The Brain and Gambling Addictions

Farris Jabr at Scientific American reports on studies of those who become addicted to gambling. He notes that the latest DSM-V reclassifies problem gambling as an addiction rather than a compulsion, as it was previously called, and that this was done because of the similar ways that both drug addiction and gambling addiction affect the brain.

In the past, the psychiatric community generally regarded pathological gambling as more of a compulsion than an addiction—a behavior primarily motivated by the need to relieve anxiety rather than a craving for intense pleasure. In the 1980s, while updating the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association (APA) officially classified pathological gambling as an impulse-control disorder—a fuzzy label for a group of somewhat related illnesses that, at the time, included kleptomania, pyromania and trichotillomania (hairpulling). In what has come to be regarded as a landmark decision, the association moved pathological gambling to the addictions chapter in the manual’s latest edition, the DSM-5, published this past May. The decision, which followed 15 years of deliberation, reflects a new understanding of the biology underlying addiction and has already changed the way psychiatrists help people who cannot stop gambling…

The APA based its decision on numerous recent studies in psychology, neuroscience and genetics demonstrating that gambling and drug addiction are far more similar than previously realized. Research in the past two decades has dramatically improved neuroscientists’ working model of how the brain changes as an addiction develops. In the middle of our cranium, a series of circuits known as the reward system links various scattered brain regions involved in memory, movement, pleasure and motivation. When we engage in an activity that keeps us alive or helps us pass on our genes, neurons in the reward system squirt out a chemical messenger called dopamine, giving us a little wave of satisfaction and encouraging us to make a habit of enjoying hearty meals and romps in the sack. When stimulated by amphetamine, cocaine or other addictive drugs, the reward system disperses up to 10 times more dopamine than usual.

Continuous use of such drugs robs them of their power to induce euphoria. Addictive substances keep the brain so awash in dopamine that it eventually adapts by producing less of the molecule and becoming less responsive to its effects. As a consequence, addicts build up a tolerance to a drug, needing larger and larger amounts to get high. In severe addiction, people also go through withdrawal—they feel physically ill, cannot sleep and shake uncontrollably—if their brain is deprived of a dopamine-stimulating substance for too long. At the same time, neural pathways connecting the reward circuit to the prefrontal cortex weaken. Resting just above and behind the eyes, the prefrontal cortex helps people tame impulses. In other words, the more an addict uses a drug, the harder it becomes to stop.

Research to date shows that pathological gamblers and drug addicts share many of the same genetic predispositions for impulsivity and reward seeking. Just as substance addicts require increasingly strong hits to get high, compulsive gamblers pursue ever riskier ventures. Likewise, both drug addicts and problem gamblers endure symptoms of withdrawal when separated from the chemical or thrill they desire. And a few studies suggest that some people are especially vulnerable to both drug addiction and compulsive gambling because their reward circuitry is inherently underactive—which may partially explain why they seek big thrills in the first place.

Even more compelling, neuroscientists have learned that drugs and gambling alter many of the same brain circuits in similar ways. These insights come from studies of blood flow and electrical activity in people’s brains as they complete various tasks on computers that either mimic casino games or test their impulse control. In some experiments, virtual cards selected from different decks earn or lose a player money; other tasks challenge someone to respond quickly to certain images that flash on a screen but not to react to others.

Here’s why I find this interesting. In the poker world, there are lots of people who are clearly pathological gamblers who fit these patterns. TJ Cloutier, for example, has won millions of dollars in tournament poker and lost at least that much at the craps table, leaving him frequently flat broke despite having won so much money. He’s hardly alone. Many of the top poker players are constantly on a financial roller coaster not because they aren’t winning at poker but because they make massive and foolish prop bets and gamble against the house for large amounts of money.

But a lot of them aren’t. A lot of the younger players, in particular, are strictly poker players. They aren’t addicted to gambling itself, they are attracted by the psychological and intellectual parts of the game of poker specifically. They treat it like a business, playing within their bankroll and making intelligent decisions that lead to long-term viability rather than rolling the dice (literally) looking for a hit of dopamine. Obviously, those people are much healthier both financially and mentally.

I wonder what distinguishes them? Both the addicts and the businessmen (for lack of a better term) spend their lives surrounded by gambling. They face all the same temptations. What makes one person become a gambling junkie while another is able to navigate that tempting world with their good sense intact? Is it genetics, environment and upbringing, or both?

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  • Reginald Selkirk

    Off-topic, but I think many readers will find this amusing:

    Putin trumps Chuck Norris in black belt stakes

  • scienceavenger

    My very anecdotal nonscientific experience says genetics. I was one of those “businessmen” poker players when I could play online, made a nice living (fuck you Bill Frist). I played more than full time, but only within certain parameters of games, stakes, etc. I can sit and fold for hours if the cards aren’t right. I also went through a very experimental drug phase earlier in life, and despite all the hype surrounding them, none of the supposedly super-addictive drugs had that effect on me. In fact, I found them to basically be a bore…sort of like playing a losing game against the house. I think my brain is just not wired like an addicts brain, and the thrill he gets just isn’t there for me. Other experiences may vary.

  • doublereed

    My baseless guess? Internet Poker.

    From what I’ve seen of people who really play Internet Poker, is that there is lots of reading involved. You get used to reading people by how they bet and they’re playing style, rather than things like their tells and personality. It’s a lot more impersonal. So when they actually sit down at a table, they bring that impersonal businessman-like quality to their playing.

    They see you as just another faceless opponent, so don’t get as caught up by the thrill of the more social aspects.

  • eric

    A lot of the younger players, in particular, are strictly poker players.

    This is completely anecdotal and I don’t have any hard data to back it up, but I’ve gotten the impression from TV interviews that a lot of the younger players were “transfers” from other card games. IOW they started out as non-gambling card players – kids who loved playing card games first, who then took up poker when they realized they could make money at this particular card game. In contrast, with many of the older generation it seems to be the reverse; they start as non-card playing gamblers who pick up the card game of poker because its a form of gambling that they can win at.

    Thoughts? Am I completely off base here?

  • doublereed

    Yea, I’ve heard that a lot of Magic The Gathering players are also Poker players.

    We’ve always had so-called “gamers,” but generally it’s been the same as gamblers (except for very specific things like Chess or something). Now gaming is mainstream, but gamers play for the gaming first, and then transition to gambling as a way to turn those skills into money.

  • robertfaber

    Internet pornography can cause the same kind of addiction pathways in the brain, which can cause sexual dysfunction (at least with a partner, rather than the computer screen) in guys as young as 18. Fascinating site:

  • @6 (real citations to peer reviewed studies, I don’t doubt some people have issues with porn but it’s not a problem for the vast majority of people)

  • And I failed posting my < citation needed >