that about 12 million people in total in the UK had their lives affected by a family member with problem gambling.

What may help you gain control over gambling?

The talking treatment

Sometimes seen as a cure for all ills, cognitive behavioural therapy (CBT) is probably the treatment with the strongest base in Cochrane evidence.  Working with a trained therapist people can identify cycles of thought that lead to gambling, spot triggers to those cycles and then work out ways of interrupting them.  A recent Cochrane Review Psychological therapies for pathological and problem gambling (published November 2022) showed that these simple and straightforward methods may lead to a large reduction in how often people gambled and a moderate reduction in financial losses. So the problems resulting from gambling suffered by children and families may potentially be avoided.  And for the person directly affected by problem gambling there were moderate reductions in depression and anxiety

Medication for problem gambling

A large body of medical research suggests that problem gambling is linked to specific neural circuits in the brain which may be modified by drugs that block opioid receptors.  It may seem like an odd idea that such a complex behaviour can be affected by drug treatment but in the end the proof of the pudding is in the eating so does taking these reduce the risk of problem gambling?

It was interesting to read a recent Cochrane Review Pharmacological interventions for the treatment of disordered and problem gambling (published September 2022) showing that some people taking opioid antagonist medications such as naltrexone may gain small but potentially important reductions in gambling symptoms and a reduction in the amount of money spent on gambling.

Getting help

So Cochrane evidence suggests that there are options that may help people to gain control over problem gambling.  None of these options provides a sure fire cure and some treatments may work better for some people than for others.  Exploring the different options may be a journey and the National Gambling helpline is a good place to start.

References (pdf)

Join in the conversation on Twitter with @rtwalton123 @CochraneUK or leave a comment on the blog.

Please note, we cannot give specific medical advice and do not publish comments that link to individual pages requesting donations or to commercial sites, or appear to endorse commercial products. We welcome diverse views and encourage discussion but we ask that comments are respectful and reserve the right to not publish any we consider offensive. Cochrane UK does not fact check – or endorse – readers’ comments, including any treatments mentioned.

Robert Walton has nothing to disclose.


Problem gambling: what can help? by Robert Walton

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

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