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Gambling Addiction

Maya Malchin, Clinical Social Worker, Psychotherapist, MSW, Director of Addiction Prevention and Treatment, Mental Health Department, Maccabi Healthcare Services
3 May 2026

Gambling is sometimes perceived as a permitted and enjoyable activity, but it can become an escape from reality and even a trap that leads to addiction. Estimates suggest that in Israel there are between 150,000 and 250,000 people with gambling addiction.

Behavioral patterns of people with gambling addiction

People with gambling addiction devote time and money to gambling at the expense of other areas of life. They experience a temporary thrill, especially when gambling with large sums, but it is often followed by a sense of emptiness that drives them to gamble again. The thrill comes from anticipation and tension, not from the win itself.

The DSM-5 outlines 7 symptoms that may indicate possible addiction:

  • A need to increase the amounts of money wagered.
  • Frequent thoughts about gambling.
  • Gambling as an escape from problems.
  • Trying to “chase” losses.
  • Lying about the extent of gambling.
  • Risk to relationships and workplaces.
  • Requesting money from others.

Challenges and treatment of gambling addiction

Gambling addiction shares neurobiological mechanisms similar to substance addictions involving psychoactive drugs, but unlike them, it does not involve physical dependence. Treatment challenges include the hidden nature of the addiction, which makes it difficult to detect, and the “double life” many gamblers lead, which prevents sharing and seeking help.  Intensive work is needed on denial and rationalization mechanisms.

Treatment approaches may include psychological therapy, group therapy (such as Gamblers Anonymous), medication treatment (for associated symptoms), and inpatient or day-program rehabilitation.

Changes of successful recovery from gambling addiction

Recovery from gambling addiction is possible and requires treatment, support, and personal commitment. Many people are able to rebuild their lives.

Research shows that about 70%–75% of patients are able to abstain from gambling during treatment, but relapse rates after treatment are relatively high, highlighting the need for ongoing support.

Calling for help

A family doctor or an addiction treatment clinic should be contacted for consultation and support.   Additional information can be found on the Ministry of Health or the Ministry of Welfare website. 

Gambling is often perceived as a permitted and even enjoyable activity. We all know from movies and TV shows scenes of heavy gamblers sitting in casinos with stacks of chips, but the reality is less glamorous and much more varied. Gambling can also include playing poker, betting on the outcome of a football match, or filling out lottery tickets such as Lotto or Chance. All of these provide an accessible platform for escaping everyday reality. Gambling offers a temporary escape from stress and worries, a sense of entering a different world, along with tension, anticipation, excitement, and immersion in an alternative environment. For some people, especially those who have not gambled before, this form of escape can lead to gambling addiction. According to various estimates, the number of people with gambling addiction in Israel ranges between 150,000 and 250,000, which is about 1.5% to 4% of the adult population.

Behavioral patterns of gambling addicts

Gambling addicts will devote time and money to the object of their addiction. For example, people addicted to sports betting may spend many hours watching games, at the expense of sleep, work hours, and quality time with family and children. They may experience excitement and pleasure, but in reality these feelings are temporary. The excitement peaks especially when large sums are involved, sometimes even tens of thousands of shekels on a single game, and losses can quickly accumulate. If the bet succeeds, they feel elated, but after a short while the excitement and joy fade, leaving a sense of emptiness, as in any addiction. And then they gamble again. In other words, a gambler who wins will not necessarily take the winnings, stop gambling, and use the money for something positive; instead, they may continue gambling. The excitement does not come from the win itself, but from the anticipation, risk and the tension.

Are you addicted to gambling

According to the DSM-5 diagnostic manual of the American Psychiatric Association, gambling disorder is defined as a persistent and recurrent problematic gambling behavior that leads to clinically significant impairment or distress. Four or more of the following symptoms indicate a possible gambling addiction:

  • Increasing amounts
  • Obsessive thoughts
  • Difficulty cutting down
  • Gambling as escape
  • Chasing losses
  • Lying
  • Loss of relationships
  • Accumulation of debts
  • A need to increase the amounts of gambling in order to achieve the same desired level of excitement.
  • Frequent, obsessive thoughts about gambling.
  • Difficulty and failure to reduce or control the urge to gamble.
  • Gambling as a way to escape problems and uncomfortable feelings such as guilt, anxiety, or depression.
  • Gambling in an attempt to recover lost money.
  • A tendency to lie to close ones about the extent of gambling.
  • A risk of losing relationships or employment.
  • Accumulation of debts and asking others for money.

Challenges in treating gambling addiction

Gambling and substance addictions (such as drugs and alcohol) share similar neurobiological mechanisms, especially in how they affect the brain's reward system. However, unlike substance addictions, gambling addiction does not involve physical dependence, which means treatment is mainly focused on behaviors and cognitive processes.

Treatment is similar to that for psychoactive substance addictions such as drugs, but it also involves additional challenges. While psychoactive substance use has cognitive, mental, and behavioral effects that impair daily functioning, gambling addiction can be relatively easy to conceal. A gambling addict can hide and deny the harm of their addiction and financial damage for many years, and may even continue working and functioning in a seemingly normal way in daily life. All of these factors make it harder to identify the problem, both for the surrounding environment and for the gambler themselves.

The lack of sharing prevents seeking help and leaves the person trapped in a paradoxical cycle, where in the absence of hope or belief in change, they continue to mistakenly believe that the solution lies in gambling itself. The gambler's double life comes with heavy emotional costs. At the same time, out of desperation, the gambler may turn to "grey market" lenders or illegal sources of money, which can worsen financial difficulties and put both themselves and their loved ones at risk.

All of these factors, along with others such as the social legitimacy and perceived "normality" of gambling, make it more difficult for gamblers to seek treatment and to stay engaged in it. After seeking treatment, intensive work is required to break strong defense mechanisms of denial and rationalization.

Guiding the patient toward recognizing the disorder and changing gambling-related behaviors is a complex and challenging task in the recovery process. The recovery process itself requires a tailored approach that fits the specific challenges of this behavioral addiction.

Treating gambling addiction

The recovery and treatment process is similar to other addictive behaviors:

  • Psychotherapy
  • Group therapy
  • Pharmacological treatment
  • Inpatient rehabilitation
  • Psychological treatment or psychotherapy: can help identify the thoughts and behaviors that contribute to gambling and develop healthier ways to cope with stress and other triggers.
  • Group therapy: joining therapeutic or support groups such as Gamblers Anonymous (GA) can provide a sense of community, encouragement, and accountability during the recovery process.
  • Medication: certain medications may help manage withdrawal-related symptoms or treat co-occurring mental health conditions such as anxiety or depression.
  • Inpatient or day-program rehabilitation: when necessary, recovery can also take place in an inpatient setting (with overnight stay) or through a day treatment program at a therapeutic center. For reading about inpatient rehabilitation facilities and addiction treatment centers

Chances of successful recovery from gambling addiction

Research suggests that about 70%–75% of patients in gambling treatment programs are able to completely abstain from gambling during treatment. However, relapse rates (return to gambling) after treatment are still relatively high. More than 70% of patients return to gambling after a certain period of time. This highlights the need for ongoing support and aftercare programs following the initial phase of treatment.

Recovery from gambling addiction is a possible and realistic journey. With appropriate treatment, social support, and personal commitment, many people are able to rebuild their lives, improve their financial and emotional well-being, and develop healthier relationships. The path is not easy, but every small step forward is a victory in itself.

For more information on rehabilitation after recovery

How to seek help

If you or someone you know is struggling with gambling addiction, contact a family doctor or a specialized addiction treatment clinic through your health fund for professional advice and support.

Mental Health Hotlines of the HMOs