Stories about a recent study on gambling and alcohol use across the lifespan have begun popping up around the Internet with contradictory titles like “Gambling Problems Are More Common Than Drinking Problems, According To First-Of-Its-Kind Study” and “Are Gambling Problems More Common than Drinking Problems? Maybe Not”. The study, published in the Journal of Gambling Studies, is from the Research Institute on Addictions at the University at Buffalo, N.Y. (Welte, Barnes, Tidwell, & Hoffman, 2010). The study is primarily about patterns of gambling behavior across the lifespan compared to patterns of alcohol use and other potentially problematic behaviors, but the researchers also report findings that compare gambling and alcohol problems in the general population. These differences have caused some confusion on the issue.
The researchers state that “after age 21 problem gambling is considerably more common than alcohol dependence” (Welte et al., 2010, p. 57). At first, this statement seems to be at odds with previously published research. It is generally accepted that the rate of alcohol dependence is about double that of pathological gambling (Keyes, Geier, Grant, & Hasin, 2009; Stucki & Rihs-Middel, 2007).
However, a look at the definitions the researchers use explains the apparent discrepancy. The “problem gambling” they refer to is defined as anyone who endorses three or more items on the Diagnostic Interview Schedule (DIS) for the DSM-IV,the handbook for psychiatric disorder in the United States (American Psychiatric Association, 1994). This is a standard way to define problem gambling, a less severe form of the disorder, with pathological gambling being defined as endorsing “five or more criteria,” as the researchers state in the methods section of the paper (Welte et al., 2010, p. 53). The researchers found this broadest definition of problem and pathological gambling to be between 3 and 5 percent for people ages 22 to 60. This is in line with previous research on the subject.
The confusion comes from comparing this broadest definition of disordered gambling with a narrow definition of alcohol disorders. Like gambling disorders, alcohol use disorders are categorized by severity. Alcohol abuse is the less severe disorder while alcohol dependence is the most severe, and the two together are called alcohol use disorders. One of the largest studies of alcohol use disorders is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (Hasin, Stinson, Ogburn, & Grant, 2007). The NESARC is a nationally representative survey consisting of face-to-face interviews with more than 43,000 Americans. The NESARC found that people ages 30 to 44 suffered from alcohol abuse at 6 percent and alcohol dependence at 3.8 percent, for a total alcohol use disorder rate of 9.7 percent. When the rate of 9.7 percent is compared with the combined rate of problem and pathological gambling in the Welte et al. study, about 4.5 percent, we find that alcohol use disorders are about double gambling disorders. Note that Welte et al. divided their age groups differently, so this analysis combines the 31-40 and 41-50 groups.
The researchers at the University of Buffalo did not discuss the discrepancies in definitions in their study. However, their larger discussion of alcohol use and gambling across the lifespan is an interesting one that certainly deserves more in-depth study.
More information about the University of Buffalo study is available on the Journal of Gambling Studies website. As always, we welcome your thoughts and questions in the Comments section below.
References
American Psychiatric Association. (1994). DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.
Hasin, D. S., Stinson, F. S., Ogburn, E., & Grant, B. F. (2007). Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 64(7), 830-842. doi:10.1001/archpsyc.64.7.830
Keyes, K. M., Geier, T., Grant, B. F., & Hasin, D. S. (2009). Influence of a drinking quantity and frequency measure on the prevalence and demographic correlates of DSM-IV alcohol dependence. Alcoholism, Clinical and Experimental Research, 33(5), 761-771. doi:10.1111/j.1530-0277.2009.00894.x
Stucki, S., & Rihs-Middel, M. (2007). Prevalence of Adult Problem and Pathological Gambling between 2000 and 2005: An Update. Journal of Gambling Studies / Co-Sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming. doi:10.1007/s10899-006-9031-7
Welte, J. W., Barnes, G. M., Tidwell, M. O., & Hoffman, J. H. (2010). Gambling and Problem Gambling Across the Lifespan. Journal of Gambling Studies / Co-Sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming. doi:10.1007/s10899-010-9195-z
