Gambling is an activity that involves risking something of value on an event that is primarily a matter of chance in the hope of realizing a profit. It has existed in virtually all societies throughout prerecorded history and is a part of many local customs and rites of passage. Although the exact underlying causes of pathological gambling have varied over time, the clinical significance of this activity has undergone profound change in recent years. It now appears that some individuals develop a gambling problem to such an extent that it has significant negative personal, social and financial consequences.

A growing role exists for evaluating patients in primary care settings for addictive disorders, including pathological gambling. This article reviews the rationale for viewing pathological gambling as a disorder and outlines a number of the key issues that should be addressed when assessing a patient for this condition.

This article is based on a literature review of articles published in the medical journal, MEDLINE (1966 to present) under the MeSH heading “Gambling.”

The author reviewed these articles for relevance to the current knowledge base and scientific evidence regarding the health risks associated with gambling behaviors. The author also considered cultural considerations that may impact the assessment and treatment of this behavior. These factors include a societal acceptance of gambling and the varying degrees to which individuals may be genetically predisposed to thrill-seeking behavior and/or impulsivity. In addition, he discussed the relationship between gambling and health, as well as screening for and treatment of pathological gambling.