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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