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ORCA House Inc.
Post Discharge Specialist/Case Manager
Many clients at alcohol and drug (AOD) organizations are referred by the courts system, in lieu of other charges. We know to reduce recidivism it is important to address the root cause of the offense. One client was referred in this way after finding drug paraphernalia in her car while driving home from the casino. This is the first example of the relationship between substance abuse and gambling.
During her assessment it was found she met criteria for a substance use disorder and also disordered gambling. The woman stated that she started gambling in college and that “initially I would bet on sporting events then lottery and scratch offs, leading me straight to the casinos.” She began to gamble for fun and boredom but, when she started using drugs she gambled to win and earn money for drugs. This relationship between gambling and financing drug use is not uncommon. Some have described these two behaviors as being part of a certain lifestyle of high risk decision making.
Throughout the last decade she either suffered problems in her life arising from her substance abuse or gambling. Financial problems became more severe however, and relationships, mental and physical health, and work also suffered. She stated that “wherever I was or whatever I was doing I was always thinking about gambling/winning as soon as I get free.” She reports “it was like a flip flop thing, I was either trying to figure out a way to gamble or a way to get high and sometimes it was a combination of both.” Most individuals with a substance use and/or gambling disorder display this type of preoccupation.
In the past she successfully completed two AOD out-patient treatment programs where she had periods of sobriety. She reported that as soon as she got sober her thought process turned “straight to gambling.” Over and over again this became the routine of her life. She stated “it was like a dog chasing his tail.” This is when she began to cry and told the counselor that “something is terribly wrong with me and I need help.”
The comorbidity for substance use disorders and gambling has been well documented, with about 15% of people with a substance use disorder also having problems with gambling. At even higher rates, 75% of individuals with a primary gambling problem have had problems with alcohol and 38% have had problems with drugs.
However, not many treatment programs/facilities have begun to incorporate evidence based practices to treat both disorders simultaneously. This may stem from the episodic nature of the gambling problem while the manifestation of substance use disorder is in full affect; the problem gambling often is overlooked and untreated.
There is a significant need and demand for more skilled clinicians and other behavioral health professionals to become qualified in treating individuals suffering from the comorbidity of both disorders. Dual diagnosed treatment programs specializing in problem gambling as well as substance abuse disorder and mental health is a must. The efforts taken by organizations such as the Problem Gambling Network of Ohio (PGNO) and the Cuyahoga Problem Gambling Coalition (CPGC) to address and raise awareness for this disorder have been remarkable. However, the need to integrate diagnosis and treatment of these three disorders are paramount. Going forward, an increase in funding is needed to help more organizations, professionals and facilities in Cuyahoga County. Funding will help create treatment programs that will assist this population to recover and heal from these individual, family, and community disorders.