Gambling
Is gambling addiction a real disorder?
Short answer
Yes. Gambling disorder is a recognized diagnosis in both major diagnostic systems. DSM-5 places it in its Substance-Related and Addictive Disorders section, and the World Health Organization's ICD-11 lists it as 6C50 among disorders due to addictive behaviours. WHO estimates that 1.2% of adults worldwide have a gambling disorder. It is treatable: the UK's NICE guideline recommends cognitive behavioral therapy (CBT).
Key takeaways
- DSM-5 moved gambling disorder into its Substance-Related and Addictive Disorders section, formally recognizing it as a behavioral addiction.
- ICD-11 codes gambling disorder as 6C50, grouped with gaming disorder under disorders due to addictive behaviours.
- A DSM-5 diagnosis requires four or more of nine criteria within a 12-month period.
- WHO estimates 1.2% of adults worldwide have a gambling disorder, and more people experience some level of gambling harm.
- NICE recommends group or individual CBT; a Cochrane review found CBT helps right after treatment, but long-term evidence is limited.
How does DSM-5 classify gambling disorder?
In DSM-5, gambling disorder was moved out of the impulse control disorders chapter and into the newly expanded Substance-Related and Addictive Disorders section. Researchers explain that the move reflected findings that it is very similar to substance use disorders in its causes, symptoms, course, and treatment approaches. Psychologists Carla Rash and Nancy Petry describe the change as a formal recognition of behavioral addictions: addictions that don't involve a psychoactive drug.
DSM-5 also lowered the threshold for diagnosis from five symptoms to four. A diagnosis is now made when someone meets four or more of nine criteria within a 12-month period. The criteria include needing to gamble with increasing amounts of money to get the desired excitement, and chasing losses.
How does ICD-11 define gambling disorder?
The World Health Organization's ICD-11 lists 6C50 Gambling disorder within the grouping 'Disorders due to addictive behaviours', next to 6C51 Gaming disorder. It also distinguishes gambling disorder that is predominantly online (6C50.1).
WHO summarizes the ICD-11 diagnostic requirements as three features: impaired control over gambling; increasing priority given to gambling, so that it takes precedence over other life interests and daily activities; and continuing to gamble despite negative consequences.
Is 'gambling addiction' the same as gambling disorder?
'Gambling addiction' is the everyday phrase; 'gambling disorder' is the clinical name. Both major systems treat it as an addiction: WHO notes that gambling disorder is described alongside substance use disorders in both DSM-5 and ICD-11.
Gambling holds an unusual place among behavioral problems. ICD-11 currently has only two diagnoses for specific behavioral conditions, gambling disorder and gaming disorder, with 'hazardous gambling' listed as a health risk factor rather than a disorder.
Not meeting the criteria doesn't mean gambling is harmless. WHO points out that gambling harm also occurs well below clinical thresholds.
How common is gambling disorder?
WHO estimates that 1.2% of the world's adult population has a gambling disorder, while noting that standardized global estimates have been limited. Harm is more widespread: the same WHO fact sheet reports that around 5.5% of women and 11.9% of men globally experience some level of gambling harm.
Can gambling disorder be treated?
Yes. The UK's National Institute for Health and Care Excellence (NICE) recommends offering group CBT to reduce gambling severity and frequency, with individual CBT when a group isn't wanted, possible, or suitable. NICE says the medicine naltrexone can be considered if psychological therapy has not achieved the desired outcomes. WHO describes long-term CBT or motivational interviewing as the most effective therapies currently available.
The evidence has limits. A 2012 Cochrane review found that CBT reduced gambling behavior and other symptoms immediately after therapy, but said the durability of those gains is unknown, and it rated the evidence as very low to low quality.
How Vow can help
Vow is not a diagnosis or a treatment, but it can sit alongside professional help. You anchor your quit to your own reason for stopping, track your streak and the money you no longer spend, and can use Craving Shield (Premium), a guided ~3-minute urge-surfing timer, when an urge to gamble hits. Notifications keep sensitive habit names off your lock screen, and regional crisis resources are always free in the app.
Sources
Each source below was read when this answer was reviewed. Open a source to see the passages the answer relies on.
Rash & Petry, Current Addiction Reports (2016), via PMC — Gambling Disorder in the DSM-5: Opportunities to Improve Diagnosis and Treatment Especially in Substance Use and Homeless Populationspmc.ncbi.nlm.nih.gov
GD was moved from the Impulse Control Disorders Not Elsewhere Classified chapter to the newly expanded Substance-Related and Addictive Disorders section
signals a formal recognition of behavioral addictions, which are addictions characterized by their lack of psychoactive agents
diagnosis of GD is made when an individual meets four or more of the following criteria within a 12-month period
needs to gamble with increasing amounts of money in order to achieve desired excitement
chases losses
Open the sourceWeinstock & Rash, Current Addiction Reports (2014), via PMC — Clinical and Research Implications of Gambling Disorder in DSM-5pmc.ncbi.nlm.nih.gov
findings that the disorder is very similar to substance use disorders in terms of etiology, symptoms, course, correlates, and treatment approaches
In DSM-5 the threshold for diagnosis was lowered from endorsement of five symptoms to four symptoms.
Open the sourceWorld Health Organization — Alcohol, Drugs and Addictive Behaviours: Terminologywho.int
6C50 Gambling disorder
6C51 Gaming disorder
Open the sourceBrand et al., Journal of Behavioral Addictions (2020), via PMC — Which conditions should be considered as disorders in the ICD-11 designation of 'other specified disorders due to addictive behaviors'?pmc.ncbi.nlm.nih.gov
Gambling and gaming disorders have been designated as 'disorders due to addictive behaviors' in the eleventh edition of the ICD-11.
Open the sourceGonzález-Cabrera et al., Journal of Clinical Medicine (2020), via PMC — Design and Measurement Properties of the Online Gambling Disorder Questionnaire (OGD-Q) in Spanish Adolescentspmc.ncbi.nlm.nih.gov
There has been a notable advance with respect to the DSM-5 by adding the nuance of 'predominant online gambling' (6C50.1).
Open the sourceWorld Health Organization — Gambling (fact sheet, 2 December 2024)who.int
The ICD-11 describes three diagnostic requirements: 1) impaired control over gambling; 2) increasing priority given to gambling, taking precedence over other life interests and daily activities; and 3) continuation of gambling despite negative consequences.
Gambling disorder is described alongside substance use disorders in both the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5), and the International Classification of Diseases, eleventh revision (ICD 11).
Gambling harm also occurs well below clinical thresholds.
Standardized global estimation of gambling harms has been limited, but estimates suggest that 1.2% of the world's adult population has a gambling disorder.
Around 5.5% of women and 11.9% of men globally experience some level of harm
A range of therapies exist for those with gambling disorder. Currently, the most effective are long-term cognitive behavioural therapy or motivational interviewing.
A Swedish study estimated that those with a gambling disorder were 15 times more likely to die by suicide than the general population.
Open the sourceSaunders, European Psychiatry (2025), via PMC — Alcohol, Drugs and Addictive Behaviors in ICD-11: major changes have improved the diagnostic systempmc.ncbi.nlm.nih.gov
There are currently two diagnoses available for specific behavioural conditions, namely gambling disorder and gaming disorder, together with the health risk factors of hazardous gambling and hazardous gaming.
Open the sourceNICE guideline NG248 (via NCBI Bookshelf) — Gambling-related harms: identification, assessment and managementncbi.nlm.nih.gov
Offer group CBT to reduce gambling severity and frequency. Start this intervention as soon as possible after diagnosis.
Offer individual CBT if the person does not wish to join a group, if group therapy is not possible ... or it is assessed as not suitable for the person.
Consider naltrexone to reduce gambling severity if psychological therapy has not achieved the desired outcomes after an appropriate course has been completed
Open the sourceCowlishaw et al., Cochrane Database of Systematic Reviews (2012), via PMC — Psychological therapies for pathological and problem gamblingpmc.ncbi.nlm.nih.gov
This review supports the efficacy of CBT in reducing gambling behaviour and other symptoms of pathological and problem gambling immediately following therapy. However, the durability of therapeutic gain is unknown.
The evidence supporting these various classes of therapy ranged from very low to low quality.
Open the sourceNational Institute of Mental Health — Help for Mental Illnessesnimh.nih.gov
Call or text 988 or start a chat online to connect with a trained crisis counselor.
Open the sourceNHS — Where to get urgent help for mental healthnhs.uk
Call 116 123 to talk to Samaritans
Call 999 or go to A&E now if someone's life is at risk or you cannot keep yourself or someone else safe.
Open the sourceNational Council on Problem Gambling — NCPG Adopts 1-800-MY-RESET as New National Problem Gambling Helpline Number (January 29, 2026)ncpgambling.org
The National Council on Problem Gambling (NCPG) today announced it has adopted 1-800-MY-RESET as the new National Problem Gambling Helpline™ number
Open the sourceNHS — Help for problems with gamblingnhs.uk
The National Gambling Helpline (run by GamCare) – call 0808 8020 133 for free 24 hours a day, 7 days a week
Open the source
This page is general information, not medical advice, and it does not replace care from a qualified professional. If you are in immediate danger, call your local emergency number. Vow is not a medical service.