You can't see it in the eyes and you can't smell it on the breath, which is why compulsive gambling is often referred to as the "hidden addiction."
But it can be a terrible affliction, and suicide attempts are more common among compulsive gamblers than among those with other forms of dependence. Getting hooked on games of chance appears to be on the rise; poker's new TV and Internet profile has generated a legion of dangerously over-involved card players.
Thing is, though, gambling is a popularly sanctioned activity that also enjoys the support of our government - so how can you tell the difference between fun and fixation?
What the experts say
"The greatest number of gamblers I have treated are machine gamblers. Video machines are designed to addict, and will do so quickly. Gamblers put their addiction above everything else in life. They've chosen [it as a form of self-medication] so they [can avoid] their underlying problems. Keeping a daily log is useful, tracking hour by hour how you feel about wanting to gamble or, if you do, how you feel about that. Frequently, when I ask, 'What could you do with this time if you weren't gambling?' they have no idea, because they haven't thought about anything else for so long. I find [they have] problems that are extremely painful and go way back. Many addicted gamblers are also alcoholics and/or drug users. Twelve-step programs can give encouragement but won't deal with underlying issues."
BRENDA THOMAS, psychotherapist, Vancouver
"We've noticed that there's a lot of Internet gambling. People get very lost online: they lose track of time, their brains get locked in the same pattern and their movements go on autopilot. The first thing they could do is set an alarm clock or beeper. When it goes off, they should get up and walk away - and not just away, but outside. Changing eye movement patterns helps. People looking at a computer screen are generally looking down, and by going outside and looking up they can actually link into different parts of their brain."
ELIZABETH PAYEA-BUTLER, neurolinguistic master trainer, Toronto
"Compulsive or pathological gambling is more prevalent among adolescents and young adults than among adults. Most people have the stereotypical picture of the pathological gambler who has lost his family, his job, his home. Seldom do we think about teenagers, for whom the prevalence rates are anywhere from 3.5 to 7 per cent, in contrast to 1 to 3 per cent for adults. Parents encourage their children to go to the basement to play poker. Why? Because they'd rather have them do that than something supposedly more problematic, like drinking or drugs. They don't understand the risks. We need more prevention initiatives and public service announcements. Many of the kids we treat are angry. They say, 'I went to school and they told me about drugs, smoking and unprotected sex. Why didn't anyone tell me about gambling?'"
JEFFREY DEREVENSKY, professor of applied child psychology, McGill University, Montreal
"There are things that are very distinguishable about a gambling disorder. One is that the financial consequences tend to be deeper than other addictions. I don't think the alcoholic believes the next six-pack is going to solve his life's problems, and the heroin addict doesn't believe the next injection is going to solve his either. But the gambling addict has a delusion that his problem is financial and that the next big win is going to solve it. Sometimes they get that big win, and then they say, 'See? I'm not an addict, I'm a professional gambler.' If as a gambler I win $1,000, I'll believe I can turn it into $10,000. And if I lose $5,000, I'm not leaving until I get my money back. We've recently seen a 20 per cent increase in people presenting themselves for treatment with a poker addiction. We believe in group and individual therapy. Acupuncture helps with the diminishment of cravings. We also use art therapy and psychodrama."
RICK BENSON, director, Algamus Recovery Centers, Florida
"You're much more likely to have a gambling problem at 20 than you are at 50. Young people have an image of gambling as a rush, a thrill, something you do with your friends. But you can get in over your head, especially if you think of it as a way to make money. These are mindsets that can lead to big problems. We have a live drama program in high schools to demonstrate the mythology. With slot machines, for example, players have absolutely no control over the outcome but very often believe they do, by pressing the button faster or sitting at a certain machine. Friends For Friends is an indirect campaign [on TV and in the subway] based on influence. We need a wide variety of strategies."
JON KELLY, CEO, Responsible Gambling Council, Toronto
"Most of what we do is cognitive behavioural treatment, looking at the life situations and issues that set people up for this problem and what they can change to get control. If depression is triggering them, we might refer them to a doctor for medication. If the gambling is related to another disorder like anxiety or ADD, then medication for that specific problem can be helpful. I don't think problem gambling itself can be addressed by any particular medication."
NINA LITTMAN-SHARP, problem gambling service, CAMH, Toronto (hotline 1-888-230-3505)