Problem Gambling and Homelessness: Results from an Epidemiologic Study

Abstract

The purpose of this study was to investigate the prevalence of gambling disorder and comorbid psychiatric disorders in a homeless population and identify features related to potential subtypes. At baseline, participants were administered a structured interview including socio-demographic sections of the National Comorbidity Study (NCS) interview; seven diagnostic sections of the Diagnostic Interview Schedule (DIS); the alcohol and drug abuse sections of the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM); and the Homeless Supplement to the DIS. At nine months post-baseline assessment, participants were administered additional NCS family history questions and the South Oaks Gambling Screen (SOGS). Participants were an epidemiologic sample of 275 predominately African-American homeless individuals, grouped as lifetime non-gamblers (n = 60), recreational gamblers (n = 152), and problem gamblers (n = 63), recruited on the street and through homeless shelters. Results indicate that lifetime rates of sub-clinical problem (46.2%) and disordered (12.0%) gambling were significantly higher than in the general population. Problem gamblers were more likely than non-problem gamblers to meet diagnostic criteria for antisocial personality disorder, post-traumatic stress disorder, bipolar disorder, and any psychiatric disorder, and more likely than non-gamblers to use illicit drugs or meet criteria for abuse/dependence for nicotine, alcohol, or any substance. This study provides evidence that problem gambling is a significant public health issue among the African-American homeless population. Homeless services should include assessment for problem gambling along with psychiatric disorders and referrals to resources and treatment programs. Future studies should explore the relationship of the onset and course of problem gambling and other psychiatric disorders with homelessness as well as racial differences in gambling patterns and problem severity over time.

Gambling Problems Among Community Cocaine Users

“…Findings are similar to those observed among people addicted to cocaine who are in treatment (Hall et al 2000;Toneatto and Brennan 2002) and those reported by consumers of alcohol or other drugs in treatment (Barnes et al 2015). Also, results align with previous studies of active consumers of substances such as the homeless (Nower et al 2014;Shaffer et al 2002;Sharman et al 2015). The present study findings highlight the vulnerability of community-based cocaine users attending homeless and harm reduction programs to gambling problems.…”

“…Considering nearly one in five cocaine users in this sample suffered from the harmful consequences of gambling activities, it is crucial that the resources they are offered address problems associated with these types of activities (Nower et al 2014). Research by Holdsworth and Tiyce (2013) has previously emphasized the secretive nature of problems gambling, stemming perhaps from feelings of shame and from associated stigma, which underscores the importance of engaging in proactive efforts to detect them.…”

Down and Out in London: Addictive Behaviors in Homelessness

“…As a postal survey, the BGPS did not include various demographic sectors including the homeless, and a number of international studies have reported elevated levels of problem gambling in the homeless, in the range of 11.6–25% (LePage, Ladouceur, & Jacques, 2000; Matheson, Devotta, Wendaferew, & Pedersen, 2014; Nower, Eyrich-Garg, Pollio, & North, 2015; Shaffer, Freed, & Healea, 2002; Sharman, Dreyer, Aitken, Clark, & Bowden-Jones, 2015). In the first study to examine this in the UK, we recruited 456 homeless individuals from day centers and hostels in Westminster, London.…”

“…For example, Nower et al. (2015) found that 63% of their sample met lifetime criteria for alcohol abuse or dependence, and 60.4% met lifetime criteria for substance abuse or dependence. In a study of people sleeping rough in London, 36% were drug dependent and 25% were alcohol dependent (Fountain, Howes, Marsden, Taylor, & Strang, 2003).…”

Self-Reported Gambling Problems and Digital Traces

“…56 For instance, a person that gambles may be less likely to own his or her own home and thus lack the necessary electronic infrastructure at their place of residence. In such circumstances, Internet cafes can help to bridge the digital divide, providing access to the Internet.…”