Will Psychedelics Help Treat Gambling Disorder?

Psychedelics have shown promising results in treating various mental health conditions. They can have a powerful healing effect on those who struggle with substance use disorders. But can they help those with behavioral addictions such as gambling disorder?

“Psychedelics can influence brain regions and networks involved in addictive behaviors, potentially helping to reset or change maladaptive patterns.”

— Katharine Chan, MSc, BSc, PMP

What is Gambling Disorder?

Gambling disorder, also known as pathological gambling, is a behavioral addiction characterized by an uncontrollable urge to gamble despite negative consequences. This gambling can include activities at a casino, online poker and other games, lotteries, and sports betting.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes it as a mental health disorder and includes it under the category of “Substance-Related and Addictive Disorders.”

In the United States, experts estimate that 1% of the population is severely affected by gambling disorder. However, this does not reflect the reality of the problem; many who have gambling issues are not diagnosed and do not seek professional treatment.

Risk Factors

Men are more likely to experience gambling problems than women; however, in recent years, this gap has narrowed. Women tend to partake in non-strategic forms of gambling, such as slot machines and bingo. On the other hand, men are more attracted to strategic forms of gambling, such as sports betting and card games.

Other risk factors for gambling problems or a disorder, such as the following, may contribute to such a development.

Biological Factors

• Genetics: Research suggests that genetic factors may predispose individuals to developing gambling problems. Those with a family history of gambling problems or other addictions are at higher risk.
• Neurobiology: Differences in brain chemistry and function, particularly in areas related to reward, impulse control, and decision-making, may contribute to developing gambling problems or a disorder. For example, variations in dopamine pathways can affect the brain’s reward system.

Psychological Factors

• Personality Traits: Individuals with certain personality traits, such as high impulsivity, sensation-seeking, and a tendency toward risk-taking behaviors, are more susceptible to developing gambling problems. Those who are easily bored, restless, or overly competitive can also be at higher risk of developing the condition.
• Mental Health Disorders: Co-occurring mental health issues, such as depression, anxiety, bipolar disorder, schizophrenia or antisocial personality disorder, or attention deficit hyperactivity disorder (ADHD), can increase the risk of developing gambling problems from this disorder. These conditions may lead individuals to lean on gambling as a coping mechanism.

Social and Environmental Factors

• Exposure and Accessibility: Early exposure to gambling activities, especially during adolescence, can increase the likelihood of developing gambling problems later in life. Easy access to gambling venues or online gambling platforms also plays a significant role.
• Peer Influence: Social circles and peer pressure can influence gambling behavior. Having friends or family members who gamble can normalize the activity and increase one’s likelihood of participating.
• Cultural Attitudes: Cultural norms and attitudes towards gambling can affect prevalence rates. In societies that see gambling as an acceptable and glamorous activity, individuals may be more prone to developing gambling problems.
• Life Stressors: Major life changes or chronic stress, such as financial difficulties, relationship issues, or work-related stress, can contribute to the onset of gambling disorder as individuals may turn to gambling for relief or escape.

Signs and Symptoms

There is a difference between enjoying an evening at the casino and having a gambling disorder. The following are signs that indicate a more serious problem.

• Preoccupation with Gambling: Persistent thoughts about gambling, such as reliving past gambling experiences, planning the next venture, or thinking of ways to get money to gamble.
• Increasing Amounts of Money: There is a need to gamble with increasing amounts of money to achieve the desired excitement.
• Unsuccessful Control Attempts: Repeated unsuccessful efforts to control, cut back, or stop gambling.
• Restlessness or Irritability: Feeling restless or irritable when attempting to cut down or stop gambling.
• Escape: Using gambling as a way to escape from problems or relieve feelings of helplessness, guilt, anxiety, or depression.
• Chasing Losses: After losing money from gambling, returning another day to get even (“chasing” one’s losses).
• Lying: Lying to conceal the extent of involvement with gambling.
• Jeopardizing Relationships and Opportunities: Risking or losing a significant relationship, job, or educational/career opportunity due to gambling.
• Relying on Others for Money: Relying on others to provide money to relieve desperate financial situations caused by gambling.

Diagnosis

To be diagnosed with gambling disorder, an individual must exhibit at least four of the above symptoms within a 12-month period, as outlined in the DSM-5.

Current Treatment Options

There are different therapeutic options for those with problem gambling.

Therapy

• Cognitive-Behavioral Therapy (CBT): CBT helps individuals identify and change thought patterns and behaviors related to gambling. It focuses on developing coping skills, problem-solving strategies, and healthy ways to manage stress and emotions.
• Motivational Interviewing (MI): MI is a client-centered approach that helps individuals explore and resolve ambivalence about changing their gambling behavior. It enhances motivation to engage in treatment and make positive changes.
• Family Therapy: Involving family members in therapy can provide support and address relational dynamics that may contribute to the gambling disorder. It helps improve communication and rebuild trust within the family.

Medication

• Antidepressants: Medications such as selective serotonin reuptake inhibitors (SSRIs) can help manage symptoms of depression and anxiety that often co-occur with gambling disorder.
• Mood Stabilizers: For individuals with bipolar disorder or significant mood swings, mood stabilizers like lithium or anticonvulsants may be beneficial.
• Opioid Antagonists: Medications such as naltrexone, which doctors typically use to treat substance use disorders, have shown promise in reducing the urge to gamble by affecting the brain’s reward system.

Support Groups

• Gamblers Anonymous (GA): GA is a 12-step program modeled after Alcoholics Anonymous. It provides a supportive community of individuals with similar experiences and offers peer support, accountability, and a structured approach to recovery.
• SMART Recovery: This stigma-free program focuses on self-empowerment, teaching practical skills and tools to manage addictive behaviors and achieve lasting change.

Self-Help Strategies

• Setting Limits: Establishing strict limits on time and money spent on gambling can help individuals regain control. These strategies include setting a budget, using self-exclusion programs, and avoiding triggers such as casinos or online gambling sites.
• Alternative Activities: Engaging in healthy and fulfilling activities, such as exercise, hobbies, and socializing, can reduce the urge to gamble and provide alternative sources of enjoyment and satisfaction.
• Financial Management: Seeking financial counseling and developing a plan to manage debts and finances can alleviate the stress that often drives gambling behavior. Such steps might involve working with a financial advisor or credit counselor.

Integrated Treatment Approaches

• Dual Diagnosis Programs: For individuals with co-occurring mental health disorders, integrated treatment that addresses both the gambling disorder and the co-occurring condition simultaneously can be highly effective.
• Holistic Therapies: Incorporating holistic approaches such as mindfulness, meditation, yoga, and nutrition can support overall well-being and aid in the recovery process.

Psychedelics For Gambling Disorder

Recovery for those with a gambling disorder varies depending on the severity of the condition, the presence of comorbid disorders, the individual’s motivation for change, and the availability of support systems.

With appropriate and comprehensive treatment, individuals can achieve significant improvements and regain control over their gambling behaviors. However, gambling disorder is often a chronic condition that requires ongoing management and support to prevent relapse and maintain recovery.

Currently, there are no published clinical studies that directly investigate psychedelics as an intervention for a gambling disorder. However, symptoms and features of gambling disorder are similar to those of substance use disorders and addiction. Here are potential mechanisms for which psychedelic-assisted therapy can help with this condition.

Potential Mechanisms

• Modulating Brain Activity: Psychedelics can influence brain regions and networks involved in addictive behaviors, potentially helping to reset or change maladaptive patterns.
• Enhancing Psychological Insight: They may facilitate deep psychological insight and emotional breakthroughs, helping individuals understand and address the underlying causes of their addiction.
• Promoting Behavior Change: These substances can facilitate deep emotional processing, allowing individuals to confront and understand the underlying issues contributing to their behavior and developing gambling problems. The profound experiences induced by psychedelics can lead to lasting changes in behavior and mindset, aiding in the recovery process.
• Neuroplasticity: Psychedelics can promote neuroplasticity, enhancing the brain’s ability to reorganize and form new neural connections, potentially breaking the patterns associated with addiction.
• Reduction of Cravings: Studies suggest that psychedelics can reduce cravings and compulsive behaviors by affecting serotonin receptors, which play a role in mood and impulse control.

Further research is needed to fully understand these mechanisms and their effectiveness in treating gambling addiction.

Psilocybin

Although researchers have not yet published any studies, the idea that psychedelics can play a role in treating gambling disorders is not new. Many researchers have supported it for years.

In 2014, The Pharmaceutical Journal published an article, Psychedelics: Entering a New Age of Addiction Therapy, that discussed the possibilities of this. It interviewed Matthew Johnson, associate professor of psychiatry and behavioral sciences at Johns Hopkins, about the promising results of his psilocybin tobacco addiction trial. The findings were inconclusive at the time; however, Johnson stated that he suspects psilocybin played a role in the increased quit rate. He added:

“It is not just applicable to smoking — it could also treat other drug addictions, and non-drug disorders like gambling addiction and eating disorders too.”

In 2022, Johnson published the psilocybin study’s results and strengthened his statement.

“Future research should examine classic psychedelic treatment of additional substance use disorders including for opioids, cocaine, methamphetamine, and cannabis, and other disorders broadly characterized as addictions (e.g., obesity, problem gambling, hypersexual disorder).”

Integrating Psilocybin and Psychotherapy

In 2019, Italian researchers published an article in Cosmos and History: The Journal of Natural and Social Philosophy titled Integrating Psilocybin and Existential-humanistic Psychotherapy For Pathological Gambling Treatment: A New Perspective. The authors proposed combining psilocybin and their intensive residential intervention program called Orthos to treat pathological gambling. Orthos uses a non-judgmental approach to gambling with existential-humanistic psychotherapy. They based their recommendation on the following:

• Psilocybin has a low potential for dependency
• Studies have shown that psilocybin improves mood, attitudes, and behavior
• Research shows that a single high dose of psilocybin might have a stronger therapeutic effect than small, gradually increased doses.
• Researchers have studied psilocybin to treat anxiety, obsessive-compulsive disorder, and treatment-resistant depression
• Studies have shown that psilocybin enhances brain function networks, including improving connectivity between different areas and modulating parts affected by addictive behaviors
• Evidence for psilocybin in the treatment of smoking addiction and alcoholism. 

Explore The Role of Psychedelics in Addiction 

• Learn About Holistic Addiction Recovery with Psychedelics
• Read More on Psychedelic Therapy for Addiction Recovery: New Directions for Substance Use Treatment
• Understand How Psychedelics Can Help With Addiction
• Get the Truth: Psychedelics and Addiction: A Magic Bullet?
• Find Out About the Research on Ibogaine for Addiction
• Dive in: Psilocybin Therapy for Alcohol and Substance Use Disorders

A Need For Further Research

A 2024 paper discussed why researchers need to conduct more studies on psychedelic-assisted therapy for a gambling disorder. The authors presented several points to support this.

• There are similar psychosocial and neurobiological mechanisms of pathological gambling and other addictive disorders.
• The successful results of psychedelic-assisted therapy studies on treatment-resistant conditions may be due to its careful design, which considers the set and setting and includes preparation and integration sessions. This therapeutic approach is suitable for addressing chronic gambling behaviors.
• Psychedelic-assisted therapy enhances talk therapy.
• Psychedelic-assisted therapy has a strong potential to address comorbid disorders of pathological gambling.
• Psychedelic therapy only requires a limited number of dosing sessions.
• There is strong evidence of psychedelic therapy and major depressive disorder.
• There have been positive results for LSD and alcoholism, psilocybin, and tobacco and alcohol dependence.
• Researchers see lower drop-out rates and fewer persistent side effects in psychedelic therapy studies compared to the current therapeutic options for gambling disorder. 
• Ketamine and MDMA have shown promising results in treating different substance use disorders.

Current Research: Imperial College Centre for Psychedelic Research and Neuropsychopharmacology

In 2023, the researchers at Imperial College London’s Centre for Psychedelic Research began a small trial looking at psilocybin as a treatment for gambling disorder. 

The study involves five volunteers with gambling addiction. The intervention includes talk therapy in combination with psilocybin. Researchers performed brain imaging using electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) to monitor brain activity and connectivity.

Dr Rayyan Zafar, one of the researchers, spoke with Psychedelic Health and explained that fMRI and EEG could be used to identify translational biomarkers seen in those with addiction disorders and may respond to psychedelic therapy. 

Dr. Zafar describes how his work will inform the study. In his lab, they are conducting experiments designed to “probe the brain’s reward and plasticity systems, which are known to dysregulate in Gambling Disorder.”

“[In this study]…we want to see whether psychedelics can target these systems involved in Gambling Disorder and whether that is how they lead to their therapeutic effects.”

Dr. David Erritzoe, another researcher in the study, shared with Imperial College how psychedelics can help those with behavioral addictions.

“Psychedelics tap directly into the psychotherapeutic paradigms that we are applying, so it is a compelling idea to test them together…Expecting this to be a magic bullet is slightly optimistic, but for some patients, a single session might have long-lasting effects. It might be what it takes for them to break out of the addiction.”

Therefore, psychedelics have potential as a treatment for gambling addiction; however, ongoing and future research will provide clearer insights into their effectiveness and safety for this specific condition.

References

Gambling Disorder

Colon-Rivera, H., Fischer, K.. (2024, May). What Is Gambling Disorder?. American Psychiatric Association. https://www.psychiatry.org/patients-families/gambling-disorder/what-is-gambling-disorder.

Buchanan, T. W., McMullin, S. D., Baxley, C., & Weinstock, J. (2020). Stress and Gambling. Current Opinion in Behavioral Sciences, 31, 8–12. https://doi.org/10.1016/j.cobeha.2019.09.004.

Cleveland Clinic.(2023, August 7). Gambling Disorder. https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction.

Commonwealth of Massachusetts. (2024). Treatment Recommendations for Gambling Disorders. Mass.gov. https://www.mass.gov/info-details/treatment-recommendations-for-gambling-disorders.

Department of Health & Human Services. (2023, March 6). Gambling – How to Regain Control. Better Health Channel. https://www.betterhealth.vic.gov.au/health/healthyliving/gambling-how-to-change-your-habits.

Martins, s. S., Storr, C. L., Lee, G. P., & Ialongo, N. S. (2013, February 1). Environmental Influences Associated with Gambling in Young Adulthood. Journal of Urban Health, 90(1), 130–140.  https://doi.org/10.1007/s11524-012-9751-1.

Rennert, L., Denis, C., Peer, K., Lynch, K. G., Gelernter, J., & Kranzler, H. R. (2014, February 1). DSM-5 Gambling Disorder: Prevalence and Characteristics in a Substance Use Disorder Sample. Experimental and Clinical Psychopharmacology, 22(1), 50–56. https://doi.org/10.1037/a0034518.

Yale Medicine. (2022). Gambling Disorder. Yale Medicine. https://www.yalemedicine.org/conditions/gambling-disorder.

Psychedelics and Gambling Disorder

Johnson, M. W. (2022). Classic Psychedelics in Addiction Treatment: The Case for Psilocybin in Tobacco Smoking Cessation. Current Topics in Behavioral Neurosciences, 56, 213–227. https://doi.org/10.1007/7854_2022_327.

Lawrence, J. (2014, October 27). Psychedelics: Entering a New Age of Addiction Therapy. The Pharmaceutical Journal. https://pharmaceutical-journal.com/article/feature/psychedelics-entering-a-new-age-of-addiction-therapy.

Mundell, I. (2024, January 11). Psychedelic Therapy May Help Break the Chains of Gambling Addiction. Imperial News. https://www.imperial.ac.uk/news/250473/psychedelic-therapy-help-break-chains-gambling/.

Price, S. (2023, August 10). World First Study to Explore Psilocybin for Gambling Addiction. Psychedelic Health. https://psychedelichealth.co.uk/2023/08/10/study-psilocybin-gambling-addiction/.

Prykhodko, O. (2024, July 2). Psychedelic Drugs: Neurobiology and Potential for Treatment of Behavioral Addictions. Jagiellonian University in Kraków. https://ruj.uj.edu.pl/entities/publication/0599aad0-87ba-4702-acaf-352961b82bd8.

Re, T. S., Penazzi, G., Bragazzi, N. L., Khabbache, H., Neri, B., Simões, M., Zerbetto, R., Raymondo, S., & Firenzuoli, F. (2019). Integrating Psilocybin and Existential-Humanistic Psychotherapy for Pathological Gambling Treatment: A New Perspective. Cosmos and History: The Journal of Natural and Social Philosophy, 15(2) 210–224. https://cosmosandhistory.org/index.php/journal/article/view/792/1408.

Romero, P.,  Czakó, A., Van Den Brink, W., & Demetrovics, Z. (2024). Psychedelic-Assisted Therapy for People with Gambling Disorder?. Journal of Behavioral Addictions, 13(1) 6–11. https://doi.org/10.1556/2006.2024.00004.