Original Research Effect of a New Casino on Problem Gambling in Treatment-Seeking Substance Abusers

The DSM-IV has modelled pathological gambling aftersubstance dependence (1). Symptoms defining patho-logical gambling strongly resemble those for substance de-pendence (for example, preoccupation with gambling, tolerance to gambling-related excitement, gambling-related withdrawal symptoms, and repeated efforts to cut down or stop gambling [2]). Further, treatment approaches for prob-lem gambling have tended to resemble those offered to sub-stance abusers, including residential, outpatient, and self-help approaches such as Gamblers Anonymous (3). Discussions of treatment for both chemical and behavioural addictions com-monly employ concepts such as high-risk situations, relapse prevention, urges and cravings, denial, abstinence, and with-drawal. Not surprisingly, a considerable body of research has established a robust relation between chemical dependencies and pathological gambling (4,5). In general, higher rates of al-coholism and other substance use have been reported among gamblers, compared with the general population (6–8). Like-wise, rates of pathological gambling appear to be higher among substance-abusing populations than among the gen-eral population (9–12). Spunt and others have noted that most of the available data have focused on subjects with alcohol or methadone-maintained opiate addictions (4); much less is known about gambling and other psychoactive substances. The primary goals of this study were to assess the prevalence of problem gambling in samples of treatment-seekin