More Than a Quarter of American Adults Gamble Online Daily, APA Poll Finds

As millions of Americans prepare to track their college basketball pools throughout March Madness, new poll data from APA reports that more than one-quarter of American adults report a daily habit of online gambling.

The poll shows that among U.S. adults, 28% have a daily habit of gambling online, with men being more likely than women to gamble online for at least a few minutes a day (36% compared with 20%, respectively). More than half of adults (58%) who gamble online daily said that they have intentionally taken a break or limited the amount of time they spend gambling, with men more likely to report doing so than women.

However, 9% of adults reported gambling online for more than four hours daily, with 2% of individuals indicating they regularly gamble for more than 10 hours a day.

Maladaptive gambling behavior is diagnosed as gambling disorder when it is persistent and recurrent and disrupts personal, family, and/or vocational pursuits. While previously categorized as an impulse control disorder, gambling disorder is now recognized in the DSM as a behavioral addiction.

Gambling disorder is marked by behaviors such as preoccupation with gambling, increasing amounts gambled, unsuccessful control attempts, restlessness or irritability when attempting to stop, and “chasing losses.” As noted in a Psychiatric News Special Report, however, most people with this disorder do not show any clear physiological signs of intoxication or withdrawal that may suggest a problem.

One-third (35%) of respondents who said they gamble online daily said they began doing so between the ages of 18 and 25, suggesting that late adolescence and early adulthood is a crucial period for shaping attitudes toward online gambling. For each age ascending range following 18-25, respondents were less likely to report having begun gambling during that time.

For related information, see the Psychiatric News “Viewpoints” article “The Real Madness of March: Why Every Psychiatrist Should Be Screening for Gambling Disorder.”

(Image: Getty Images/iStock/bluecinema)

---

Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here.

Follow Psychiatric News on X!

Follow Psychiatric News on LinkedIn!

Technology Addictions Are Real, but Treatable

Yesterday, as the 2024 Annual Meeting wound down, outgoing APA President Petros Levounis, M.D., M.A., capped his presidential theme of “confronting addiction” with a presentation titled “Technological Addictions: The New Frontier in Addiction Medicine.” During the session, he outlined some of the parallels between technological addictions and substance use disorder (SUD) in terms of assessment, diagnosis, and treatment.

Levounis said that technological addictions (such as video/internet gaming, cybersex, and online gambling addiction) have several characteristics in common with other addictions such as SUD, as follows:

• Tolerance, such as needing to use technology increasingly more often to get the same mood-enhancing effect, and withdrawal, such as feeling anxiety or irritability upon stopping use of the technology abruptly.
• Internal concerns, such as being preoccupied with the technology, being unable to cut down on using the technology when desired, and using the technology as a way of relieving negative moods.
• External consequences, such as giving up other activities, jeopardizing relationships, or losing a job.

Treatments for technological addictions are similar to those used for other addictions, namely cognitive behavioral therapy (CBT) and motivational interviewing, said Levounis, professor and chair of psychiatry and associate dean for professional development at Rutgers New Jersey Medical School.

Levounis said that cognitive behavioral therapy is better suited to patients who already recognize they have a problem and want to address it. “CBT does require some motivation. There’s a lot of structure and there’s homework.”

In contrast, motivational interviewing may work best early in the process, he said.

“Motivational interviewing does its best job with people in the precontemplation and contemplation stage of change,” Levounis said. “It can help people who are either highly ambivalent about their use or who think there is nothing wrong with what they’re doing.”

Levounis noted that there are currently no approved medications for any technological addictions, but there are a few potential options. He said that opioid antagonists such as naltrexone or nalmefene may help patients whose technological addiction is characterized by arousal and impulsivity. He added that these medications decrease dopamine function by blocking opioid receptors, which may reduce the “high” patients get from using the technology.

He added that serotonin enhancers like SSRIs may help patients whose technological addiction is characterized by problems with control or compulsivity because these medications may decrease obsessiveness.

Psychiatrists who treat patients with technological addictions should be sure to treat any co-occurring mental disorders aggressively, Levounis said.

“Do a very thorough diagnostic assessment. See if there are other psychiatric disorders for which we have robust pharmacological treatments and treat them in order to help the person both with the other psychiatric disorder and the technological addiction,” Levounis said.

For related info, see Dr. Levounis’ Psychiatric News special report: “Be Prepared to Address Technological Addictions in Psychiatric Practice.”

(Image: Getty Images/iStock/audioundwerbung)

---

Open Payments Review Period Ends Next Week

Open Payments, CMS’ national disclosure program, promotes transparency into financial relationships between pharmaceutical and medical device companies and health care providers. The program allows providers an opportunity to review, affirm, and if necessary, dispute payments attributed to them by these companies before they are made public. The review and dispute period ends on Wednesday, May 15.

Open Payments encourages all covered providers to review the reported data to ensure their information is accurate prior to publication. Get started by registering here and learn more at OpenPaymentsData.cms.gov.

Overuse of Digital Technology May Indicate Addiction, Expert Says

Addiction to digital technology is bound to become an increasing focus of psychiatrists, wrote addiction psychiatrist Petros Levounis, M.D., M.A., in a recent Psychiatric News special report. Levounis is a professor and chair of the Department of Psychiatry and associate dean at Rutgers New Jersey Medical School.

“Just as happens with substances like alcohol or opioids, some people become so caught up in their virtual world that their real world—jobs, finances, relationships, physical health—begins to suffer,” Levounis wrote. “As smartphones and other modern devices become more and more integrated into all facets of life, understanding, identifying, and treating these technological addictions will become a significant aspect of psychiatric care.”

Diagnosing technological addictions accurately requires more research. “Only one technological addiction has been semi-officially recognized by APA as of DSM-5: internet gaming disorder is in Section III of our manual as a condition for further study,” he wrote. However, Levounis said that the framework used to define internet gaming disorder could be extended to other online behaviors that addiction specialists agree may be of concern: online gambling, online shopping, cybersex, internet surfing, texting/emailing, and social media.

Under the current DSM-5 entry, internet gaming disorder is likely present if someone meets five of the following nine symptom criteria over a 12-month period:

• Being preoccupied with video games.
• Experiencing withdrawal symptoms when video games are inaccessible.
• Requiring more and more playing time to gain the same level of satisfaction.
• Being unable to cut down on game playing despite efforts to do so.
• Giving up other activities to play more frequently.
• Deceiving family members about how much time is spent gaming.
• Using video games to alleviate negative moods.
• Jeopardizing jobs or relationships due to gaming.
• Continuing to play video games despite knowledge of adverse consequences.

Just as psychiatrists’ ability to diagnose technological addictions requires further research, guidance on how to treat patients will as well. “The best advice currently is to rely on what works well across the broad addiction sphere: providing patients an integrated treatment that incorporates addiction psychotherapy, pharmacological treatment of other psychiatric disorders, and possibly mutual-help (otherwise known as 12-step) facilitation,” he wrote.

No medications are approved for any behavioral addiction, technology based or otherwise. “The optimal use of medications for most patients is in the management of common psychiatric comorbidities like depression or anxiety, which have been shown to worsen the problematic behavior,” Levounis wrote.

Recognizing, diagnosing, and treating people with technological addiction is a field just being born. “Research on the phenomenology and nosology of these illnesses will help us further elucidate the distinction between problematic and nonproblematic use of technology, especially in children and young adults,” he wrote. “[W]e will need to be ready to guide our patients, our colleagues, and the general public on how to best handle technology with an eye on maximizing its enormous potential for fulfillment, gratification, and happiness while minimizing its significant risks for dissatisfaction, misery, and despair.”

For related information, see the Psychiatric News article “CBT Intervention May Reduce Addictive Internet Use.”

(Image: iStock/DisobeyArt)

---

Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here.

Follow Psychiatric News on Twitter!