Problem gambling deserves attention from the public and health care providers alike, says a British expert on gambling.

Problem gambling often doesn’t lead to overt signs of problems until late, says Mark Griffiths, professor of gambling studies at England’s Nottingham Trent University, in a news release.

He notes that at least 65 percent of those with problem gambling report at least one physical withdrawal symptom, such as heart racing, headaches, loss of appetite, insomnia, and chills. His editorial appears in the Nov. 6 issue of the British Medical Journal.

Griffiths cites several studies that show problem gambling’s toll on individuals and society. For instance, people with problem gambling reported depression, anxiety, stomach problems, and suicidal thoughts when calling a national gambling helpline in Britain.

Those with problem gambling aren’t the only ones who may suffer. Migraine, insomnia, depression, intestinal disorders, and other stress-related issues can affect partners of people with problem gambling as well as the gamblers themselves, says Griffiths.

People with problem gambling are also more likely to be involved in domestic violence and child abuse, says Griffiths.

He cites a study of 286 women seen in a Nebraska emergency room. Researchers found that women whose partners had problem gambling were more than 10 times as likely to have suffered partner violence than women whose partners did not have problem gambling.

Another study cited by Griffiths tied a 42 percent increase in child abuse and an 80 percent rise in domestic assaults to the opening of casinos in South Dakota. That study was conducted in 2003 by the National Coalition Against Legalized Gambling, says Griffiths.

The spectrum of gambling behavior ranges from occasional gambling to regular gambling (once or twice a week) to problem gambling, which troubles the gambler themselves, to pathological gambling, which is a psychiatric problem, says Griffiths.

Not everyone who gambles will suffer the worst-case consequences, says Griffiths. However, he warns that it can be a slippery slope from simple betting to full-blown gambling addiction.

Health care providers should be aware of risks of problem gambling, says Griffiths. Doctors routinely ask patients about smoking and drinking, but problem gambling is something that is not generally discussed.

By Miranda Hitti, reviewed by Michael W. Smith, MD

SOURCES: Griffiths, M. British Medical Journal, Nov. 6, 2004; vol 329: pp 1055-1056. News release, BMJ.