Key Practice Points for Doctors and Health Professionals on Gambling-Related Harms

Key Practice Points for Doctors and Health Professionals on Gambling-Related Harms

(Based on NICE Guideline NG248)

1. Identifying Gambling-Related Harms

  • Routine Screening: Ask about gambling when discussing smoking, alcohol, or substance use, especially during general health checks or service registrations.
  • Targeted Screening: Ask patients at higher risk, including those with:
    • Mental health conditions (e.g., depression, anxiety, PTSD, ADHD)
    • Substance use issues (especially alcohol or cocaine)
    • Medications affecting impulse control (e.g., dopamine agonists, aripiprazole)
    • Financial concerns, homelessness, or involvement in the criminal justice system
    • Family history of gambling issues

2. Initial Support & Referral

  • Encouragement & Normalization: Acknowledge that gambling-related harms are common and recovery is possible.
  • Motivational Interviewing: Use brief motivational interventions to encourage individuals reluctant to seek help.
  • Immediate Referral: Provide information on available support services (e.g., NHS gambling support, helplines, and peer support groups).
  • Suicide Risk Assessment: Recognize gambling as a major risk factor for suicidal thoughts and take urgent action if necessary.

3. Treatment and Intervention Strategies

  • Self-Exclusion & Financial Controls: Advise patients on practical steps like:
    • Blocking gambling websites and marketing messages
    • Self-exclusion programs for betting venues
    • Setting bank restrictions on gambling transactions
    • Seeking financial advice for debt management
  • Psychological Interventions:
    • Cognitive Behavioral Therapy (CBT): Offer group or individual CBT for gambling disorder.
    • Peer Support: Encourage participation in peer support groups.
    • Relapse Prevention: Educate on identifying triggers, using self-control techniques, and planning for lapses.
  • Pharmacological Treatment: Consider naltrexone if psychological interventions alone are ineffective.

4. Support for Families and Affected Others

  • Providing Guidance: Educate families on supporting their loved one while protecting their own well-being.
  • Emotional & Practical Support: Offer family members access to counseling and financial assistance services.

Implementing These Strategies During Consultations

  • Adopt a Non-Judgmental Approach: Acknowledge stigma and encourage open discussions about gambling habits.
  • Use Direct, Simple Questions: Ask, “Do you gamble?” or “Are you worried about your own or someone else’s gambling?”
  • Offer Immediate, Actionable Advice: Provide patients with self-help tools, helpline numbers, and treatment options.
  • Personalize Care Plans: Tailor interventions based on the severity of gambling-related harms and co-existing mental health conditions.
  • Follow-Up & Relapse Prevention: Schedule follow-ups to check progress, reinforce strategies, and address any setbacks.

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M Moyo

Founder of GP Pharmacy Club. Clinical Pharmacist working in GP Primary Care. Experienced community pharmacist. Independent Prescriber.

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