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Patterns of alcohol and substance use among treatment-seeking problem gamblers

This study examines the changing patterns of alcohol and substance use among treatment-seeking problem gamblers over time. The aim is to investigate if problem gambling treatment affects drug and alcohol behavior in these individuals.

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Patterns of alcohol and substance use among treatment-seeking problem gamblers

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  1. Patterns of alcohol and substance use among treatment-seeking problem gamblers Linshan Gu (Jessica), Grace Wang, Maria Bellringer, Nick Garrett 6th National Addiction Symposium, Auckland, 22 April 2015

  2. Background • High rates of comorbidity have been consistently reported • Research shows that over 35% of problem gamblers have problem of AOD use (Hodgin et al., 2005, Stinchfield & Winters, 2011) • People with problem gambling and substance abuse have improved not only gambling but also other areas • However, a concern has been raised in terms of switching one substance for another during treatment • There are some uncertainties around the change patterns of AOD use over the gambling treatment periods

  3. Aim and research question Aim • To investigate the changing patterns of AOD problems in help-seeking gamblers over time Research question • Does problem gambling treatment change drug and alcohol behaviour among help-seeking gamblers?

  4. Methods • Participants: help-seeking callers to the Gambling Helpline • Recruitment: August 2009 to May 2011 • Participants (N=150): over the age of 18 years • Treatment: Helpline’s standard care including • brief intervention, • suggestions for self-care and/or • referral to face-to-face problem gambling counselling services • Note that this research is a part of a larger study on gambling treatment outcome (Abbott et al., 2013)

  5. Methods • Measures - Problem Gambling Severity Index (PGSI) • 0 = non-problem gambling; • 1-2 = low risk; • 3-7 = moderate risk; • 8+ = problem gambling - Drug Abuse Screening Test (DAST) • 0-2 = non-problem drug use; • 3-10 = moderate to severe level of drug use - Alcohol Use Disorders Identification Test (AUDIT-C) • social drinkers = drink 2 or more times a week; • heavy drinkers = have 5 or more drinks on a typical day; • binge drinkers = drink six or more drinks on one occasion weekly or almost daily

  6. Results

  7. Change patterns- AOD use

  8. Change patterns- AOD use

  9. Discussion • Comorbidity between problem gambling and AOD use are high (11% for drug use and over 24% for drinking problems) • 2007/2008 New Zealand Alcohol and Drug Survey (Ministry of Health, 2009): 17% for recreational drug use and 10% for alcohol use • Compared to the general population of NZ, severity of AOD use is greater in problem gamblers • Help-seeking gamblers showed improvement in • problem gambling • moderate to severe drug use and • binge drinking • But did not show significant improvement in • social drinking and • heavy drinking

  10. Discussion • Potential contributing factors for improved treatment outcome • Attitude: desire to change (Ladd & Petry, 2003) • Gambling may be a conditioned cue for AOD use (Steward, 2002) • Help-seeking population • Factors related to increased heavy drinking and social drinking - Switch addiction - Social drinking may not have been considered a problem - Not related to gambling - Other psychological distress

  11. Strengths and Limitations Strengths • Measured problem gambling as well as AOD use • Followed up at 12 months Limitations • Small sample size • High dropout rates, however, it is common for longitudinal studies

  12. Conclusion and Implications • AOD use is a common comorbid condition of problem gambling • Therefore should be screened for in routine clinical assessments • Severity of problem gambling, moderate to severe drug use and binge drinking are likely to be reduced following gambling treatment • Better outcome may be achieved with the combined gambling and AOD treatment

  13. Acknowledgement • Funding body: - Ministry of Health - AUT summer research award • Gambling and Addictions Research Centre • Gambling Helpline • Participants

  14. References Castren, S., Pankakiski, M., Tamminen, M., Lipsanen, J., Ladouceur, R., & Lahti, T. (2013). Internet-based CBT intervention for gamblers in Finland: experiences from the field. Scandinavian Journal of Psychology, 54, 230-235. doi: 10.1111/sjop.12034 Lorains, F., Cowlishaw, S., & Thomas, S. (2011). Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys. Addiction, 106(3), 490-498. Ministry of Health. (2009). Alcohol use in New Zealand: key results of the 2007/8 New Zealand alcohol and drug use survey. Wellington: Ministry of health. Ministry of Health. (2007). Drug use in New Zealand: analysis of the 2003 New Zealand health behaviours survey - drug use. Wellington: Ministry of Health. Petry, N. M., Stinson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on alcohol and related conditions. The Journal of Clinical Psychiatry, 66, 564-574. doi: 10.4088/JCP.v66n0504 Rash, C. J., Weinstock, J., & Petry, N. M. (2011). Drinking patterns of pathological gamblers before, during, and after gambling treatment. Psychology of Addictive Behaviours, 25(4), 664-674. doi: 10.1037/a0025565

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