I have noticed with great concern a recent surge of gambling platforms in Botswana, most of which have set up physical shop and online platforms for easy accessibility. This has created a lot of buzz and excitement on social media amongst people who use these platforms. My concerns are around the long-term deleterious effects of gambling, which will ultimately affect many Batswana.
Gambling is defined as placing something of value at risk with the hope of gaining something of greater value. In most cases people using more with the hope of making more money. Gambling can a pastime for most people who do it for fun, however it can lead to addiction and bad consequences. Just drugs and alcohol, gambling stimulates the reward centres of the brain leading to addiction. Compulsive gambling, also called gambling disorder, is the uncontrollable urge to keep gambling despite the toll it takes on your life.
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), gambling disorder is defined as persistent and recurrent maladaptive gambling behaviour, as indicated by four or more of the following criteria;
Frequently preoccupied with gambling.
Needs to gamble with increasing amounts of money in order to achieve the desired excitement
Has made repeated unsuccessful efforts to limit, cut back, or stop gambling
Is restless or irritable when attempting to cut down or stop gambling
Often gambles as a way of escaping from problems
After gambling and losing money, often gambles another day to get even (“chasing” after one’s losses)
Lies to family members, therapist, or others to conceal the extent of gambling
Has jeopardized or lost a significant relationship (e.g., spouse), job, or educational or career opportunity because of gambling
Relies on others to provide money to relieve a desperate financial situation caused by gambling
Gambling disorder is often difficult to difficult to recognise and is underdiagnosed. This is many because of individuals deny of hide their gambling habits. In addition to this, gambling disorder is often associated with high rates of depressive, bipolar, psychotic, anxiety, personality, and substance use disorders (including alcohol and tobacco.
Managing gambling disorders is even more difficult. It needs a multi-disciplinary approach which involves psychotherapy and pharmacotherapy. Psychotherapy focuses on identifying reasons for gambling, confronting defence mechanisms and stopping the behaviour of chasing gratification from gambling. Pharmacotherapy for problem gambling is most effective when directed toward the patient’s comorbid psychiatric condition such as bipolar mood disorder, depression, anxiety, OCD and substance use disorder.
Public Health interventions that can reduce gambling include; decreasing available gambling platforms, banning advertising on gambling, age restriction on gambling and adding warning labels on betting platforms.
The Botswana gambling authority through its website provides an online questionnaire, known as the Problem Gambling Severity Index (PGSI), which helps to risk stratify and identify high risk gamblers. They also offer services of free counselling to those at risk. I urge those who have a gambling problem to use this available free platforms before their problem is advanced.
