Guidelines for preventive activities in general practice

Mental health and substance use


      1. Gambling

Mental health and substance use | Gambling

Case finding age bar

0–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 ≥80

It is estimated that over 7% of Australians are at risk of gambling-related harms.1 In Australia, 48% of men and 28% of women gamble at least weekly. Of these, 53% of men who gamble and 38% of women who gamble experience or are at risk of experiencing gambling-related harm.1 When the impact of gambling on others is considered, even low-risk gambling affects other people (usually family members), rising to an impact of six people per typical problem gambler.2 Gambling-related harms include effects on relationships, health, emotional wellbeing, finances and work/study, in addition to cultural harms and criminal activity.3 There has been extraordinary growth in recent years in opportunities to gamble, both in-person and online, leading to concern about the potential for associated harm, and a call for more research into the potential for screening in healthcare settings.4

While GPs wait for screening tools to be validated and tested in primary care to demonstrate improved health outcomes for gamblers, a case finding approach is warranted, given the opportunities afforded GPs by knowing their patients over time and within the context of their families and communities.

Case finding

Recommendation Grade How often References
In patients experiencing stress, mental health issues or substance use problems; in people experiencing or perpetrating domestic violence; in people experiencing relationship breakdown; and/or in people with symptoms of compulsive gambling (see Box 1), ask about gambling behaviours (eg sports betting, wagering, card playing, pokies, casino gambling, online gambling). For example, ‘In the past 12 months, have you or someone you are close to ever had issues with gambling?’ Practice point Opportunistically 5,6,7,8

Calls for a public health approach to gambling will hopefully see reductions in the future rates of problem gambling, along the same lines as the success Australia has had in smoking cessation and immunisation. Health professional awareness of the problem is one factor within a larger conceptual framework required to address this problem.9

This approach allows for GPs to offer brief interventions, such as motivational interviewing or referral to gambling support helplines and websites, for patients who report gambling issues.

Box 1. Symptoms of compulsive gambling (gambling disorder)10
  • Being preoccupied with gambling, such as constantly planning gambling activities and how to get more gambling money
  • Needing to gamble with increasing amounts of money to get the same thrill
  • Trying to control, cut back or stop gambling without success
  • Feeling restless or irritable when you try to cut down on gambling
  • Gambling to escape problems or relieve feelings of helplessness, guilt, anxiety or depression
  • Trying to get back lost money by gambling more (chasing losses)
  • Lying to family members or others to hide the extent of your gambling
  • Risking or losing important relationships, a job or school or work opportunities because of gambling
  • Asking others to bail you out of financial trouble because you gambled money away

For specific recommendations and advice for Aboriginal and Torres Strait Islander people, please refer to the Gambling section in the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people.

Gambling Help Online, an online counselling, information and support service for problem gambling issues (includes contact details for local face-to-face counselling and support)

National telephone counselling services:

  • National Gambling Helpline, 1800 858 858
  • National Debt Helpline, 1800 007 007
  1. Australian Institute of Health and Welfare. Gambling in Australia. Australian Government, 2023 [Accessed 22 February 2024].
  2. Goodwin BC, Browne M, Rockloff M, Rose J. A typical problem gambler affects six others. Int Gambling Stud 2017;17(2):276–89. doi: 10.1080/14459795.2017.1331252.
  3. Langham E, Thorne H, Browne M, Donaldson P, Rose J, Rockloff M. Understanding gambling-related harm: A proposed definition, conceptual framework, and taxonomy of harms. BMC Public Health 2016;16:80. doi: 10.1186/s12889-016-2747-0.
  4. Blank L, Baxter S, Woods HB, Goyder E. Should screening for risk of gambling-related harm be undertaken in health, care and support settings? A systematic review of the international evidence. Addict Sci Clin Pract 2021;16(1):35. doi: 10.1186/s13722-021-00243-9.
  5. Sharman S, Butler K, Roberts A. Psychosocial risk factors in disordered gambling: A descriptive systematic overview of vulnerable populations. Addict Behav 2019; 99:106071. doi: 10.1016/j.addbeh.2019.106071.
  6. Australian Institute of Family Studies. The impact of gambling problems on families. Australian Government, 2014 [Accessed 22 February 2024].
  7. Victorian Responsible Gambling Foundation (VRGF). One simple question on the path to recovery. VRGF, 2022 [Accessed 22 February 2024].
  8. Problem Gambling Research and Treatment Centre (PGRTC). Guideline for screening, assessment and treatment in problem gambling. Monash University, 2011.
  9. Browne M, Langham E, Rawat V, et al. Assessing gambling-related harm in Victoria: A public health perspective. Victorian Responsible Gambling Foundation, 2016 [Accessed 22 February 2024].
  10. Mayo Clinic. Compulsive gambling. Mayo Clinic, 2022 [Accessed 22 February 2024].
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