A recent study shows that a family history of addiction to one thing – say, alcohol – can mean a higher risk for other types of addiction, like gambling.
Dr. Csaba Barta is a co-author of the study and Associate Professor in the Department of Molecular Biology at Semmelweis University in Hungary. He says:
It has been previously proven that a strong genetic influence exists for various addictions. Heritability – the degree to which genetics determine a trait – is estimated to be between 50% to 70% for addictions, while environmental effects account for the rest.
That means if you’re genetically predisposed to becoming an alcoholic, say, you’re also susceptible to becoming addicted to other things. That includes other chemicals but also habits like sex, food, and gambling.
The study assessed multiple addictive behaviors among 3,003 Hungarian high school and college students. The international research team found a likely relationship between substance use and non-substance-related addictive behaviors.
Marc Potenza is a Professor of Psychiatry at the Yale School of Medicine and director of the university’s Center of Excellence in Gambling Research. He agrees with the team’s conclusions, telling Bonus:
The study provides support that some genetic factors may be responsible for the overlap we observed previously.
Not One Gene, But Many
While such news may not surprise everyone, it’s still significant.
It also points to the growing effort in the research community to pinpoint why some people lose control of their gambling while others do not. Dr. Danielle Dick, director of the Rutgers Addiction Research Center, says:
Understanding there is a genetic component to addiction can be helpful to individuals and the industry.
Dr. Dick stresses, however, that no one gene determines whether someone will or won’t suffer from addiction. She says that thousands of genes influence risk, each just a little bit. Researchers have a word for these types of traits: polygenic.
Dr. Victor Hesselbrock of the University of Connecticut holds the school’s endowed chair in addiction studies. He also emphasized to Bonus the importance of such studies:
It indicates that the clinical and research communities are taking the problem extremely seriously.
This sort of research isn’t only of academic interest, however. Understanding the root causes of addiction ultimately helps in its treatment. Gambling addiction, in particular, is a problem that requires considerable study.
Bonus asked Keith Whyte, executive director of the National Council on Problem Gambling, for his opinion on the study. He said:
It provides additional confirmation to the longstanding knowledge that genetics plays an important role in problem gambling [and that it] shares some of the same roots as other addictive disorders.
It’s All Chemistry
Fundamentally, addiction refers to a loss of self-control. That can be substance use (e.g., opioids or alcohol) or behavioral addiction (e.g., gambling or an eating disorder).
Dr. Hesselbrock notes that outside of the clinical and research communities, the apparent difference between substance use and other addictive behaviors can confuse the conversation. Some people may argue that playing slots for six hours straight can’t possibly be the same as consuming an addictive substance. After all, nothing enters the body when someone gambles.
But Dr. Hesselbrock points out that chemistry is involved either way.
We look at the mechanisms of action of how they’re metabolized.
Whether the addictive behavior is gambling or, for instance, pulling out one’s hair (known as trichotillomania), engaging in it sets off chemical processes inside the brain. The reaction our minds and bodies experience to those chemicals is not all that different from the effects of alcohol, painkillers, or caffeine.
Dr. Hesselbrock observes:
When you look at the effects on a person, being horribly in debt, not maintaining social contact, inability to maintain relationships, not taking care of their personal hygiene and health, they are very similar. And the idea of one addiction having a co-occurrence or comorbidity with another addiction, that has been around for decades.
Dr. Dick points out that the similarity applies to causes as well as outcomes:
There is compelling evidence that many of the same factors that increase risk for substance use problems also increase risk for gambling problems.
Fighting the Stigma of Addiction
The risk factors in question include traits related to impulsivity and sensation-seeking. These can have a genetic component caused by differences in how our brains are wired to process risk and reward.
Addiction can also stem from other sorts of mental health issues, says Dr. Dick:
Another genetically influenced pathway of risk is a predisposition toward depression or anxiety, whereby individuals may use substances or other behaviors (gambling, eating) as a means of coping. It is remarkable how similar the pathways of risk are for substance-use problems and gambling problems.
The stigma surrounding addictions can make recovery more difficult. When it comes to gambling, there is a stubborn belief among the public that it’s a moral issue or a simple matter of willpower. Researchers are hoping to put that myth to bed.
Dr. Lia Nower is a colleague of Dr. Dick’s and director of the Rutgers’ Center for Gambling Studies & Addiction. She says:
Historically, people have viewed problem gambling as a vice and individuals with gambling problems are weak-willed or ‘degenerate.’
According to Dr. Nower, it wasn’t until 2013 that the psychiatric community finally acknowledged that people with gambling problems have the same urges, cravings, and withdrawals as those with substance-based addictions.
That was the year the American Psychiatric Association put out the fifth and latest edition of its Diagnostic and Statistical Manual of Mental Disorders, considered in the US to be the definitive text for the field of psychiatry.
Dr. Nower says that realization hasn’t yet made it into the mainstream:
[Gambling addiction] was included in the manual as the first non-substance-based addiction. But the general public does not yet have that understanding.
Nature vs. Nurture
Dr. Nower points out that she came to similar conclusions in a paper she published last year. Her study found that youth who are exposed to or participate in the addictive behavior of other household members are more likely to gamble at higher frequencies. They’re prone to developing gambling problems as well as issues with alcohol or drugs.
That suggests that there’s more going on than just genetics, says Dr. Nower:
Taken together, these studies suggest there are genetic similarities among addictions, whether behavioral or substance-based, but that environment, social learning, and conditioning may play a more important role.
The effect of this eventually will be for regulators to require more safeguards for people who seem to be gambling more than they can afford. This is already happening in the UK where the Gambling Commission is requiring operators to conduct affordability checks.
(Editor’s Note: Mandatory affordability checks are still a proposal in the UK, not policy, though some operators have begun conducting them following regulatory action for responsible gambling failures. Making them universally mandatory is highly controversial due to the perceived intrusion on consumer privacy.)
Progress on the research front is what keeps Dr. Hesselbrock optimistic.
We do these genetic studies and environmental studies in hopes that we can find things that people can use, but not use too much.
Genetics Are Not Destiny
Whyte describes studies like Dr. Nower’s and Dr. Barta’s as “an important reminder that problem gambling is a serious addiction with deep biological roots.”
However, it’s important to remember that predisposition is not certainty. Even those at risk may still avoid succumbing to addiction, but they need to be more careful.
Dr. Dick notes:
We can start a conversation about how best to prevent the harms associated with gambling problems when we understand the causes and who is most at risk.
A critical point is that DNA is not destiny. Just because you may be at elevated risk does not mean you are destined to develop problems.