The UK is home to one of the largest gambling markets in the world, generating £14 billion in profit in 2020. For many, it is seen as harmless entertainment, but for others it can become a serious problem.
The socioeconomic costs associated with harmful gambling have been estimated at £1.5 billion, with disadvantaged groups most susceptible to problem gambling.
Psychedelic-assisted therapy is increasingly being studied in the treatment of behavioural addictions, with UK-based Awakn Life Sciences conducting the first-ever study investigating ketamine as a treatment for gambling disorder.
In recognition of the scale of harmful gambling in the UK, and amidst growing pressure from the public health community, the UK’s Gambling Commission is conducting a review of the Gambling Act, with a white paper expected to be published this month.
Ahead of the review, PSYCH spoke with Pedro Romero, a psychologist and safer gambling consultant who was previously Head of Safer Gambling Policy at William Hill.
In the UK, gambling is ubiquitous; bookmakers are everywhere on the high street, and when you watch sports there are gambling ads every five minutes,’ stated Romero. ‘Around half of the UK adult population gambled in the last month, roughly 30 million people.
‘For most of them, gambling is just a bit of fun, but for others it is a serious problem. Charities have said that 2.8% of the UK’s population has a gambling problem – that’s 1.5 million people struggling with a gambling addiction or gambling to a harmful level.
‘It is a massive burden on society, with a lot of controversy surrounding how much gambling disorders cost society in terms of suicides, mental health conditions and job losses. For some, it is an unhelpful coping mechanism when they are anxious, depressed or dealing with trauma – the same way that some drink to deal with internal discomfort.
‘That is why psychedelic-assisted therapy for gambling holds such potential, because it can treat the addiction and the underlying issues at the same time. Gambling then often turns into a secondary problem in its own right. That is why psychedelic-assisted therapy for gambling holds such potential, because it may help people get to those underlying issues, whether it’s anxiety, depression or trauma.
‘I think psychedelic-assisted therapy for gambling addiction really has a future, and I’m really excited by the work done by Awakn and Professor Celia Morgan in this area.They are looking into the potential for ketamine on breaking down the positive reinforcement associated with gambling memories, and I cannot wait to learn about the outcomes of the study. It is the first of his kind and may lead to using psychedelic-assisted therapy for other behavioural addictions.
‘I would like to study the potential of psychedelic-assisted therapy for gambling disorder, as there is often this double stigma with behavioural addictions. People struggle to see a behavioural addiction as an addiction and instead see it as some kind of moral failure, similar to someone who struggles with comfort eating or any other behavioural addiction. They often don’t get as much empathy as other addictions.’
On the subject of the government’s review of the Gambling Act, PSYCH was interested to learn whether this had been instigated by the rise of online gambling and whether harmful gambling had been exacerbated by the cost-of-living crisis.
‘Things need to change,’ said Romero. ‘Accessibility is now a huge risk factor. There is a casino open 24/7 on your phone, and it’s in your pocket, on your bedside table or under your pillow. It has become almost like social media addiction. If it’s your coping mechanism, it is close to you at all times, and that availability is an additional risk.
‘With the cost-of-living crisis, people are in desperate situations, and often gambling is seen as an easy solution. Of course, there are no easy solutions, and greater education is desperately needed. Gambling is entertainment, and the probability is that in the long run you are going to lose.’
In 2018, the government unveiled restrictions that set a maximum stake of £2 on fixed-odds betting terminals in bookmakers. PSYCH asked Romero about these restrictions and how they had impacted safer gambling.
‘A few years ago, there was a campaign to apply betting limits to casino machines in bookmakers, with the best intentions. However, if there is a maximum stake of £2 per spin on a betting shop terminal, but online you can place bets of £50, and people are used to that level of gambling, they will stop going to the bookies and just play online instead. If you simply restrict but don’t educate, the restrictions will not work.
‘Last year, the UK regulators banned the use of credit cards, which was a good thing, as people shouldn’t be gambling with debt; however, people who have a serious problem will find a way. People would go to a payday loan company, with extortionate interest rates, and then move the money from one bank account to another, which is difficult for the operator to identify. There is no single silver bullet, and further restrictions could move people to unregulated markets, like crypto casinos, where often they don’t check your age and players have very little protection.
‘We need to educate people, and we need companies to be responsible. We need to have good regulations, but we also need to be clear on what we expect from operators. We then need the resources to ensure the regulations are met. Commercial interests cannot outweigh responsibilities to player protection, and gambling companies need to contribute to further research into tackling gambling addiction.
‘I’m a firm believer in regulation and making operators accountable. We need more people doing inspections and the support of people who want to change things from the inside, with appropriate accountability.
‘Regulations will also need to be consistently reviewed. Updating regulations to take into consideration gambling availability on smartphones is fit for purpose for now, but might not be in a couple of years with the metaverse, so we need to review and update these regulations frequently.’
Romero was optimistic about the possibility of treating gambling disorders with ketamine-assisted therapy and was undeterred by the treatment’s cost, explaining that the cost of not treating problem gamblers was far higher.
‘Psychedelic-assisted therapies could hold huge potential, and we need to research these treatments effectively. These treatments are sometimes seen as expensive, but I don’t think they are when you look at how much people can benefit from them.
‘A course of psychedelic-assisted therapy could cost £10,000, but a gambling addiction could get someone into very serious debt totalling hundreds of thousands. When a person is in crisis, they may do something they wouldn’t normally do, like defrauding family members or employers. We see cases where people steal huge amounts of money because they have a gambling problem.’