Gambling Addiction, Lottery and Betting: Signs, Effects and Treatment

Written by the medical team at Day One Rehabilitation Center, Nakhon Nayok, Thailand · Medically reviewed by Dr. Pichayut Kasemphakdeephong (Psychiatrist)

Gambling isn’t limited to casinos or betting tables — it also includes online gambling, sports betting, baccarat, slots, underground lottery, online lottery, and the lottery itself. When playing starts to feel out of control — needing to raise the stakes, trying to stop multiple times but going back, or spending more money hoping to win back what was lost — this behavior can develop into gambling disorder, a behavioral addiction that can affect the brain, emotions, finances, work, and family relationships.

Gambling problems tend to be noticed later than substance addiction, because there’s no intoxication or physical residue for family members to spot. Some people can still work and function normally day to day, yet start borrowing money, hiding expenses, juggling funds from multiple sources, or spending large amounts of time thinking about what to play, what numbers might come up next, or where to find money to keep playing.

With the lottery in particular, buying a ticket now and then doesn’t mean everyone will develop a gambling disorder. But once someone starts buying beyond their means, loses control, keeps increasing the amount, or believes they must keep playing to win back what they lost, it’s time to start evaluating the problem. Treatment therefore isn’t just about banning play — it has to address the cravings, the thoughts around gambling, access to money, triggers, debt, and any underlying co-occurring psychiatric conditions.

How to recognize a gambling, lottery, or betting problem

Gambling stimulates the brain’s reward system. The excitement isn’t limited to winning — the anticipation while waiting for a result, or a near-miss, can also make someone want to keep playing. When this happens repeatedly, gambling can gradually take up a bigger role in a person’s thoughts and daily life.

Signs to watch for include

• Thinking about gambling, lottery numbers, or prizes so often it disrupts daily life

• Needing to increase the bet amount to feel the same level of excitement

• Intending to play only a little but spending more than planned

• Trying to cut back or stop multiple times without success

• Feeling irritable, restless, or upset when not gambling

• Gambling when stressed, sad, lonely, or facing problems

• Rushing back to gamble after a loss, hoping to win the money back

• Hiding or lying to family about how much money is being spent

• Borrowing money, taking out loans, or asking family to help pay off debt

• School, work, or relationships being affected by gambling

A particularly important sign is chasing losses — for example, losing 5,000 baht today and thinking that betting another 10,000 baht might win it all back. This thinking can cause losses to spiral quickly, because the next round of play has no obligation to return what was lost in the last one.

Why the lottery can also cause a gambling problem

The term “gambling addiction” may make many people think only of casinos or online betting, but the form of gambling isn’t the only thing that matters. What matters most is the ability to control the behavior and the impact it has.

For example, one person might buy a lottery ticket occasionally with a fixed amount of money and experience no impact on their life, while another might buy tickets every draw through several channels, increase the amount after losing, borrow money to buy tickets, or spend hours searching for numbers and thinking about the next draw.

Some people start with small amounts, but after winning once, may start thinking, “If I won that time, I should win again next time.” Or after losing several times in a row, they might think, “This draw, I have to win it back.”

Another common thought is believing they’ve started to see a pattern in the results — for example, thinking a number that hasn’t come up in a long time is “due to come up,” or a number that’s been missing for several draws “has to appear soon,” even though past results don’t guarantee the next outcome.

So families don’t need to argue over whether the lottery “really counts as gambling.” What matters is whether the behavior has started to take control of that person’s life, finances, and emotions.

The impact of gambling addiction isn’t only financial

Debt is the impact families tend to notice most clearly, but gambling disorder can affect several areas of life at once.

Financially, it may start with shrinking savings before progressing to borrowing money, using credit cards, taking out multiple loans, selling assets, or asking family to help pay off debt. Some families end up in a cycle of “debt happens, the family pays it off, the person gambles again,” creating new debt over and over.

In relationships, the problem often isn’t about money alone but about the secrecy and eroding trust that come with it — saying they’ll quit but going back to gambling, hiding the extent of debt, having accounts or sources of money the family doesn’t know about, or borrowing money without saying it will be used for gambling.

Mentally, people with a gambling problem may experience stress, anxiety, depression, irritability, insomnia, or a sense of hopelessness as debt grows. Co-occurring conditions such as depression, bipolar disorder, ADHD, and problems with alcohol or other substances are also common, so mental health should be evaluated alongside the gambling behavior.

If someone with a gambling problem shows thoughts or behaviors of self-harm, severe hopelessness, or an inability to control dangerous behavior, they should receive a medical evaluation as soon as possible.

How is gambling, lottery, and betting addiction treated?

Gambling addiction has no substance that needs to be detoxed from the body the way alcohol or heroin does, but after stopping, a person may still feel strong urges to gamble, irritability, restlessness, boredom, or repeated thoughts about playing again. Treatment therefore focuses on managing the cycle of thoughts, emotions, cravings, and triggers that lead to gambling.

Cognitive behavioral therapy

Cognitive behavioral therapy, or CBT, is a key approach to treating gambling problems because it helps the person in treatment recognize the thoughts that push them to keep playing, such as

“I’ve already lost so much, I have to win it back.”

“I almost won — next time the odds are better.”

“Today’s my lucky day.”

“If I just increase my bet once, I might be able to clear all my debt.”

The person in treatment then practices examining these thoughts and reframing them to be more consistent with reality, such as

“Money I’ve already lost can’t be won back by playing more. Increasing the bet could just add to the debt.”

“A near-miss doesn’t increase my odds next time. Each outcome doesn’t depend on the one before it.”

“Feeling like today’s my lucky day isn’t proof that I’ll win, and I don’t need to decide anything while I’m this excited.”

“Increasing my bet doesn’t guarantee I’ll clear my debt. A safer choice is to stop playing and make a debt plan that doesn’t rely on gambling.”

Therapy doesn’t just tell someone these thoughts are wrong — it helps them learn to notice their thoughts, check them against reality, and build new ways of responding before deciding to gamble again.

Building motivation for change

Many people with gambling problems have a part of themselves that wants to stop and a part that still wants to keep playing, because they hope to win their money back or still feel they’re in control.

Motivational conversations help the person in treatment explore, in their own words, what gambling gives them and, at the same time, what it’s taking away from their life — money, trust, relationships, sleep, or peace of mind.

The goal isn’t to force someone to accept that they “are a gambling addict,” but to help them see the gap between the life they’re currently living and the life they want.

Limiting access to money and gambling channels

For gambling, controlling the environment matters a great deal, because cash, bank accounts, credit cards, phones, apps, and gambling websites can all become triggers and pathways back to gambling.

In the early stages of treatment, it may be necessary to set up a financial system together with the family — for example, limiting accessible funds, separating money for essential expenses, avoiding taking on more loans, and reducing access to gambling channels.

However, controlling money alone isn’t the whole treatment. If the cravings, thoughts, and underlying problems driving the gambling haven’t been addressed, the person may return to gambling once they regain financial freedom.

Is there medication to treat gambling addiction?

Currently, psychological therapy and behavioral change remain the core of treating gambling disorder, and there is still no single medication that can treat every person with a gambling addiction. However, some medications are supported by research as potentially helping reduce cravings and urges to gamble in certain patients, particularly naltrexone, which a psychiatrist may consider using based on what’s appropriate for each individual.

Naltrexone is a medication that works on the opioid system and the brain’s reward system, so it may help reduce cravings, excitement, or the urge to return to gambling. However, treatment results vary from person to person, and this medication should not be bought and taken without supervision, because it requires evaluating contraindications, liver function, other medications being taken, and any history of opioid painkiller use before starting.

Beyond medications that may directly reduce urges, a psychiatrist may also treat co-occurring conditions such as depression, anxiety disorder, obsessive-compulsive disorder, bipolar disorder, ADHD, or substance use problems, because when mood, stress, or preoccupying thoughts are better managed, patients may indirectly gain better control over their urges and behavior.

However, medication should not replace cognitive behavioral therapy, motivational work, limiting access to money and gambling channels, or managing debt. Choosing to use medication should be done together with an evaluation by a psychiatrist and a treatment plan suited to each person’s problem.

How to prevent relapse into gambling

Relapse into gambling usually doesn’t begin the moment someone opens a website or buys a lottery ticket — there are thoughts and triggers that come first.

Common triggers include

• Payday, or a lump sum of money arriving in an account

• Stress from work or family

• Debt and thoughts of wanting to find a lump sum to clear it

• Seeing advertisements or gambling results

• Conversations about lucky numbers or match results

• Friends inviting them to play

• Boredom or loneliness

• Drinking alcohol

• Regaining easy access to a bank account or credit line

• The thought, “It’s been so long since I quit, playing just a little won’t hurt”

A relapse prevention plan should therefore cover managing money, closing off gambling channels, managing cravings, changing daily routines, and planning who to contact when the urge to gamble returns.

If a relapse does happen, it shouldn’t be seen right away as a treatment failure — instead, the cycle should be stopped as quickly as possible, and what triggered it should be assessed, in order to refine the prevention plan.

What to do when a family member has a gambling problem but won’t admit it

Families often start the conversation after discovering debt or catching the person hiding something, which means the conversation tends to happen when everyone’s emotions are running high. Starting with phrases like “Why can’t you just stop,” “How much have you lost already,” or “If you gamble again, I won’t help you anymore” may make the other person become defensive and share even less.

It helps to start from observable effects instead, such as: “Over the past three months you’ve had to borrow money several times, and I can see you’re more stressed about debt. I’d like us to look together at how much gambling is affecting your life.”

You might ask, “When you started playing, how much did you plan to spend, and how much are you actually spending now?” “If you stopped gambling for a month, what part do you think would be hardest?” or “If you didn’t have to win back what you lost through gambling, what would you want your life to look like?”

Another important point: families shouldn’t rush to pay off debt every time without a shared plan, because even when it’s done out of a wish to help, if the person quickly regains money or credit to gamble with again, the same cycle can repeat. Resolving debt should therefore go hand in hand with treatment and setting up a financial system.

If the person with the problem isn’t ready for treatment yet, the family can consult a specialist first, to assess the severity, set boundaries around money, and prepare ways to talk about it without waiting for a new pile of debt to build up.

Treating gambling disorder at Day One Rehabilitation Center

Residential treatment may suit people with severe gambling problems — repeated relapse, heavy debt and family conflict, an inability to stop accessing gambling in their current environment, or co-occurring substance use and psychiatric conditions that need to be addressed at the same time.

Day One Rehabilitation Center will assess the pattern of gambling, frequency, amounts of money, the impact of debt, triggers, thoughts related to gambling, use of alcohol or other substances, and mental health, in order to plan treatment suited to each individual’s problem.

Being in a structured environment helps the person in treatment break the cycle of accessing gambling in the early stages, while receiving individual and group therapy, practicing craving management, reworking thoughts about winning money back, and building routines that aren’t tied to gambling.

If depression, anxiety, bipolar disorder, ADHD, sleep problems, or co-occurring substance use are present, a psychiatrist can assess and plan treatment for these alongside the gambling problem, because the goal isn’t just to stop gambling while inside the center, but to reduce the factors that lead to relapse once the person returns to everyday life.

That said, not everyone with a gambling problem needs residential treatment. Those who can still control their environment, don’t have complex co-occurring problems, and are suited to outpatient care can start with an evaluation by a psychiatrist and psychotherapist.

For those based in Bangkok, outpatient evaluation is available at Piti Clinic, our outpatient mental-health clinic in Bangkok (Pradiphat Road, Saphan Khwai), to assess gambling problems, mental health, and plan treatment without needing to stay at the center.

Frequently asked questions about gambling, lottery, and betting addiction

Does buying lottery tickets every draw count as a gambling addiction?

Frequency alone can’t decide it. What matters is whether the person can still control the money and the behavior. If someone buys beyond their means, keeps increasing the amount, hides it from family, has tried to stop but can’t, or has fallen into debt, they should be evaluated.

Is being addicted to the lottery the same as being addicted to online gambling?

The format is different, but the same gambling problem can develop either way. What matters is the level of control, the preoccupation, chasing losses, and the impact on life — not the name of the game being played.

Why do people who lose at gambling still want to play again to win it back?

Because the player may believe the money they lost can be recovered with the next bet, so they increase the stake or play more often. This is called chasing losses, and it’s a key warning sign of a gambling problem.

Does gambling addiction cause withdrawal symptoms?

There’s no physical withdrawal the way there is with alcohol or heroin. But when someone tries to stop, they may feel strong urges to play, irritability, restlessness, boredom, or repeated thoughts about gambling — all of which need to be addressed during treatment.

Is there medication to treat gambling addiction?

There is no single medication that serves as the main treatment for everyone with a gambling problem. Cognitive behavioral therapy, motivational work, limiting access to gambling, and managing money are the core components. A psychiatrist may prescribe medication when there is a co-occurring psychiatric condition, or consider certain medications for suitable patients.

Should the family pay off gambling debts?

Helping pay off debt without a plan to control finances and treat the gambling behavior can allow the same cycle to repeat. The debt should be assessed, boundaries set around access to money, and the gambling problem addressed at the same time.

Does gambling addiction require going into a treatment center?

Not for everyone. People with less complex symptoms may be treated as outpatients with a psychiatrist and psychotherapist. But if relapse is severe and repeated, access to gambling can’t be controlled, there is co-occurring substance use or a psychiatric condition, or the person needs to leave their current environment, residential treatment may be more suitable.

Gambling addiction can be treated — no need to wait until debt runs out of options

Families don’t need to wait until they discover a massive debt, a lost job, or severely damaged relationships before seeking help. If you start to notice someone close to you preoccupied with gambling, increasing their bets, chasing losses, hiding money matters, or trying to stop repeatedly only to go back to gambling, it’s time to start evaluating the problem early.

Treating gambling disorder isn’t simply about confiscating a phone, closing an account, or telling someone to have more discipline. It requires helping the person in treatment understand the cycle of thoughts and cravings, reduce exposure to triggers, organize their finances, treat related mental health conditions, and build new ways of coping with stress or the urge to gamble again.

Even after losing a large amount of money, what matters most isn’t trying to gamble again to win it all back, but stopping the damage from growing further and beginning a systematic recovery — mentally, financially, and relationally.