Key Practice Points for Health Professionals on Gambling-Related Harms

Welcome to the GP Pharmacy Club Pod. Today, we are discussing the key practice points for identifying, assessing, and managing gambling-related harms, based on the NICE guideline (NG248). This guidance is crucial for doctors and healthcare professionals to effectively address and mitigate the impacts of gambling-related issues. The brief guidance document is available as a separate post here.
So, how do we identify Gambling-Related Harms?
Firstly, it’s important to routinely screen for gambling behaviors during general health assessments. This should be done alongside discussions about smoking, alcohol, and substance use. Direct questions such as “Do you gamble?” and “Are you worried about your own or someone else’s gambling?” can be very effective.
For high-risk individuals, targeted screening is essential. This includes patients with mental health conditions like depression, anxiety, PTSD, ADHD, and psychosis. Additionally, individuals taking medications that affect impulse control, those with substance use issues, people facing financial difficulties, homelessness, or legal troubles, and those with a family history of gambling problems should be closely monitored.
As we identify such patients, it is important that we provide initial support and referral.
When providing initial support, it’s important to encourage and normalize the discussion around gambling-related harms. Acknowledge that these harms are common and emphasize that recovery is achievable. Use a non-judgmental, empathetic approach to encourage open discussion.
Motivational interviewing can be a useful tool for individuals reluctant to seek treatment. Brief motivational interventions can help them take the first step towards recovery. Additionally, it’s important to signpost to NHS gambling support services, helplines, and peer support groups. Recommend self-assessment tools available on the NHS website and ensure urgent referral for patients at high risk of self-harm or suicide.
So, what are the treatment and intervention strategies at our disposal?
There are several treatment and intervention strategies that can be employed. Encourage practical self-restriction measures such as blocking gambling websites and marketing messages, enrolling in self-exclusion programs for land-based gambling venues, setting banking restrictions to block gambling transactions, and seeking financial advice and debt management support.
Psychological interventions like Cognitive Behavioural Therapy (CBT) can be very effective. Offer group or individual CBT sessions and encourage participation in recovery communities. Educate patients on relapse prevention by recognizing triggers, managing cravings, and having a recovery plan in place.
For patients who do not respond adequately to psychological therapy, consider pharmacological treatment with naltrexone. Ensure medical oversight when prescribing and monitoring pharmacological interventions.
We also need to look at supporting families and affected others.
It’s also important to support the families and others affected by gambling-related harms. Educate family members on how to support their loved ones while maintaining their own well-being. Provide access to family counselling and financial support services and offer guidance on non-judgmental communication and boundary-setting.
So, how do we implement these strategies in consultations?
We need to integrate gambling screening into routine assessments to normalize discussions about gambling. Provide immediate, actionable support by offering helplines, online resources, and treatment referrals during consultations. Tailor interventions to individual needs, considering co-occurring mental health conditions, and ensure follow-up and relapse prevention by scheduling check-ins to monitor progress and adjust treatment plans as needed.
In conclusion, early identification and intervention can significantly reduce long-term harm and improve patient outcomes. By following these guidelines, healthcare professionals can play a crucial role in managing and mitigating gambling-related harms.
See you next time on the GP Pharmacy Pod.
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