As more research delves into the manifestations of pathological gambling, many similarities to substance addiction are beginning to emerge. Some of the latest research points to the potential value of anti-craving medications in controlling gambling behavior.
Research presented last December at the annual meeting of the American College of Neuropsychopharmacology found that gamblers who are driven by urges respond well to medications that block the opioid system in the brain or that block receptors for the neurotransmitter glutamate. Jon Grant, MD, MPH, associate professor of psychiatry at the University of Minnesota, says the research points to promise for use of the medication naltrexone or the amino acid N-acetylcysteine as part of treatment for pathological gambling.
Grant urges professionals to “keep an open mind about the issue of medication,” adding, “Referral to Gamblers Anonymous, although helpful to many, doesn’t have to be the only thing one does.”
Grant believes that what might emerge in treatment of pathological gambling will resemble an emerging mindset about substance addiction, regarding the value of combination treatments that incorporate both therapy and medication. “There are promising medications, but they don’t work for everyone,” he says.
In another parallel to substance addiction, certain genetic factors appear to be coming into play in the study of pathological gambling. In the recent research on the effects of opioid blockers, investigators found a better overall response to the medications among individuals with a family history of addiction—alcoholism in particular. This suggests that some genetic factors are involved in the development of and response to gambling addiction.
Grant says current research offers hope to families devastated by pathological gambling behavior, but warns that this should be tempered by an understanding of medications’ limitations. He adds that future research will need to offer a clearer perspective on which treatments might work best for which individuals, so that treatment can be administered on something more than a trial-and-error basis.
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