What is gambling?

Gambling is risking money or something of material value on an activity or event with an uncertain outcome in hope of winning additional money or something of material value.

Forms of legal gambling in NC include:

  • Lottery
  • Casino – Cherokee
  • Bingo

Forms of illegal gambling in NC include:

  • Games
  • Sports betting (currently illegal)
  • Internet
  • Poker
  • Bets among friends
  • Office pools

What is problem gambling?

Problem gambling is any gambling behavior that disrupts a person’s life. In extreme cases, problem gambling can result in financial ruin, legal problems, loss of career and family or even suicide. Gambling Disorder, 312.31 listed in the “Substance-Related and Addictive Disorders” section in Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5); is viewed on a continuum of mild, moderate and severe, and can be episodic or persistent.

Not all people who experience problem gambling are alike, nor are the problems they experience. People with gambling problems are found in all age groups, income levels, races, religions and cultures. Some people develop gambling problems suddenly while others take many years to develop a problem.

Higher prevalence rates of problem gambling are found in people in their teens and twenties. Even further, ethnic minorities, active duty military, veterans, older adults and individuals with a mental health or substance use disorder history have even higher prevalence rates.

What are the risk factors for problem gambling?

Risk factors:

  • Being in teens and twenties
  • Males are at greater risk of developing a gambling disorder
  • Gambling in childhood or adolescence
  • Access to gambling opportunities
  • Friends who gamble
  • Parents who are frequent or problem gamblers (genetic and/or environmental)
  • Being an athlete (attracted to competition)
  • Other addictions
  • Family history of addiction or mental illness
  • Antisocial behavior and impulsivity
  • Mental illness
  • Having an early big win
  • Not understanding gambling fallacies

Mental health professionals, educators and family members should be aware there is a high rate of suicide and suicidal thoughts among problem gamblers. Click Here to Access the Suicide Prevention Helpline.

What to know about comorbidity?

Comorbidity is defined as the co-occurrence of two or more chronic diseases or conditions. The National Epidemiological Survey on Alcohol and Related Conditions (NESARC) was derived from a large sample of people living in the U.S. The survey results indicate pathological gamblers have a co-occurrence of other addictions and disorders as indicated below. Notable is the co-occurrence of alcohol use disorder for 73 percent of those living with pathological gambling addiction. Many times, one addiction is substituted for the other.

Pathological gamblers with the following comorbidity:


  • Alcohol use disorder - 73%
  • Drug use disorder - 38%
  • Nicotine dependence - 60%
  • Mood disorder - 50%
  • Anxiety disorder - 41%
  • Personality disorder - 61%

What are the signs of a problem gambler?

  • Being preoccupied with gambling
  • Needing to gamble with increasing amounts of money to get the same thrill
  • Trying to control, cut back or stop gambling, without success
  • Feeling restless or irritable when trying to cut down on gambling
  • Gambling to escape problems
  • Attempting to relieve feelings of helplessness, guilt, anxiety or depression
  • Trying to get back lost money by gambling more (chasing losses)
  • Lying to hide the extent of the gambling
  • Jeopardizing or losing relationships, a job, or school or work opportunities
  • Resorting to theft or fraud to get gambling money
  • Asking others for a bail out to financial trouble because money has been gambled away

Adolescent warning signs may be different than those experienced by adults:

  • Unexplained absences from school or classes
  • Sudden drop in grades or failure to complete assignments on time
  • Change of personality or behavior
  • Exaggerated display of money or other material possessions
  • Daily or weekly card game
  • Bragging about winning at gambling
  • Intense interest in gambling conversations
  • Unusual interest in newspapers, magazines, periodicals or sports scores
  • Unaccountable explanation for new items of value in possession
  • Borrowing or stealing money
  • Missing possessions throughout the house
  • Credit cards taken out in family members names
  • Unauthorized debit card use
  • Withdrawing from family and friends
  • Uncharacteristically forgetting appointments or dates
  • Use of gambling language in conversations