The nature and social costs of pathological gambling are reviewed. Costs of gambling in terms of indebtedness for the gambler, costs for family members, costs for the workplace, illegal activities, and physical and psychological costs are examined. The interaction of pathological gambling with other disorders, including substance abuse, anxiety, and depression, are noted. Methods of screening pathological gamblers are summarized. Different treatment approaches and their effectiveness are reviewed, including Gamblers Anonymous and Gam-Anon, psychodynamic treatment, behavioral and cognitive approaches, and treatment based on an addiction model. Treatment for spouses is discussed. Gambling expenditure data are then examined to determine what portion of total expenditures is accounted for by problem gamblers.
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