The Neurology of Gambling Addiction

This is your brain. This is your brain on gambling. Readers of a certain age will remember those television ads, but, of course, they used the word “drugs” instead of the word “gambling.”

The purpose of this post is to look at the similarities neurologically between taking drugs and playing gambling games. The parallels are closer than many people think. I used to be from the school of thought that said you couldn’t be addicted to an activity like gambling because you weren’t ingesting a substance. I also rejected the disease theory of addiction.

As I’ve grown older, wiser, and better-informed, my opinions on such issues have changed. I understand first-hand how hard addictions can be to recover from. I’m not anti-gambling, though—just like I’m not anti-alcohol. I do believe, though, that for many people, gambling (and/or alcohol) can be a devastatingly poor life choice.

Here’s how the neurology of gambling addiction works:

A Gambler’s Story

Here’s a common story you might hear in the rooms of Gamblers Anonymous, a 12-step support group for people who have a desire to quit gambling:

I was only 20-something the 1st time I visited a casino. It was just for giggles and grins, and my buddies and I had a lot of fun. I was a successful entrepreneur with a degree, and my business was doing well. I lived driving distance from a casino, and over the 10 years or so since I started gambling, I started visiting the casino more often.

But it wasn’t the end. With the help of Gamblers Anonymous and mental health professionals, I’ve started the long road of recovery. I don’t gamble anymore, ever, at all. Absolute abstinence from gambling activities is the only solution that makes any sense for someone like me. Of course, the above account is fictional, but it reflects the kinds of stories you’d hear in a Gamblers Anonymous meeting.

It sounds like a horror story—and it is—an normal people wonder how someone could ever go so far down such a lonely, sad road. The truth is that mental health professionals mostly agree that gambling is as addictive in nature as almost any kind of recreational drug.

Gambling’s Classification in the Psychiatric Community

Psychiatrists used to overwhelmingly agree that pathological gambling should be classified as a compulsion, not an addiction.

What’s the difference? Someone with a compulsion has a primary goal of getting some relief from anxiety or worry. Someone with an addiction has a primary goal of achieving some kind of intense pleasure.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), pathological gambling fell into the “impulse-control disorder” category. Other mental illnesses that fell into this category include:

• Eating disorders
• Kleptomania
• Nymphomania
• Pyromania
• Trichtillomania (hair pulling)

But in the 5th edition of the DSM, pathological gambling was reclassified as an addiction—this new classification reflects the growing scientific understanding of how gambling addiction really acts on a person’s neurology. In other words, addictive gambling has a huge biological component.

The psychiatric community also now recognizes that treatment is more important now than ever. Access to gambling is easier now than at any other time in United States history. 80% of American adults have gambled on something. 48 of our 50 states offer some kind of legal gambling activities, too. Internet gambling is easily accessible, too, even though most of the time it’s only quasi-legal—depending on where you live.

As many as 2 million people in the United States are addicted to gambling, but that might be a low estimate. Some claim that 20 million or more claim that gambling interferes with their professional and/or personal lives. And a whopping 1 in 5 gambling addicts attempt suicide at some point.

How Gambling and Drug Addiction Are Physically Similar

The American Psychiatric Association is the body that classifies mental illnesses. Naturally, they pay attention to research in the areas of science that compare gambling and drug addiction. Here’s what the research has determined:

Your brain has a system of neural connections called “the pleasure network.” These circuits connect various parts of the brain with different functions to affect your motivations. When something is healthy, it’s supposed to result in a dopamine release in the pleasure network of your brain.

Here’s an example of something healthy that most people can relate to: Sex.

But the more you use such drugs, the less effective they become at stimulating that dopamine response. The brain eventually just stops producing so much dopamine. This is what people mean when they talk about building up a tolerance to a drug. It takes more of that drug to get the same feelings of pleasure. These connections also become weaker as they’re over-used. It’s like these neural pathways get “burned out.”

Furthermore, if you take that drug away from people who use it constantly, the body responds by going through withdrawal symptoms. These are intense flu-like symptoms—insomnia, chills, and the shakes are common.These 2 factors combine to make it almost impossible for an addict to give up a substance. It looks like some of these tendencies are also hereditary. Some people are just more likely to become addicts than others because of their genes. It turns out that these same genes are common in both problem gamblers and drug addicts.

That might all sound circumstantial to the skeptic who doesn’t believe in the disease model of addiction. But science has clearly demonstrated that the neurology of gambling is remarkably similar to the neurology of drug use. Scientists can measure neurological activity in people who play casino games on a computer.

One of the areas of the brain that’s heavily involved in impulse control and the pleasure center is the prefrontal cortex. In drug addicts, this part of the brain is under-active until it’s stimulated by certain drugs. Studies have demonstrated that this is the same part of the brain that’s under-active among problem gamblers.

Studies in Parkinson’s disease have also contributed to this classification of gambling as an addiction. Parkinson’s disease is a neurological disorder that results in stiff muscles and shaking. Parkinson’s patients also usually have a lower number of the neurons that create dopamine in the brain, which is one of the reasons Parkinson’s patients are often depressed.

The way psychiatrists view addiction has also changed over the years. They used to define addiction as a dependence on a chemical, but now they define it as doing something repeatedly in spite of the negative consequences. It doesn’t matter if it’s getting blackout drunk or gambling until all your money is gone; it’s still addictive behavior.

Treatment and Recovery for Gambling Addiction

These might seem like word games or pedantic attempts to re-classify certain behaviors that have no practical application. That’s not the case, though.

Here’s why:

Sadly, the stigma associated with mental illness often prevents both drug addicts and gambling addicts from seeking help. Most compulsive gamblers never get any help at all, and even those that do often relapse. It’s become enough of a problem that casino managers are now regularly trained to spot troubling behavior.

Even internet casinos have options to help such people, including voluntary self-exclusion programs. In traditional casinos, problem gamblers often get so much credit that they’re never able to pay off their gambling debts anyway.

Slot Machines Are Especially Insidious

It’s common to hear stories in the casino industry about slot machine “zombies” who don’t seem to notice stuff that people who weren’t in an altered state of mind would notice immediately. This stuff includes:

• Fire alarms
• Flood water in the floor of the casino
• Other gamblers having heart attacks

You’ll see slot machine gamblers talk about how they’re not even really present during these kinds of events. Their world becomes limited to the machine and its results. It’s hard to imagine that this kind of mental removal from your environment has no neurological component.

The casino industry spends an enormous amount of time and energy determining the most effective way to lay out the floorplan of a casino to maximize the probability of a gambler spending all of his or her money in the slot machines. They also pay attention to the other physical elements of the casino environment:

• The color
• The lighting
• The smells
• The sounds
• The temperature

The way these sensory inputs affect gamblers is important to the casinos, because their goal is to get the gamblers into a “zone,” where everything besides the game ceases to exist. Books have been written measuring specifically what the optimal light and sound levels are in a casino, as measured in foot candles and decibels. (See a book called Designing Casinos to Dominate the Competition by Bill Friedman.)

Behavioral scientist B.F. Skinner is well-known for his design of something called “Skinner boxes.” These were boxes that dispensed food to rats when they pulled a lever. Initially, they monitored the likelihood that a rat would pull a level if he got food every time.

They then changed the settings so that the rats got food on every 4th pull of the lever. And they went further to randomly provide rewards when pulling the lever. The rats who were most motivated to pull the lever were the rats in the 3rd group. This became an example of the power of intermittent positive reinforcement. If you don’t see the obvious parallel to how a slot machine works, you’re not as perceptive a reader as I thought (smile). Seriously, though—what is a slot machine if not a Skinner box that dispenses money to people instead of food to rats?

I’ve written in the past about brainwashing, too, which is a fascinating subject. One of the facts I learned about brainwashing is that just being aware of how it works doesn’t make you immune to being brainwashed—even if you’re an expert on the subject. I’ll contend, based on personal experience, that this applies to slot machines, too. When I describe myself as a gambler, I self-identify as a poker player. As a poker player, I try to stick with bets where my decisions matter and bets where I have a positive expectation.

But this last weekend, I spent some time on a couple of different slot machines. On the 1st game, Lightning Sevens, I kept careful track of how many spins I made in a specific period of time. I called it research for a post about calculating your actual average loss per spin and how you can use that to gauge how much you might expect to lose per hour in the long run. I had a surprising amount of fun playing the game, but eventually I needed a soft drink.

I probably played The Big Lebowski slots for half an hour, and I know I came out ahead, because I recouped my losses from the Lightning Sevens machine. I think I had a net win for the evening of $5 or $10. It was a lot of fun, but I worry that I’m less immune to the siren call of the slot machines than I’d prefer to admit.

Conclusion

Much of the data related in this post was pulled from a wonderful Scientific American article I read. I also found a lot of useful information in a book called Addiction by Design: Machine Gambling in Las Vegas by Natasha Dow Schüll. Some of it was also based on my own personal experience.

The upshot of all this is that gambling addiction is a real phenomenon with a physical, neurological component—just like drug addiction. This might seem like a “let the victim off the hook” attitude, but the reality is that lives are ruined by gambling addiction every day.

Why would we not want to better understand the neurological and physiological aspects of this phenomenon so that we can better help these people? Also, it might serve as a useful warning for folks who are starting to develop what might be a problem.