Gambling and Sports Betting Addiction: Screening and Interventions

In this season 2 finale of ASAM Practice Pearls, Dr. Stephen Taylor sits down with Dr. Timothy Fong to discuss one of the fastest-growing and most overlooked concerns in addiction medicine: gambling disorder. With sports betting now legal in over 40 states and digital gambling accessible on every smartphone, gambling and sports betting are rapidly expanding. This episode breaks down the prevalence, consequences, and unique aspects of gambling disorder and offers practical, actionable guidance on screening, brief intervention, and treatment. ----more---- Looking for this episode's transcript? Download it HERE Get credit for listening! Claim your 0.5 CEs HERE Have an idea for a future episode? Share it with us at education@asam.org. Host Stephen M. Taylor, MD, MPH, DFAPA, DFASAM Dr. Stephen M. Taylor is ASAM's President and is board certified in general psychiatry, child and adolescent psychiatry, addiction psychiatry, and addiction medicine. With over 30 years of practice experience, Dr. Taylor is dedicated to helping adolescents and adults overcome addiction and co-occurring psychiatric disorders. He has served as the Medical Director of the NBA and NBPA Player Assistance and Anti-Drug Program for 16 years and is the Chief Medical Officer of Pathway Healthcare, which operates multiple outpatient addiction and mental health treatment offices across six states. Expert Timothy Fong, MD Dr. Timothy Fong is the President of the American Academy of Addiction Psychiatry (AAAP) and a clinical professor of psychiatry at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA. He is board certified in adult and addiction psychiatry. He is the co-director of the UCLA Gambling Studies Program, a program that examines the clinical characteristics of gambling disorder in order to develop effective, evidence-based prevention and treatment strategies. Dr. Fong is also a member of the Steering Committee of the UCLA Center for Cannabis and Cannabinoids, whose mission is to address the most pressing questions about the impact of cannabis legalization through rigorous scientific study and interdisciplinary discourse. He is a member of the UCLA Sports Psychiatry Service and the UCLA Sports Medicine Mental Health Team. 📖 Show Segments 00:05 - Introduction  02:38 - Modern Day Gambling: Investing vs Gambling vs Betting 04:38 - Prevalence and Public Health Impact 08:21 - Consequences of Gambling Disorder 14:30 - Screen and Clinical Assessment 20:03 - Interventions and Treatment Options 23:59 - Practice Pearls 27:40 - Conclusion 📋 Key Takeaways Recognize that we are practicing in a gambling-centered environment: The rapid expansion of mobile sports betting, online wagering, and prediction markets has normalized gambling and lowered perceptions of risk. Clinicians should expect to encounter gambling-related harms more frequently across patient populations. Recognize gambling disorder as a serious and potentially life-threatening condition: Gambling disorder is associated with high rates of suicidality, co-occurring substance use disorders, mental health disorders, financial strain, relationship problems, and intimate partner violence. Clinicians should approach it with the same level of concern as substance use disorders. Remember that gambling disorder is often a hidden addiction: Patients may appear highly functional, professionally successful, and psychologically intact while experiencing severe financial losses, emotional distress, and compulsive gambling behaviors. Do not rely on appearance or external functioning to assess risk. Screen routinely and ask the right questions: Gambling should be assessed alongside substance use during intakes, annual assessments, and follow-up visits. Because many patients do not view sports betting, poker, online wagering, or prediction markets as "gambling," ask specifically about betting behaviors. Consider questions such as: Have you ever lied to anybody about spending money on gambling or betting? Have you ever increased your bet, wager, or gambling amount to get the same thrill or rush? How much time, energy, and money do you spend online trying to make more money? Assess financial heal