Down and Out in London: Addictive Behaviors in Homelessness

Abstract

Backgrounds and aimsProblem gambling occurs at higher levels in the homeless than the general population. Past work has not established the extent to which problem gambling is a cause or consequence of homelessness. This study sought to replicate recent observations of elevated rates of problem gambling in a British homeless sample, and extend that finding by characterizing (a) the temporal sequencing of the effect, (b) relationships with drug and alcohol misuse, and (c) awareness and access of treatment services for gambling by the homeless.MethodsWe recruited 72 participants from homeless centers in Westminster, London, and used the Problem Gambling Severity Index to assess gambling involvement, as well as DSM-IV criteria for substance and alcohol use disorders. A life-events scale was administered to establish the temporal ordering of problem gambling and homelessness.ResultsProblem gambling was evident in 23.6% of the sample. In participants who endorsed any gambling symptomatology, the majority were categorized as problem gamblers. Within those problem gamblers, 82.4% indicated that gambling preceded their homelessness. Participants displayed high rates of substance (31.9%) and alcohol dependence (23.6%); these were not correlated with PGSI scores. Awareness of treatment for gambling was significantly lower than for substance and alcohol use disorders, and actual access of gambling support was minimal.Discussion and conclusionsProblem gambling is an under-recognized health issue in the homeless. Our observation that gambling typically precedes homelessness strengthens its role as a causal factor. Despite the elevated prevalence rates, awareness and utilization of gambling support opportunities were low compared with services for substance use disorders.

Gambling-related harms and homelessness: findings from a scoping review

“…However, such awareness was significantly lower than for alcohol services (94.7 per cent) or substance disorder services (95.7 per cent). Furthermore the actual use of treatment services by gamblers was significantly lower than for people with substance or alcohol problems (Sharman et al, 2016). Less than a third of gamblers (26.9 per cent) in the "some risk" group (i.e.…”

“…Problem Gambling Severity Index score W 0) disclosed experiencing gambling problems prior to becoming homeless compared to a sixth (15.4 per cent) who reported only experiencing gambling problems after becoming homeless. Problem gambling was evident among just under a quarter (23.6 per cent) of the sample, of whom most (82 per cent) said that their gambling preceded their homelessness, while 17.6 per cent had experienced gambling problems after homelessness (Sharman et al, 2016).…”

“…Emerging knowledge about the extent that people experiencing homelessness access gambling support services Knowledge about the extent to which people experiencing homelessness are aware of, or access gambling support services is also limited. Sharman et al (2016) found that the majority (76.9 per cent) of their participants who gambled were aware of support services for gambling. However, such awareness was significantly lower than for alcohol services (94.7 per cent) or substance disorder services (95.7 per cent).…”

“…There is limited knowledge about why people experiencing homelessness may participate in gambling. Some studies note that people experiencing homelessness may visit high-street gambling environments because they offer shelter, have extended opening hours (when other venues are closed), offer low-stake gambling, are warm and often provide free sustenance (Sharman et al, 2016;Wardle et al, 2014). Furthermore, rough sleepers may be victims of violence and abuse on the streets (Crisis, 2016).…”

“…A later UK study conducted by Sharman et al (2016) examined the extent to which problem gambling was a cause or consequence of homelessness. They recruited 72 mainly male participants (87.5 per cent ¼ male) from homeless centres also in Westminster, London.…”