Gambling and Drugs — Escaping the Escape

October 28, 2025

How the Link Develops

While gambling provides emotional highs and lows, drugs can either magnify or dull those extremes. Some people may use stimulants (such as amphetamines or cocaine) to stay alert during long gambling sessions, while others may turn to depressants or opioids to numb emotional pain after heavy losses.

In both cases, the substances become a way to either enhance the gambling experience or escape its negative consequences, reinforcing a destructive cycle between the two addictions.

Research shows that gambling and substance use share overlapping neurobiological mechanisms — both activate the brain’s reward system, particularly involving dopamine and serotonin pathways, and both are associated with impulsivity and poor decision-making.

 — See Potenza M.N., 2008, Philosophical Transactions of the Royal Society B

What the Data Says

Among substance abuse treatment populations, rates of gambling problems are substantially higher than in the general population.

- In a statewide study of Ohio drug treatment participants, 4.9% screened positive for problem gambling, and 12.1% met criteria for probable pathological gambling. Source: Ohio Substance Abuse Monitoring Network (2013), Gambling Study Report

- Meta-analyses of clinical samples indicate that problem and pathological gambling are two to ten times more prevalent among individuals with substance use disorders compared to the general population. Source: Cowlishaw et al., 2014, Addiction

- Population-based studies show that individuals who report drug use or daily tobacco use are significantly more likely to screen positive for problem gambling. Source: Håkansson A., Ford M., 2020, PLOS ONE

- Clinical reviews confirm that gambling disorder and substance use disorders frequently co-occur, sharing common risk factors like impulsivity, stress sensitivity, and trauma history. Source: Grant J.E. & Chamberlain S.R., 2016, CNS Spectrums

Why the Dual Addiction is Especially Risky

Poly-substance danger: Combining gambling and drug use increases the risk of severe health and behavioral consequences, including accidents, overdoses, and impaired decision-making.

Debt + health risk synergy: Financial losses from gambling can intensify substance use as a coping mechanism, pushing individuals toward riskier drug choices or relapse.

Addiction escalation: Each addiction can reinforce the other, leading to faster progression and reduced ability to stop.

— See Verdejo-García A. et al., 2008, Addiction Biology

Secrecy & isolation: Both addictions often thrive on shame and concealment, which reduces the likelihood of seeking help and worsens emotional distress.

Pathways to Recovery

Thorough assessment

Professionals should screen for gambling disorder, drug use disorder, and co-occurring mental health issues simultaneously, as treating one in isolation rarely works.

Integrated treatment

Approaches like Cognitive Behavioral Therapy (CBT), Motivational Interviewing, and trauma-informed care are most effective when addressing both disorders together.

— See Dowling et al., 2015, Addiction

Harm reduction and relapse prevention

Encourage personalized plans to avoid high-risk environments (casinos, drug-use contexts) and develop healthy coping mechanisms.

Peer support and community
Dual-diagnosis peer groups and online recovery communities help normalize shared experiences and provide accountability.

How Incumental can help:

- Host or curate resources on managing concurrent addictions (gambling + substances).

- Provide or connect users to dual-diagnosis treatment programs and professional counseling.

- Foster peer-led communities where individuals can discuss both struggles openly.

- Offer relapse-prevention tools tailored to address both gambling and substance triggers.

References

- Ohio Substance Abuse Monitoring Network (2012). Gambling Study Report.

https://www.researchgate.net/publication/235354887_Ohio_substance_abuse_monitoring_network_Co-occurrence_of_problem_and_pathological_gambling_with_substance_use_disorder_A_targeted_response_initiative_January-June_2012

- Cowlishaw S., Merkouris S., Chapman A., Radermacher H. (2014). Pathological and Problem Gambling in Substance Use Treatment: A Systematic Review and Meta-analysis. Addiction, 109(3), 377–388.

https://pubmed.ncbi.nlm.nih.gov/25950376/

- Håkansson A., Ford M. (2020). Problem Gambling and Associations with Comorbid Health Conditions, Substance Use, and Behavioural Addictions. PLOS ONE.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227644

- Grant J.E., Chamberlain S.R. (2016). Expanding the Definition of Addiction: DSM-5 vs DSM-IV. CNS Spectrums, 21(4), 289–291.

https://pubmed.ncbi.nlm.nih.gov/27603136/

- Verdejo-García A. et al. (2008). Impulsivity and Decision-Making in Addictions. Addiction Biology, 13(1), 196–211.

https://pubmed.ncbi.nlm.nih.gov/18782383/

- Dowling N. et al. (2015). Interventions for Co-occurring Gambling and Substance Use Disorders. Addiction, 110(8), 1405–1419.

https://pubmed.ncbi.nlm.nih.gov/25720494/