Gambling problems rarely occur in isolation. One of the most consistent findings in addiction research is how often gambling and substance use — especially alcohol — occur together. The two share underlying brain mechanisms, reinforce each other in the moment, and complicate recovery when they are not treated together. Understanding the link is important for anyone gambling regularly, and essential for effective treatment.
How Often They Occur Together
Studies of people in treatment for gambling disorder find strikingly high rates of co-occurring substance use. The figures vary by population and how problems are measured, but the pattern is unmistakable.
| Co-occurring condition | Approximate rate among people with gambling disorder | How it compares |
|---|---|---|
| Any substance use disorder | Roughly half or more in clinical samples | Far above the general population |
| Alcohol use disorder | Estimates commonly around 60–70% in clinical studies | Several times the population rate |
| Any co-occurring mental health or addiction condition | A large majority | Co-occurrence is the norm, not the exception |
These figures come from clinical and research samples and are higher than in the general population, but the direction is clear: where there is problem gambling, substance use is very often present too.
Why They Reinforce Each Other
- Shared brain pathways. Both gambling and substances act on the same dopamine-driven reward system, so a person vulnerable to one is often vulnerable to the other.
- Disinhibition. Alcohol lowers impulse control and impairs judgement, leading to longer sessions and larger bets than intended.
- Shared settings. Casinos and many gambling venues serve alcohol, deliberately pairing the two activities.
- Coping cycles. Each can be used to manage the stress or low mood the other creates, deepening both.
The Combined Risk
When gambling and substance use occur together, outcomes tend to be worse: greater financial and health harm, higher rates of depression and anxiety, and an elevated risk of self-harm. The combination also makes each problem harder to treat if only one is addressed. This is why clinicians screen for both.
What to Do: Treat Both Together
Because the two are so intertwined, the most effective approach addresses them at the same time rather than one after the other. Cognitive behavioural therapy and other addiction treatments can target both, and Canadian services such as ConnexOntario (1-866-531-2600) cover gambling, alcohol, and drugs through a single point of contact. If you drink while gambling, a simple first step is to separate the two — a change that alone can reduce harm.
Related reading: gambling and mental health and how gambling affects the brain.
Sources and Further Reading
The information on this page draws on Canadian public-health, clinical, and regulatory sources. For the underlying research and official guidance, see:
- Gambling disorder comorbidity: a narrative review (peer-reviewed, 2025).
- PLOS One — Problem gambling and comorbid substance use and health conditions.
- Centre for Addiction and Mental Health (CAMH) — Canada’s largest mental health teaching hospital.
- Statistics Canada — Who gambles and who experiences gambling problems in Canada (Health Reports, 2022).
If Gambling Is Causing Harm, Help Is Available in Canada
Support is free, confidential, and available across the country. If you or someone close to you is struggling, you don’t have to wait until things reach a crisis point.
- ConnexOntario — free, confidential help for gambling, alcohol, drugs, and mental health, 24/7 at 1-866-531-2600.
- 9-8-8 Suicide Crisis Helpline — call or text 9-8-8 any time if you or someone you know is in distress.
- Responsible Gambling Council — a Canadian non-profit with tools, self-assessments, and provincial resources.
- Read more across our guides, starting with the Responsible Gambling in Canada hub.