Co-occurring substance use and problem gambling: Implications for clinicians

Louise King BA, MSW

A Clinician Perspective

• Curiosity

• Pat, not his real name

• Ice and the pokies

• Help - there are no clinical guidelines

here!

Evidence of Co-occurrence

• Evidence for co-occurrence of AOD and gambling in many studies

• 63% of problem gamblers seeking treatment have co-occurring AOD issues (Black & Moyer, 1998)

• 1 in 10 substance users seeking treatment report co-occurring problem gambling (Cunningham-Williams et al, 2000; Toneatto & Brennan, 2002)

• One study reported up to 21% of treatment seeking AOD clients had problem gambling (Mathias et al, 2009)

What else the literature tells us…

• Alcohol, cannabis and methamphetamines

• Substance use precedes gambling

• Increased risk of suicide, incarceration, mental &

physical health problems (Bruner et al 2010)

• Harms of AOD/Gambling – individual & community

• Screening

• Concurrent treatment helps prevent relapse

Methodology

• Exploratory, practice based research

• Literature Review, Policy Review & Qualitative study

• 20 clinician interviews

Key Questions

• Are gambling issues raised as part of normal, everyday practice a in typical AOD service?

• How do AOD clinicians assist clients who disclose gambling issues?

• What extent of knowledge do AOD clinicians have about gambling issues and the best practice treatment for clients?

Themes

• Co-occurrence of AOD and gambling

• Interventions

• Barriers to treatment

• Future directions for practice

Summary of findings

• AOD clinicians do perceive problem gambling as an issue for some clients

• Literature indicates co-occurrence of AOD and gambling (& mental health)

• Screening for both issues and concurrent treatment is appropriate.

• Training staff and development of relationships between AOD & gambling services.

The Future

• Development of Clinical Guidelines

• Training

• Future research opportunities

Acknowledgments

University of Melbourne

Dr David Rose

Dr Winsome Roberts

ReGen

All my colleagues and clients

Donna Ribton-Turner

Trevor King

Malcolm Doreian

Questions….