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Wednesday, January 04, 2017

Comments

Is there any sense of whether the disordered gambling behavior was present before the start of methodone treatment or as a result of the treatment?

In other words, when your character is weak, you are more likely to gamble your money away.

Thanks for your question, Alan. Due to the cross-sectional nature of this study, it is difficult to comment on when the participants' Gambling Disorder symptoms began. The questionnaire they used to determine GD prevalence specifically asks about symptoms within the previous 12 months. Since participants had been in treatment for an average of 3 years, it is plausible to assume participants had experienced GD symptoms concurrent with their treatment. The researchers, however, did not have any information on whether or not participants experienced symptoms of Gambling Disorder before their treatment began, and therefore cannot comment on any causal relationships. --Layne Keating

Thanks for your comment, CA. Addiction is a complicated issue, and I believe those affected by it deserve our compassion. If you're interested in understanding addiction, you might want to take a look at the Surgeon General's recent report, available freely here: https://addiction.surgeongeneral.gov/surgeon-generals-report.pdf.
This statement, from pg. V of the report, sums up what science tells us about the nature of addiction:

"We also need a cultural shift in how we think about addiction. For far too long, too many in our country have viewed addiction as a moral failing. This unfortunate stigma has created an added burden of shame that has made people with substance use disorders less likely to come forward and seek help. It has also made it more challenging to marshal the necessary investments in prevention and treatment. We must help everyone see that addiction is not a character flaw – it is a chronic illness that we must approach with the same skill and compassion with which we approach heart disease, diabetes, and cancer."

--Heather Gray

This article is enlightening, and has provided valuable information. I currently treat individuals that receive medication assisted treatment (MAT), and several of my patients are struggling with GD. Some individuals seem to have replaced the fast lifestyle of opioid addiction with the "high" of purchasing scratch off tickets, or playing games of chance at the casino. They look forward to payday to engage in gaming, when before receiving MAT, they headed to the "spot" to use their drug of choice. Treating those with a propensity to engage in high risk behavior is challenging to say the least. Addiction, as you mentioned in the response to CA, is a chronic illness, a disease; no different than diabetes, or heart disease, and can be treated. However, as with any other disease, if the patient does not comply with the recommendations of their health professionals, change may not occur. I remain hopeful, as I've seen many individuals achieve goals, and live successful, productive lives while receiving MAT.

Thank you for your comment, Celeste! We really appreciate you sharing your insight with us.

--Layne Keating

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