Alcohol and Gambling

Question 1

link between alcohol and gambling

Answer 1

• Nearly ¾ of pathological gamblers have lifetime alcohol use disorder
• Problem gamblers with an alcohol use disorder display more gambling harms and worse treatment outcomes
• Combining gambling with alcohol use is common in regular EGM gamblers and student samples

Question 2

alcohol consumption rates

Answer 2

• Alcohol is the most consumed drug world wide

- In Canada, 79% of people aged 15 years or older report drinking within the past 12 months

Question 3

pharmacological and physiological effects

Answer 3

• Increased GABA (inhibitory), decreased glutamate (excitatory)
• Dopamine release

Question 4

expectancy theory

Answer 4

• Effects of alcohol depend on personal expectations, which are based on past experience with alcohol and observational influences (e.g. parents, adverts)
• Ex. People may behave as they would expect to behave with alcohol even if they’ve unknowingly just drank alcohol-free beer

Question 5

alcohol expectancy effects study

Answer 5

• Participants given either a vodka cran (alcohol + expectancy), cranberry juice with vodka only on rim of glass (expectancy, but no alcohol), or water (no alcohol, no expectancy)
• People generally can’t tell if they were in the high or low alcohol condition
• This allows us to parse out what effects are due to alcohol vs. Expectancy
• • Negative expectancy: expecting a negative outcome
• • Positive expectancy: expecting a positive outcome

Question 6

alcohol’s biphasic effects

Answer 6

• For the first 30-60 mins after drinking, people experience euphoric effects (ex. Being more social, less inhibited, etc.)
• Afterwards, dysphoric effects occur (ex. Sedative effects, feeling tired)

Question 7

cognitive effects of alcohol

Answer 7

• Dominant account: alcohol causes “prefrontal shutdown” (poor planning, inhibition, decision-making)
• “Alcohol myopia”: narrows focus of attention and reduces processing of peripheral events
• Via dopamine: increased reward sensitivity (and decreased loss sensitivity)
• Alcohol may increase reliance on heuristics / distortion proneness (limited research)

Question 8

problem gamblers and alcohol

Answer 8

• 60 regular EGM players: 30 pathological, 30 non-pathological, randomized to alcohol or placebo, then play a real video poker game in lab
• PG become more risky on EGM after alcohol
• “Double-up”: when you win, you can take a 50-50 chance on doubling or losing your win –> good measure of risk-takin

Question 9

bidirectional effects

Answer 9

• 20 minutes of either slot machine play or watching Modern Family, followed by ‘ad libitum’ alcohol consumption (you decide how much to drink, up to a certain limit)
• Gambling group consumed significantly more alcohol than the Modern-Family group
• Shows that alcohol consumption can lead to risky gambling and vice versa

Question 10

potential positive effect of alcohol on gambling

Answer 10

Based on alcohol myopia theory, if the game makes low chances of winning very salient, intoxicated participants may be less likely to gamble

Question 11

implications for policy

Answer 11

• Should we just ban alcohol from gambling venues?
• Alternative: restrictions to the availability of alcohol in venues (no ‘comping’ of free drinks; insert distance between bar and EGMs; refuse to serve intoxicated customers…)
• Public awareness of risks of alcohol when gambling at home (online gambling)
• Clinically: problem gamblers may be more susceptible to risk-enhancing effects of alcohol, even when they do not have an alcohol use disorder
• Monitoring (surveillance) on a regular basis the proportion of gamblers who drink while gambling