Our expert explains the psychology and neuroscience behind problem gambling.
From slot machines and scratch tickets to sports betting and loot boxes, gambling has become increasingly common in today’s society. For many people it is a form of entertainment, but for others it can become an addiction that affects health, relationships and finances.
Vancouver Coastal Health Research Institute researcher Dr. Luke Clark describes how gambling affects the brain and why both genetics and environment play a role in treatment and prevention.
Q: I enjoy gambling, but at what point should I be concerned about my gambling habits?
A: Gambling disorder is defined by several warning signs, including withdrawal, betting larger amounts over time and experiencing negative impacts on work or relationships. A key feature is loss chasing — going back to the gambling website or casino to try to recover past debts. This pattern can spiral into an addiction that becomes highly debilitating.
Gambling in moderation looks different for everyone, but it often comes down to what you can afford to lose. On any single bet or casino visit, you may win, but the more time you spend gambling, the more likely you are to lose overall. Many gambling products are also designed to keep people playing longer than intended, which is important to keep in mind when reflecting on your own habits.
Q: How does gambling affect brain chemistry?
A: A core feature of gambling is reward uncertainty, in which the neurotransmitter dopamine plays a central role. Dopamine signals help us predict rewards, such as eating food or earning money. When rewards are delivered randomly, the anticipation itself leads to heightened dopamine activity. Over time, the dopamine system becomes activated simply by placing the bet, whether you win or lose. Under these chance conditions, the brain cannot detect a predictable pattern, so the dopamine cycle continues indefinitely.
Other neurotransmitters also play a role in gambling, including those involved in emotions and attention. Interestingly, in clinical research, the most promising medications for treating gambling disorder target the opioid system rather than dopamine, suggesting the need for broader research across different brain systems to develop more effective treatments.
Q: What does research tell us about how different types of gambling affect the brain?
A: While reward uncertainty is common across all gambling, different forms carry different levels of risk. For decades, slot machines have been recognized as one of the most harmful types. In clinical settings, slot machines and other fast-paced electronic games are the most common source of addiction. By contrast, lottery tickets are widely purchased but rarely linked to problematic play, likely because of their slower pace.
Current research is examining what characteristics of people are most likely to engage in sports betting — for example, young men, athletes or sports fans — and how design features of the platforms, such as rapid and overlapping bets, increase harm.
Q: Are some people more biologically or psychologically predisposed to compulsive gambling? What roles do genetics and mental health conditions play?
A: Research shows that traits like impulsivity and conditions such as mood or anxiety disorders are closely linked to excessive gambling and other addictive behaviors. However, gambling is also shaped by the environment. For example, easy access to online gambling through smartphone could increase risk. This means that regulating gambling products and environments to make them safer is an important part of prevention and treatment.
Q: How can research on the brain’s reward system and impulse control help improve treatments for gambling addiction and related conditions?
A: Most research in clinical neuroscience views reward and impulse control in binary terms, but gambling highlights how the signals in these brain systems can become distorted. People with gambling addiction lose money over time yet continue to believe they can win. A good example is the near-miss: when an outcome looks close to a win but is really a loss. These events strongly influence people’s willingness to keep gambling and trigger distinctive brain responses. By studying these patterns at the neurobiological level, researchers can gain new insight into how biases and distortions in the brain’s reward system influence behaviour. This knowledge could lead to better treatments not only for gambling addiction but also for related mental health conditions.
