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 [email protected].

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 health as part of both screening and recovery: Ask patients about debt, paycheck-to-paycheck living, loans, and financial stress. Financial difficulties may uncover gambling-related harms that patients are reluctant to disclose, and addressing financial wellness should be part of ongoing recovery planning.
• Think about gambling when patients are not improving as expected: If depression, anxiety, substance use treatment, or other behavioral health conditions are not improving as expected, consider whether an undiagnosed gambling disorder might be contributing to ongoing distress or risk of return to use.
• Use brief physician interventions to increase motivation for change: A nonjudgmental conversation that connects gambling behavior to physical health, mental health, finances, and overall well-being can have a meaningful clinical impact. Just two to three minutes can make a difference. Remember to always frame concerns in a supportive, motivating way.
• Apply a biopsychosocial approach to treatment: Treatment should address biological, psychological, and social factors by supporting healthy sleep, nutrition, and physical activity, treating co-occurring psychiatric and substance use disorders, and connecting patients to appropriate therapeutic and recovery resources.
• Use harm-reduction goals when appropriate: Help patients develop realistic, measurable goals, such as reducing gambling expenditures or limiting gambling frequency. Revisit those goals regularly and adjust the treatment plan based on progress, just as you would for any other substance use disorder.
• Create a gambling disorder toolkit for your practice: Maintain referral pathways to gambling-certified therapists, Gamblers Anonymous meetings, telehealth services, helplines, and digital recovery tools. Incorporate screening tools, patient education resources, and community support into your existing addiction treatment workflows so gambling becomes part of routine clinical care.

🔗 Resources

• ASAM Review Course 2026: Behavioral Addiction: Criteria, Challenges, and Considerations
• ASAM’s Special Interest Group: Behavioral Addictions Community
• Screening Tools:
  • Brief Biosocial Gambling Screen (BBGS)
  • DSM-5 Criteria for Gambling Disorder
  • Emerging Adult Gambling Screen (EAGS-4)
  • Gambling Harms Scale-20 (GHS-20)
  • Internet Gaming Disorder Test-20 (IGD-20)
  • The South Oaks Gambling Screen (SOGS)
• National Gambling Problem Helpline: 1-800-MY-RESET
• Gamblers Anonymous Meeting Locator: GamblersInRecover.com
• Telehealth Gambling Treatment Providers:
  • Kindbridge Behavioral Health
  • Birches Health
• Digital Recovery App: EVIVE digital health tool
• Voices in Recovery Podcast Series:
  • ALL IN: The Addicted Gambler’s Podcast
  • The Broke Girl Society
• Gambling Addiction Conferences:
  • The National Conference on Problem Gambling (NCPG) Annual Conference
  • The International Center for Responsible Gaming (ICRG) Annual Conference on Gambling and Addiction

📢 Join the Discussion

Share your thoughts using #ASAMPracticePearls — we’d love to hear from you!

In support of improving patient care, the American Society of Addiction Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.