Gambling disorder has emerged as a significant public health concern in Australia and New Zealand, a recent narrative review on the issue argues.
The review published in the Medical Journal of Australia highlights the disorder’s widespread impact, outlining current strategies for identification and treatment, and emphasizing the urgent need for improved long-term solutions.
According to the report, carried out by researchers from the Auckland University of Technology and Deakin University in Melbourne, gambling disorder is not just a matter of personal financial ruin but a catalyst for profound mental health crises, including depression, anxiety, and even suicide.
‘The past 25 years has seen a rapid expansion in gambling disorder research, prompted mainly by the introduction of levies on gambling operators. Across Australia, more than $24 billion is gambled each year on poker machines, wagering, lotteries, and sports and casino gambling, with the highest expenditure and prevalence of problems associated with poker machines’, the study suggests.
In recent months, gambling reform debate has intensified in Australia over gambling advertising and youth protection.
As reported by AGB, the Australian government is contemplating significant restrictions on gambling advertising, which could include a complete ban on digital ads and a prohibition on television commercials for one hour before and after sports broadcasts.
With an estimated 1 percent of the adult population in both countries suffering from the disorder, and an additional 3-5 percent at risk, the review described the issue as affecting a diverse demographic, with certain groups like men, online gamblers, and those using poker machines being particularly vulnerable.
At the same time the prevalence of gambling disorder or problem gambling internationally was said to range from 0.5 percent to 7.6 percent, with an average of 1.3–2.3 percent.
According to the review, the gambling landscape has shifted dramatically over the past decades, with the rise of online betting exacerbating the issue, and although poker machine gambling has been declining across Australia and New Zealand, engagement with sports betting and wagering has been increasing.
The COVID-19 pandemic also intensified this trend, pushing gamblers towards online platforms, which are often harder to regulate.
Meanwhile, efforts to tackle gambling harm in both countries are robust but fragmented, with government-funded counseling services, available both in-person and online, provide free support to those struggling with addiction.
However, the report reveals that only 20 percent of those with gambling problems seek help, with barriers such as shame and self-reliance deterring many from treatment.
From a clinical standpoint, the most effective treatments for gambling disorder include cognitive behavioral therapy (CBT) and motivational interviewing, but long-term data on treatment outcomes remain scarce.
While short-term interventions show promise, the report highlights a troubling gap in understanding what works best for different populations, particularly in community-based settings where many people access care.
Moreover, the introduction of self-help tools, including smartphone apps and online resources, has opened new avenues for treatment. Yet, despite their accessibility, their long-term efficacy is still unclear.
A significant hurdle in effectively managing gambling disorder is treatment retention, as longer treatment durations lead to better long-term outcomes. While gambling disorder can inflict serious harm on both the individual and their loved ones, many individuals delay seeking help.
In New Zealand, for instance, gambling issues are most common among those aged 18-24, yet the highest rates of help-seeking occur in the 25-44 age group. The progression of gambling disorder varies, with individuals alternating between regular and binge gambling, or experiencing periods of remission.
Relapse is a critical concern, with approximately 25 percent of individuals relapsing within their first year of recovery, and rates increasing to 30 percent by the second year and 40 percent by the third. Consequently, relapse prevention strategies and ongoing monitoring are essential components of effective treatment.
The review also stresses the need to focus on prevention, with Australia and New Zealand shifting towards a harm-reduction approach, recognizing that intervening earlier may be more effective than waiting until individuals meet the clinical threshold for gambling disorder.
In conclusion, the researchers argued that gambling disorder is not just an addiction but a complex public health issue that demands coordinated efforts across government, healthcare, and community sectors.
