Help on Gambling, Behavioural Addictions and Eating Disorders

  • 20 Feb 2013
  • Reading time 13 mins
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There are two types of triggers for addiction: mood-altering substances and mood-altering activities or behaviours. The process of addiction as we have described it can result from excessive ingestion of a substance such as alcohol, cocaine, heroin, marijuana, nicotine, caffeine, sugar or prescription drugs. The same process can occur as a result of excessive behaviours or activities that change brain chemistry. Behaviours that can become excessive and compulsive, and therefore addictions, are gambling or risk-taking, working or over-achieving, excessive sexual activity and certain eating behaviours. We can also include here any excessive or compulsive behaviours such as excessive spending or compulsive saving, or perhaps a relationship that becomes excessive or compulsive. It can be playing computer games, or racing cars, or golfing, or running. It is not so much what you do as how you do it.

You may be wondering how an activity can bring about brain-chemistry changes if no addictive substance as such is ingested. The explanation lies in a better understanding of the relationship between body, mind and biochemistry.

The power of our thoughts and feelings

All our thoughts, feelings and actions affect brain chemistry; and brain chemistry affects our thoughts, feelings and actions. You have no doubt heard about the ‘power of positive thinking’. There is also power in negative thinking. Happy thoughts cause a release of chemicals in the body. So do angry thoughts, sad thoughts and worry thoughts. Were you ever in physical or emotional pain and then smiled because of something sweet your child or pet did and then realised that your pain was diminished? Were you ever feeling great and then happened to think about some disturbing situation that caused you to feel tired or perhaps develop a headache? These are examples of the power of our thoughts and feelings.

Our thoughts and actions

Even more powerful than thoughts and feelings are our actions. Think about a time when your child or pet did something amusing and you laughed out loud. How did you feel? A full body laugh changes your brain chemistry for 45 minutes. We refer to these as endogenous (inner) opioids because the release of this brain neurotransmitter is not triggered by something you consume; it comes from within.

There are activities that change our biochemistry so much that we want to do them over and over. Some people get a biochemical response from shoplifting or inappropriate sex that is equal to, or greater than, a heroin injection. Nature has given us natural substances in the brain to give us pleasure and a sense of reward, and to mediate pain. These neurotransmitters work to give pleasure as well as relieve physical as well as emotional pain. People born with the inability to feel good will look for ways to stimulate the release of these chemicals.

The neurotransmitters that are released from risk-taking or sex are metabolised through the same dopamine pathway as cocaine, heroin or alcohol. And if the person has a reward deficit that predisposes to addiction, the activity that works will be repeated as often as necessary to get the desired reward. For the person predisposed to addiction the chosen activity will rapidly go from self-medication to addiction.

Addictive behaviour

Work addiction is fairly common in our society because overworking is applauded and rewarded. And the painful consequences of overworking may not be as apparent or recognised as activities that do not have the same kind of social payoff. But work addiction is not the same as the compulsion to achieve. Some people get their biochemical payoff from the act of working whereas others get it from the accomplishment that results.

Risk-taking and gambling addiction are much the same. That is one of the reasons that this is such a difficult behaviour to control – it just changes forms. For some people gambling addiction takes the form of shoplifting or other behaviours that carry a risk of getting caught. The euphoria of shoplifting does not lie in the item taken but in the mood-altering event of taking it. If the item were free, it would not bring the same pleasure.

Case Study: Ben

Ben developed an addiction to casino gambling. His family and friends were quite astonished by this behaviour because even gambling on cards was not customary for him. A friend talked him into going to the casino the first time, where he discovered a game that was a combination of skill and luck; and the challenge of it hooked him immediately. He won, and it was exhilarating. He went back the next night – and the next. It was not long before he found himself thinking about and anticipating going again. Before long he was leaving work during the day (he was self-employed) and neglecting his business. He was winning, and the euphoria of that was beyond anything he had ever experienced with any kind of substance he had ever used. When he began losing, he was sure that the next time he would make it back.

It was not until his wife threatened to leave him that he went to Gamblers Anonymous and, with a great struggle, gave up the casino. However, the craving was intense and he was soon satisfying it with cars. He started buying cars – Porches, Lamborghinis and Aston Martins – and driving them at 120 miles an hour. He got caught and found himself in trouble with the law. That is when he realised that he had not stopped gambling; it had just taken another form.

N-acetyl cysteine may help reduce gambling and other addictions

Recent research indicates that supplementation with N-acetyl cysteine (NAC) may reduce addictive behaviour in compulsive gamblers as well as individuals with other addictions.

NAC is thought to restore extra-cellular concentrations of the chemical glutamate, which is often associated with good feelings of reward in the brain. This led researchers to believe NAC could have a promising role to play in minimising addictive behaviour. The researchers enrolled 27 pathological gamblers (12 women) in an eight-week trial of NAC. The first part of the study was an open trial where subjects each consumed daily doses of NAC. In this part of the study, 16 of the 27 subjects (59.3 per cent) reported that they experienced less urges to gamble. The effective dose of NAC ranged from 1,100mg to 1,700mg per day.

Of those 16 subjects, 13 went on to participate in a double-blind, randomised, placebo-controlled trial of NAC. Of those subjects given NAC, 83.3 per cent experienced a reduced compulsion to gamble compared with only 28.6 per cent of those assigned to a placebo.

The study authors concluded, ‘The efficacy of NAC lends support to the ......

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