1. What is the decision or change (e.g., clinical topic, practice guideline, system design, delivery of care) you are facing or struggling with where a summary of the evidence would be helpful?
A summary of evidence on potential interventions for problem gambling in youth (under 21) may be helpful to government agencies, health providers and community partners. The National Council on Problem Gambling observes that as many as 2 million Americans meet the diagnostic criteria for severe problem gambling and 4-6 million have mild or moderate problem gambling. As two authors observe: “High co-occurrence rates between behavioral and substance addictions have been observed; a recent meta-analysis suggest a mean co-occurrence of 57.5% between disordered gambling and substance addiction.” There appear to be few studies of preventive interventions to mitigate gambling in youth populations.
Gambling has a nexus to other conditions in youth, including mental health conditions and substance use disorders. Those with severe alcoholism, for instance, are up to 23 times more likely to also have a gambling problem. Problem gambling also may be associated with mental health comorbidities as well as addictions to video gaming and food. Conversely, some video games and esports may promote gambling.
Studies suggest up to 6 percent of college students are addicted to gambling, with numbers increasing in recent years as Internet and sports betting become more popular and easily accessible. Problem gambling can lead to harms to the individual, including self-harm, as well as to larger societal harms.
There appear to be few recent resources available from SAMHSA or other agencies and some materials such as SAMHSA’s Treatment Improvement Protocol (42) Substance Use Treatment for Persons With Co-Occurring Disorders mention gambling only in passing. SAMHSA also developed a 2014 advisory, archived on other non-governmental Web sites. It also would be helpful to have an evidence-review with strategies intended for college-age students and pre-college students (K-12) and those who counsel and assist them. For instance, a United Kingdom review found teachers lacked confidence in how to counsel students about potential gambling harms.
2. Why are you struggling with this issue?
Anecdotally, many colleges are noting growth in popularity of gambling among youth due to legalized sports betting in some states and developmental factors in older adolescents that may contribute to impulsive behaviors. But even younger adolescents may engage in gambling sometimes by undermining attempts by Web sites or gaming establishments to prohibit those under 18 from participating. Participation in gambling may become problematic and contribute to mental health conditions, substance use and other pathological behaviors. Tools for screening for problem gambling exist and some have been validated for youth (<21 years old) populations. However, it does not appear there are compendia of evidence-based prevention approaches for this population.
3. What do you want to see changed? How will you know that your issue is improving or has been addressed?
Clarity about evidence-based prevention interventions for problem gambling in youth could be helpful to college and postsecondary staff and faculty, employers, health professionals, patients and family members.
4. What will you do with the evidence report?
An AHRQ evidence review could support colleges and other postsecondary institutions, employers and health professionals in counseling youth and identifying and applying evidence-based interventions for problematic gambling. As well, an evidence review could support recommendations or professional guidelines by health care provider associations and health professionals in their treatment of problem gambling in youth populations. The information from an AHRQ report also could be used as the basis for additional studies or programs within the public and private health sectors and by government agencies such as NIH. SAMHSA the US Preventive Services Task Force, Community Preventive Services Task Force (CPSTF) and others in guiding future research and developing guidelines and recommendations. The resource also could support policy development and change.
Supporting Documentation
Prevention interventions for problem gambling in youth (PDF, 112 KB)
Optional Information About You
What is your role or perspective? public health
May we contact you if we have questions about your nomination? Yes
