An addiction to an altered psychological state

Neither gambling nor its problems are new to human history. Artefacts related to gambling dating from 3000 BC have been identified in the remains of ancient Babylon. Lotteries originated in Europe in the middle ages, and the first lottery to be sponsored by a government was chartered by Queen Elizabeth I of England in 1566.1 Serious gambling problems are described in the classical literature of many cultures, such as the Hindu epic the Mahabharata. The Russian novelist Dostoevsky wrote his 1866 novella The Gambler in a desperate effort to repay his own gambling debts.2 Yet despite the accelerating trend towards the legalisation of many types of wagering worldwide and the awareness that for some people gambling becomes a destructive addiction, little attention has been given to the prevention or treatment of its problems.

Gambling is big business in the United …