The world’s gambling industry is a massive, global endeavor, with estimated revenues of $10 trillion annually. Although illegal gambling may far exceed this amount, lotteries are the most popular form of gambling in many countries. State-operated lotteries expanded rapidly in the U.S. and Europe in the late 20th century, and organized football pools are found in nearly every European country, as well as several South American countries, Australia, and some African and Asian countries. In addition to lotteries, many countries offer state-licensed wagering on other sports events, such as poker, blackjack, and roulette.
Problem gambling can have serious repercussions for a person’s health, financial security, and social life. It is classified as an impulse-control disorder. Physical effects of problem gambling can include migraines, intestinal disorders, and distress. Gamblers can also develop depression and become despondent, and may even attempt suicide. In extreme cases, the effects of gambling can be so profound that the gambler may not even realize that they have a problem until they are deep in debt.
A growing number of mental health professionals are examining the relationship between gambling and health. While gambling is legal, there is evidence that it is an addictive behavior that is associated with negative health outcomes. Considering these potential benefits and risks, there are multiple reasons to evaluate patients for pathological gambling. In this article, we will review some of the most common screening criteria for pathological gambling, and suggest an appropriate role for primary care physicians in assessing patients with gambling problems.