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Simple questionnaires can help flag problem gamblers, says David Hodgins. (Riley Brandt/University of Calgary/Canadian Press)

An explosion of online gambling sites is quickly creating more gambling addicts than provincial governments can treat, new medical research suggests.

A review of the latest research on compulsive gambling — how common it is, its causes and potential treatment — was published online Thursday in the British journal The Lancet.

The authors said provincially run gambling websites in British Columbia and Quebec and plans for one  in Ontario will be luring more and more people to round-the-clock gambling.

And the trend toward internet gambling means potential addicts will need to be identified faster, said David Hodgins, a psychology professor at the University of Calgary and the lead author of the paper.

A simple survey of three questions can help identify pathological gamblers and start treatment, Hodgins said.

The questions included:

  • Have you ever tried to stop gambling?
  • Have you ever lied about how much you gamble or how much you lost?
  • Have there ever been periods lasting two weeks or longer when you spent a lot of time thinking about your gambling experiences or planning out future gambling ventures or bets?

A yes to any of the questions shows the need for a closer look.

"Training practitioners in different sectors to be able to do brief, quick and easy screening for gambling problems would be very helpful," he said.

Gambling highlights

  • Of the drug treatments tested, naltrexone (used mainly in alcohol and heroin addiction) appears to be the most promising but more research is needed.
  • Gamblers Anonymous promotes a sense of common purpose and understanding to reinforce abstinence, but some studies suggest adherence and outcomes can be poor.
  • Pathological gamblers are at much greater risk of alcohol and drug abuse.
  • Family therapy, in which close family members are helped to give interventions to their loved ones, can help the gambler but often needs the direct help of a therapist.

Source: The Lancet

Hodgins and his co-authors in Calgary and Minnesota said the estimated prevalence of gambling ranges from one in 500 people in Norway to one in 20 people in Hong Kong. In Canada and the U.S., about one in 100 people is a pathological gambler, the most serious level of addiction.

Only one in 10 problem gamblers, the second-most serious level of addiction, seeks treatment. Gamblers' sense of shame, denial and a desire to handle the problem themselves contribute to low treatment levels, the researchers said.

But research continues to reveal more about the addiction, they said.

"Our knowledge continues to evolve in parallel with a burgeoning availability of gambling opportunities," they concluded.

"Internet gambling, for example, is providing around-the-clock home access to several types of gambling activities to an increasing number of people around the world. Thus, although substantial progress has been made, this evolution warrants, and is likely to encourage, more innovative research into gambling disorders and its translation into clinical progress."

When people with less serious problems do seek treatment, therapy over the phone or online can work, said Nina Littman-Sharp, manager of the problem gambling service at the Centre for Addiction and Mental Health in Toronto.

But Littman-Sharp cautioned against using the three-question pre-screen as a substitute for formal assessment.

With files from The Canadian Press