Gambling Related Harms - What are they?

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When we hear or think of Gambling Related Harms it can be easy to focus on perhaps the most obvious adverse consequence of disordered gambling, by which we mean financial stress. Gambling normally involves risking money in order to gain money, something which, by definition, creates a risk of losing money should individual bets not work out in the favour of the person placing them. So, yes, any gambler can lose money which can start to impact on their ability to engage in other leisure and discretionary activities, such as cinema visits, buying new clothes, visiting restaurants, etc. If the individual placing these bets, or playing casino style gaming machines, remains in control of their gambling then any losses which occur should be causing minimal disruption to their everyday lives in other respects. Their ability to pay for food, living expenses, rent, or mortgage, should not be in any way diminished. 

If the only negative impact is that they might have to forgo a takeaway every so often then that is a choice which they are actively making, and one which few could argue with them having the right to make for themselves. Of course, their partners or children might not always agree with those sentiments, particularly if they had a hankering for some spare ribs in BBQ sauce that day, and that is the play off in priorities which the person participating in gambling must reconcile internally. Even if an individual is willing to forgo something relatively 'trivial' in order to satisfy their own desire to gamble is that a choice which they are fully entitled to make when it affects the wishes or wellbeing of someone else.

And what if someone's gambling is not a trivial factor in their financial wellbeing? 

Well, straight away we should try to dispel any fanciful notions that gambling can actually be a way of consistently, or even frequently, boosting household income. Gambling should only ever be seen as a fun and affordable leisure activity. It is not and never will be a way of earning a sustainable living. 

What counts as 'affordable' will vary significantly from person to person, depending on individual circumstances, but the measure of what is affordable to anyone should be closely based on the concept of asking themself, before they gamble, if the money they are about to stake could be better spent elsewhere. If, on reflection, that money is not needed for anything which they will later regret not having money to spend on then fine, go ahead and spend it. Any other (honest) response to that question means no, they should not gamble that money, and should instead keep it for that other thing. 

It should of course also be recognised that affordability should never just be measured in purely financial terms as gambling engagement also involves commitment of time, attention, focus, and emotional investment, all of which can run a risk of becoming disproportionately focused within gambling activity to the detriment of other aspects of life.

Sadly, what may start off as just sacrificing an alternative leisure activity or luxury purchase can soon escalate in both impact and significance. A missed kebab can become a delayed bill payment, a postponed holiday, perhaps a missed direct debit, an accumulating rent arrears, a maxed out credit card, and so on. All of these things are strong signals that a person's gambling is getting out of control. 

They are however all reversible and, if addressed soon enough, can all be rectified without lasting long term harm occurring. But without action being taken to control the underlying gambling spend then those unpaid bills, missed direct debits, rent arrears, etc, can quickly transition from minor temporary hassles to significant long term financial stresses. Late payments on credit accounts can become default markers; rent arrears can become evictions; unpaid council tax can become County Court Judgements; and all of these can become a lasting barrier to perhaps getting a mortgage, a loan, or even renewing and keeping an existing mortgage. They can also impact on that person's employability.

Financial harm invariably also affects others. If the Disordered Gambler is in a relationship then their financial woes may also become their partner's. Their children may suffer, missing out on holidays, school trips, new clothes, in-trend tech. Many Disordered Gamblers eventually find themselves turning to other family members for help. Borrowing money, perhaps. And unfortunately sometimes borrowing becomes something more insidious and harmful. Devoted family members can find themselves stealing from their loved ones, carrying out heinous breaches of trust that neither they nor their loved ones would ever have contemplated them capable of. And sadly, once that level of breach has occurred, it becomes increasing less inconceivable that this uncharacteristic dishonesty can spread to their employment, or to any outside bodies or organisations where they hold positions of trust and safeguarding.

Another primary harm that can, and usually does, accompany full blown Gambling Disorder is a negative impact on the health of the affected individual, in terms of both physical and mental wellbeing.

Individuals in the grip of a gambling disorders invariably feel a heightened state of guilt, and a lowered state of self-esteem. It is also common for them to experience prolonged and persistent sleep deprivation. An addicted gambler's compulsion to extend sessions of gambling for as long as they are physically able to, combined with post session restlessness due to heightened brain activity and nagging guilt and remorse over losing money and betraying the trust of loved ones, all act together to impact the individual's ability to sleep well. Sleep is the body's repair and reset function meaning that lack of sufficient sleep leads to increased metabolic stress, impaired cognitive ability, and a general feeling of listlessness and malaise, none of which is good for the long term health of the person involved.

In the initial stages of a Gambling Disorder many individuals will feel extremes of emotion depending on the outcomes of their gambling, and the significance of what the money lost or won could mean for their financial positions - for instance, winning enough to pay the next big bill could bring intensified elation, especially if they were likely not to be otherwise able to pay that bill due to monies previously wagered and lost (a.k.a. getting out of the hole). The converse scenario would be the deep despair coming from realising that as a result of a gamble not paying off they may not be able to cover their living expenses, or to buy that present which they had promised their child. A negative reaction that is only enhanced by the knowledge that without having gambled at all it would not have become an issue in the first place (a.k.a. digging the hole). Although we as humans can take enjoyment from adrenaline fuelled highs the extreme contrasts between gambling related highs and lows is not a healthy situation to be enduring over prolonged periods.

As a Gambling Disorder develops, the extreme highs of winning become muted, as indeed do the extreme lows of losing. While this might on the face of it sound a good thing, given what we just said about the rollercoaster of gambling emotions being bad in general for our mental welfare, the truth is that this phase of addiction is not at all a welcome change but instead indicates a further deterioration in our mental balance. The disordered brain has entered a phase where the person's emotional response has become detached from the results of risk/reward based actions. Often when this occurs the concept of winning or losing is no longer the primary trigger for reactive emotional outcome and it becomes the act of creating risk which primarily triggers the brain's reward centre. The possibility of gaining from engaging in gambling may still present itself as an internalised rationalisation for continuing to gamble, but in reality this is self-delusion as the brain releases more endorphins for engaging in the process of enhanced risk taking than it does as a consequence of any given outcome. 

By this stage the addiction has stopped being about winning or losing and is now purely about risking more than one can realistically afford to lose. And in such situations losing is what will invariably happen as winning does not provide the same emotional reward as risking losing does, and so only creates the opportunity to try losing again. 

The reason why disordered gamblers keep losing is that winning is no longer the primary reason for taking part in gambling - even if the addicted part of the brain tries its hardest to suggest otherwise. In some ways a gambling addiction can be compared to a virus - for both the imperative is that they continue to survive and grow. For the virus this usually means finding new hosts to colonise, for the addiction it means finding ways of persuading the sole host to keep feeding it engagement, to keep gambling.

That is not to say that losing brings much joy. It doesn't, but one of the few moments of peace which are afforded an addicted gambler often occurs directly after they have gambled all available funds away - with no money left to gamble the pressure of feeling the need to gamble can temporarily be assuaged - and a small window of clarity is afforded the brain. But alas not for long. By this stage of the addiction the Disordered Gambler is invariably so guilt-consumed that they almost feel the need to punish themselves and, as such, losing becomes a masochistic realisation of self-inflicted approbation which is accompanied by a continual need to find new funds with which to gamble again. 

Once in this cycle, Disordered Gamblers will rarely stop until they encounter their own 'rock bottom' moment of self-realisation. Unfortunately, this will often only be once they have literally gambled away everything that they can find, legally or otherwise, to use as collateral, meaning that they have effectively impoverished themselves to such an extent that life can seem very unappealing and pointless. Alternately, some other unavoidable life event overtakes them - such as illness, bereavement, unemployment, homelessness, or even the true extent of their gambling being uncovered by a partner or employer. Experiencing an enforced period of desistance from gambling due to one of these reasons can temporarily create conditions which allow the gambler to finally take action to address their addiction - a breathing space free from addictive compulsion - and thus enable them to reach out for help. It is estimated that only 3% of gamblers engaging in harmful levels of gambling ever do reach out for support and it would be our contention that most of these will have done so only as a result of encountering their own crisis point.

But not everyone finding themselves unable to gamble will reach out for help. The window of reflection which may finally bring clarity over the harmful nature of gambling and the inevitability of losing in the long run can also bring unwelcome focus on the accumulated harm already caused, and without the daily escape which gambling brought, the guilt already present can quickly snowball and lead in turn to deep despair and a sense of utter helplessness. At this stage, and without intervention from loved ones, it can lead to long term depression and suicidal ideation. It is estimated that between 4 and 11 percent of annual suicides are related to gambling (equivalent to between 250 and 650 deaths per annum in the UK). Research from Sweden suggests that gambling addicts are 15 times more likely to take their own lines than otherwise would be the case.

For further information, and help on overcoming and preventing gambling related suicides, we would suggest checking out Gambling With Lives, a UK charity formed by surviving relatives of gamblers who committed suicide and who have a wealth of experience and knowledge to share on this extremely important issue. 

Although not necessarily amongst people's first ideas of what a primary harm caused by Gambling Disorder might entail, relationship stress and breakdown is right up there in terms of meaningful negative impact and long term detriment.

Relationships are fundamentally central to everything that makes a society function. Without relationships there simply is no society. The same is true of an individual's sense of belonging within society. Regardless of whether we are gregarious and outgoing, or insular and introspective, the fact is that as human beings we need relationships with the people around us to function effectively in order to give us emotional connection and a sense of purpose. If we were to stop and think about it we all have a surprisingly varied range of relationships which make up our 'social map' to which we bring, and from which we take, differing roles, responsibilities and benefits.

The importance that each relationship has in our lives will of course vary. A relationship with a parent, partner, or child, will be of far greater priority and significance than, say, someone we see regularly at the pub, walking the dog, or standing on the other side of a shop counter when we buy some fish. The stronger the emotional bond which we share with someone then the stronger will be the bond of trust that exists between ourselves and them. Which is why a gambling disorder can be so damaging on the relationship front as, in general, it is not the local fishmonger who will be harmed by someone's disordered gambling but rather the people who are closest to the affected gambler. 

As we have already stated, an established Gambling Disorder can lead to individuals carrying out actions and betrayals of trust which neither they, nor those they love, could normally have ever contemplated participating in. Beyond the obvious hurt and recriminations which can follow on from discovering that the family finances have been gambled away, and perhaps even been stolen from under their owner's eyes by someone they implicitly trusted, there is also the emotional betrayal that accompanies addiction. The sense of detachment from reality that focussing on gambling can bring with it will often lead to the disordered gambler abrogating familial duties and responsibilities. The unthinking care and duty that would normally happen can start to lapse. Birthdays and important family events can become forgotten or overlooked, household chores might slip, necessary repairs might simply be ignored. The harbouring of guilt and secrecy combined with poor sleep levels will frequently cause excessive irritability and lead to uncharacteristic bouts of tetchiness and resentment being directed at people around them. Others in the relationship will start to pick up on emotional changes in their loved ones but might not know what is causing them. This in turn can lead to affected others experiencing their own emotional downturns, causing them to form their own self-doubts as they find their relationship not providing the mutual support and satisfaction which they had come to expect and rely on, and all without knowing the true reasons why. Arguments may start and become commonplace, causing a strained atmosphere which will in turn spread to, and adversely impact upon, children and others living in close proximity. 

As gambling has by this stage often assumed the role of an escape mechanism, a mental place where the affected gambler can buffer themselves from facing up to actual life problems, any such deterioration in close relationships can act to drive the affected individual even deeper into the harmful gambling cycle.

It is surprisingly and upliftingly often the case that even when the most awful of betrayals have occurred and have subsequently been unearthed as a consequence of a family member having fallen into a Gambling Disorder, that the family will come together to be amazingly sympathetic and compassionate to the afflicted individual. Yet, despite the likelihood of just such a thing happening, the guilt felt by the addicted gambler will often prevent them from feeling able to come forward and admit their disorder until either it has already been discovered or until after there is no way to avoid it becoming known. This unwillingness to own up is not a comment on the disordered gambler's expectations regarding their loved ones' ability to empathise but rather a sign that they fear losing the respect of the people whose opinions they value above all others. It is usually also accompanied by a sincere, if somewhat illogical, desire not to want to inflict their own suffering and unhappiness on innocent parties. As a consequence of such secrecy and unwillingness to share the sense of helplessness felt by the other parties in the relationship when faced with the intransigence and altered character of the disordered gambler will often lead to irreparable damage being done to the relationship such that it will weaken and start to break up even before the real cause is made known.

Nor is discovery and forgiveness an instant cure to the problem of gambling addiction. Compassion and support shown to a disordered gambler by their loved ones once an addiction has been uncovered is unquestionably a good thing but unless accompanied by a full understanding of gambling disorders in general and the underlying cause of their specific affliction then there is a real danger that the disordered gambler will relapse. In such circumstances the knowledge that they are doing so in direct contravention of likely promises made to their loved ones not to do exactly that will actually increase the guilt felt by the individual. If revealing their gambling addiction the first time in the absence of their loved ones' knowledge of it was hard for them to face up to then doing so a second time when their family and loved ones have already bailed them out once and reaffirmed their trust in them can often present as an unbroachable obstacle in their path to achieving full and lasting recovery. This increased sense of guilt and unwillingness to burden their family for further financial support can often be the thing that drives disordered gamblers to acts of despair previously unthinkable to them, as now even their default port of last resort seems out of reach. Criminality and attempted suicide are just two of the devastating consequences which can occur in such situations and whilst it would be wrong to say that such extreme behaviours are the norm it is certainly the case that they are alarmingly common.

Whatever the ultimate consequences which may befall the addicted gambler the one thing that invariably follows on from any prolonged gambling disorder is that the level of trust that was enshrined in their close relationships will be severely damaged, if not lost all together. If the affected others are willing and able to learn more about gambling disorders and the effects that addiction has on the brain of the addicted person, and if they and the addicted person can set aside time to talk openly and honestly about their relative perspectives on the effects of the addiction, then it is possible to repair relationships and even restore the trust element, but it can be an emotionally intense, if ultimately worthwhile, process. The best possible safeguard against continued and future disordered gambling is total openness and honesty within relationships.

It may surprise readers that we are including crime as a primary harm. Not because resorting to criminal acts to acquire money that can then be gambled with doesn't result in serious harm to the person doing it and also to those around them but surely it is such a relatively infrequent occurrence as to be of only marginal interest to anyone wanting to discover more about everyday gambling harms. Well, the reason why we do include it is because it really isn't as rare as one might think or hope.

Collated research, such as the GREO issued white paper, Gambling And Crime And Its Costs [Kryszajtys and Matheson, 2017], estimates that about half of individuals experiencing problem gambling go on to commit a crime. This is a staggering figure which needs to be put into numerical context. When applied to the Gambling Commission's conservative estimate of 350,000 UK adults currently experiencing a Gambling Disorder this  would translate to 175,000 individuals who are going to commit a crime. Now, not all crimes committed by disordered gamblers are for the express purpose of financing future gambling, and some crimes will have been committed whether the perpetrator was suffering from a gambling disorder or not, but that should not detract from the incredibly high prevalence of criminality amongst disordered gamblers which can be linked directly to a need to continue gambling and as a means of filling the hole in necessary finances caused by legitimate monies lost through gambling.

It is also the case that the protective factors - or internal protections  - against committing crime which are gradually built up during a person's journey from childhood to adulthood as a consequence of parental influence and formal education are also susceptible to being systematically dismantled as an individual's relationship with gambling transforms from harmless fun to addictive obsession.

Every day literally thousands of acts of theft and fraud will be taking place just so that a disordered gambler can continue to gamble their lives away. These crimes can be quite small, taking a tenner from the till at work, submitting false expenses, unauthorised use of a corporate credit card, or even unauthorised access to a relative's online banking app. Sometimes, however, these crimes can be massive. Million pound frauds are now common place. So common in fact that nowadays they hardly even cause a ripple in the news media consciousness other than on a strictly local level. Ten years ago if someone had stolen a million pounds it would be frontpage news on all the national papers, nowadays it hardly merits a couple of inches buried deep on an inside page. Try googling 'million pound fraud gambling addiction' and we guarantee there will be dozens of page returns. And for every million pound crime there will be thousands of lower value offences committed as a direct result of a gambling disorder.

Due to the relatively small values involved in most of these crimes they simply aren't discovered, or even if they are, they aren't reported. That doesn't mean that they don't have serious consequences for the perpetrator or for the victims whose money have been misappropriated for gambling with. Breakdown of trust, break up of relationships, and loss of employment all commonly result from such 'minor' offences. Due to many of these crimes being 'breach of trust' offences, in other words carried out by persons whom the victims implicitly trusted, there are often conflicted feelings on the part of the victims. Whilst they feel betrayed and hurt they also feel a sufficient level of personal attachment to the perpetrator that they choose not to report their actions to the authorities as they do not want to criminalise them. 

Sometimes, there is no alternative but to involve the authorities. Businesses with fidelity insurance, a form of cover against illegal activities carried out by employees which cause financial loss, will only be able to recoup their losses if they do raise a police report. Other employers may be bound by codes of practice requiring automatic disclosure due to them carrying out work which involves the regulated protection of vulnerable clients. Many of the cases where low value theft and fraud is reported will not result in prosecution but can still result in the perpetrator being given a criminal record through the issuing of cautions and admonishments, all of which will create significant future problems in terms of applying for jobs, and even getting home and motor insurance. Where cases are deemed sufficiently serious to warrant prosecution then community payback orders, fines and suspended sentences may result. While they may not directly affect the disordered gambler's freedom of liberty, these punishments will seriously affect their standings in society and bring further detrimental harm to their finances, career prospects, and housing situations.

Then there is the ultimate sanction of imprisonment. Every year increasing numbers of disordered gamblers are being sent to prison for acquisitive crimes committed to feed gambling addictions. For many of these people this will be the first and only time that they have broken the law and faced criminal charges which means that they will be facing a great unknown. While prison itself is not as scary or dangerous as is often made out, by newspaper headlines and TV dramas, it does have very serious repercussions for those sent there and, in many ways, even greater impact for those left behind. Prison causes the forced separation of families and loved ones and, following on from the probable strain that the shock discovery of the sentenced individual's disordered gambling and criminal behaviours caused to their loved ones and family, it can be the final nail in the coffin for relationships. Prisons are also rife with opportunities to gamble, many of which can be extremely hazardous to the health and wellbeing of those engaging in it as the consequences of losing can be far more instant and extreme than participants are accustomed to experiencing outside. For individuals struggling to recover from a gambling disorder, being sent to prison can be the worst possible outcome for their long term chances of beating their addiction. Most prisons provide no support or treatment for gambling addictions and for the majority of establishments it simply does not register as being an issue which they need to pay any attention to.

Nor does the punishment end with release from prison. Gone are the days in the UK when a convicted person did their time and walked out the prison door with a clean slate, ready to rebuild their lives from the ground up. The ever expanding roll out of the Proceeds of Crime Act 2002 means that almost all disordered gamblers who find themselves resorting to acquisitive crime to fund their addiction will end up being asked to repay every penny of their perceived 'criminal benefit', not what they had left after gambling it away but everything that they ever took. If they do not have the resources to pay this amount, which is extremely likely to be the case as most affected gamblers will only have turned to crime after they had already gambled away all their legitimate assets, then the burden of being asked to pay it at a later date will remain, hovering over them like a modern day Sword of Damocles, threatening their financial future and de-incentivising them from applying any entrepreneurial acumen to post-prison recovery as they know that at any point in the future the state can simply decide to take it all away from them again. The other problem with POCA is that it totally overlooks the personal debt that the disordered gambler will undoubtedly have built up through use of loans and credit prior to turning to crime in their desperation to keep gambling. This means that the majority of disordered gamblers leaving prison do so with the double burden of outstanding, or unextinguished, POCA confiscation liability, outstanding personal debt, and no resources left to meet these as their home will probably have been sold from under them and theirs. 

The criminal justice system is simply not equipped to deal with the causal linkage between gambling disorders and the crimes which are committed to fund them. There is no screening for gambling disorder done as part of pre-sentence reports for courts, there is practically no screening done during admission to prisons, and there is next to no support made available to prisoners to overcome their gambling disorders so that they are at least free from the likelihood of relapse and recidivism upon release. Gambling addiction simply does not enter into the workings of the criminal, judicial, prison, and community justice systems. That in itself is a 'crime of omission', one perpetrated by the state for which they currently are spared due censure and reprimand. Here at GamHarm we are seeking to change this, for the benefit of disordered gamblers, their affected others, and society as a whole.