The numerous forms of gambling – state lotteries, sports betting, slot machines, poker, internet gambling, and many others – are legal in certain states, fostering tourism or sometimes supporting education or other social programs. Although many people enjoy gambling as an occasional activity, for those who develop gambling disorder, the consequences can be devastating. Pathologic gambling was only recently reclassified from an "impulse disorder" to a "behavioral addiction" in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5); thus, gambling disorder is not yet as well understood as many substance addictions. Still, the information that has emerged is alarming:
Additionally, multiple studies have attempted to estimate the social cost of gambling disorder, which accounts for millions of dollars in lost productivity, law enforcement, and other expenses each year. But where is the line? When does gambling change from a socially acceptable activity to a diagnosable condition?
Prior to its addition to the DSM-5, gambling problems were often categorized as either "problem" or "pathological," depending on the severity. Although this distinction does reinforce the idea that gambling behaviors fall on a healthy-unhealthy continuum, when problems that are directly or indirectly related to the addiction begin to emerge in the gambler's life, it may be considered "disordered gambling" (including both problem and pathological). The DSM-5 outlines 9 criteria that may appear in individuals with gambling disorder:
Although a person can be diagnosed with a gambling disorder with as few as 4 criteria (4-5 = mild; 6-7 = moderate; 8-9 = severe), any of the above behaviors should be discussed with a professional to determine if the person is developing an addiction.
The above criteria help physicians get a better picture of and quantify a person's condition, but how might these points show up in an individual's behavior?
Regardless of severity, gambling disorder can have many negative consequence for the individual, family, and society as a whole.
Families suffer as well because of the damage done to their financial stability and the loss of time with their loved one. As a social problem, gambling disorder can result in lost productivity, unemployment, crime, increased use of social services, illness, bankruptcy, and other issues, amounting to an average of over $9,000 per gambler. 
Although the exact causes of gambling disorder are not fully understood, some factors have been identified as occurring more frequently among problem gamblers.
As with most addictions, gambling addicts often deny that they have a problem; thus, the first step is recognizing and admitting this, which may only be possible with pressure from family and friends. Cognitive behavioral therapy and support groups (like Gamblers Anonymous) can help people with gambling disorder gain further insight into their condition and develop tools to avoid triggers and cope with distressing emotions more appropriately. Because gambling addiction has not yet been the subject of extensive research, doctors do not know if gambling disorder will respond to certain medications. Initial results, however, report some benefit to treatment with naltrexone (an opioid agonist) and antidepressants. 
Given the complicated nature of the condition, gambling disorder can be difficult to overcome alone. For this reason, it is best to enlist the help of a physician, therapist, or other health care professional to ensure that you are on the path to recovery and that any co-occurring conditions are being treated as well.
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