Gambling in the South: Implications for physicians

Three historical cycles of legalized gambling have occurred in the South. C urrently, every southern state has legalized some form of gaming, Adult pas t-year prevalence rates of problem gambling in southern states are within t he national range. Higher prevalence rates occur in states with casinos and multiple forms of legalized gambling. States with lotteries have higher pr evalence rates of adolescent problem gambling. Problem gambling can cause s tress-induced physical diseases and psychiatric symptoms in gamblers and th eir families. Physicians can reduce personal, family, and social costs of p roblem gambling through increased awareness, strategic screening, and early intervention. Treatment approaches include inpatient treatment centers, se lf-help fellowship groups, and cognitive-behavioral and addiction-based psy chotherapies. Although no standard pharmacologic treatments for gambling di sorders exist, use of selective serotonin re-uptake inhibitors is under inv estigation. Referral resources are available to physicians in states with s tate-funded treatment programs for problem gamblers and/or state councils f or problem gambling.