When drug and alcohol counsellor Abbie Lewis asks a client what they are most stressed about in their life, one of the most frequent answers is finances. The obvious assumption is they are spending their money on drugs or alcohol, but Abbie asks them to elaborate. In most cases, the conversation takes a familiar turn.
'They say, "Yeah, I also play pokies", and that's a red flag for me that this client also has possible issues with gambling.'
So when Odyssey House Victoria, an organisation that provides treatment and support to people with alcohol and other drug problems, invited Abbie to learn more about treating people who also have gambling issues, she leapt at the chance.
Strong links between gambling and substance use issues
Odyssey House recognised that substance misuse was entangled with gambling harm for many clients. It saw a growing need for counsellors who work with clients with drug and alcohol issues to understand the links with gambling problems, and to use their skills to address both.
Caroline Long, capacity building manager at Odyssey House, says the parallels in the addictive nature of both issues mean many of the skills used to treat one can also be effective in treating the other.
'The strategies used to cope with triggers, manage cravings and prevent relapse are the same,' she says. 'So is the stigma, shame and feelings of being powerless to control the problem.'
'The parallels in the addictive nature of both issues mean many of the skills used to treat one can also be effective in treating the other.'
Caroline Long, Odyssey House Victoria
The impact of these issues on individuals, families and the community can be extreme. But when they converge, it is even more substantial.
In combination, severity also increases. For example, someone who is drinking or using drugs may bet when they otherwise wouldn't, gamble more and for longer, pay less attention to losses, and be overconfident about winning. It doesn't help that the most problematic form of gambling for people with substance use issues – pokies – are often located in venues that serve alcohol.
Research backs up this frontline evidence. People seeking help for drug and alcohol issues are more likely to have gambling problems than people in the general community. A 2014 paper published by the foundation estimated 23 per cent of people seeking treatment for substance use also had gambling problems or were at risk of developing them.
Odyssey House applied for funding from the foundation's Local Prevention Grants Program to partner with the National Centre for Education and Training on Addiction to do something about it.
Adapting skills for more holistic treatment
In May last year, Abbie attended an Odyssey House training session to test a resource for helping the drug and alcohol sector better support and refer clients with gambling problems.
Slots and shots educates counsellors to be more skilled and confident in asking about and addressing gambling harm with their clients.
A 2013 report commissioned by the Australian Capital Territory Government found that most people with a gambling issue see it as more shameful than having an alcohol or drug dependence. This stigma means many people are able to talk openly to clinicians about their substance use but are reluctant to admit to or seek help for gambling problems.
Most people with a gambling issue see it as more shameful than having an alcohol or drug dependence.
Slots and shots gives guidance on how to raise the topic sensitively to better explore gambling and how it interacts with substance use and other areas of clients' lives.
According to Abbie, many clients and their families are so focused on the drugs and alcohol, they forget about the gambling. To encourage clients to talk about gambling within drug and alcohol treatment, the resource also includes flyers and posters for waiting rooms.
Slots and shots: a life of its own
With the resource now finalised – after extensive input from academics, experts and clinicians, including Abbie – the next step is to get it out there.
Slots and shots is available on the Odyssey House and National Centre for Education and Training on Addiction websites and the organisations have shared the resource through their networks and received requests for training.
In light of the obvious appetite, Odyssey House is now using a second grant from the foundation to develop training for the gambling and drug and alcohol help sectors, and to promote the kit more broadly.