Can Naltrexone Help Problem Gamblers?
Gambling researchers have identified Naltrexone as providing potential benefits to the small group of problem gamblers for whom conventional treatment has not worked. Naltrexone is widely used in the treatment of drug and alcohol addiction.
A 2010 study by Flinders University prepared for the Independent Gambling Authority in South Australia found that a few problem gamblers benefited from naltrexone treatment, particularly those who had previously tried other forms of treatment without success. However, there are a number of challenges, including potential harm to liver and kidneys, and feelings of nausea.
The Victorian-based Problem Gambling Research and Treatment Centre (PGRTC) has recently issued guidelines offering support for using naltrexone to curb gambling cravings for some people. However, they don't recommend it for widespread use. Professor Shane Thomas, director of the PGRTC said:
I think the current evidence is in favour of psychological therapies. We have more and stronger evidence for that. People are often very interested in the use of pharmacological agents for treatment of conditions because they hope it'll be, sort of the golden bullet, you know, that we can take a pill and cure or attend to these problems.
Dr Clive Allcock, a Sydney psychiatrist with extensive experience in treating problem gamblers noted the similarity between problem gambling and other types of addiction, saying the:
same pathways are in place, and naltrexone does affect those pathways and improve people's ability to not respond to urges, cravings and ideas. I think there is a possible role for naltrexone but we need to have wider research with longer time duration before we can be satisfied about that.
Naltrexone is prescribed more frequently in the USA than Australia for problem gambling. One reason may be a greater level of enthusiasm in the USA for prescribing drugs generally. Another reason why few doctors in Australia will be prescribing naltrexone is because it is not approved by the Therapeutic Goods Administration for the treatment of problem gambling.
The Commonwealth's National Drug Strategy at 11.4.3 states that:
As naltrexone has been shown to improve problem gambling, it may be an effective treatment to manage both problem gambling and alcohol consumption.
Naltrexone is approved by the Therapeutic Goods Administration for the treatment of alcohol addiction, so it appears to clear the way for doctors to consider prescribing naltrexone where a patient presents with a combination of alcohol and gambling addictions.
