Gambling Addiction and Neuroscience with Dr. Luke Clark

We know a lot about addiction, going back forty or fifty years and that’s a field that’s very much rooted in studying the pharmacology of how addictive drugs work. So for example, there is a story about dopamine there that’s quite well developed now on how drugs abuse hijack the dopamine system. So, over the last five or ten years, there has been a movement to studying these systems in Canadian gamblers and people with gambling problems and we can use a variety of different neuroscience methods for doing that.

We do some work with PET imaging to look at the dopamine system. We do other work with functional magnetic resonance imaging where we are looking at brain responses while the gamblers play different tasks and this work is starting to come together to make what a coherent story now. Certainly, we can see that problem gambling does have a genetic contribution there and we know that for example from twins studies, looking at the identical twins of problem gamblers.

We can see higher than average rates of gambling problems in the co-twin. Now that overlap is not 100% by any means. It is probably by a 30 or 40 per cent genetic contribution. We know that the environment is also important and for example early exposure to gambling and adverse childhoods are also important determinants here. As in a lot of psychiatry, it is a mixture of both its genes and environment combination. What we can say, we can see during decision-making tasks a brain response to winning money for example, so an outcome response to winning, and this is a system in the brain that responds to a range of different positive rewarding stimuli that we often call that the ‘brain reward system’.

So as well as to responding to money, it would respond to natural rewards like chocolate or like sexual stimuli and this is also the same system that is then targeted by drugs of abuse as well. So we can measure these responses in humans. We know the that areas we expect to see activated in the brain and then we can look at how those responses differ in groups of people with a gambling problem.

It is a really important question how the neuroscience feeds into the policy and that’s actually been one of the topics of debate at the meeting. We’ve had a special session on exactly that. I think it creates awareness of that effect and it shows sort of objective marker of that effect in terms of brain activity. We can also think about that feeding back into treatment as well as for example in terms of psychological treatments acting to change the processing of near misses and correcting other gambling distortions. And we can also think in jurisdictions about how near misses occur in games and the many different ways in which they occur and whether we can sort of tighten the legislation there.