People who gamble can develop patterns of behavior that closely mimic those found in people addicted to substances such as stimulants, opioid narcotics or sedatives. According to guidelines set forth in 2013 by the American Psychiatric Association (APA), doctors can diagnose this addictive relationship to gambling as a condition called gambling disorder. In a study published in November 2013 in the journal Drug and Alcohol Dependence, a multi-institution research team examined the gender-based connections between problem gambling and the chances of developing substance abuse or addiction. The members of this team found that men and women with gambling problems have unique, gender-specific risks for developing certain types of substance-related issues. Problem Gambling and Gambling Disorder Problem gambling is a loose, unofficial term for gambling-related behaviors that cause personal, interpersonal or social difficulties because they occur frequently or pose a high level of risk for the people who engage in them. Gambling disorder, on the other hand, is a well-defined condition that doctors can diagnose when problem gambling behaviors start to contribute to a clearly dysfunctional lifestyle pattern or clearly damage the mental/psychological well-being of affected individuals. Prior to 2013, this condition was known as pathological gambling; it belonged to a group of mental disorders known as “impulse control disorders not elsewhere classified.” In accordance with the fact that behavioral addictions can have the same basic brain effects as substance addictions, the American Psychiatric Association renamed the condition and included it in a newly defined category called “substance-related and addictive disorders.” Substance Use Disorders Substance use disorders (SUDs) form the bulk of the conditions categorized as substance-related and addictive disorders. People affected by a substance use disorder either abuse a given substance without actually developing a reliance on its chemical impact, or alternately, develop a physical and psychological dependence that forms the basis for classic addiction symptoms such as persistent substance cravings and deeply dysfunctional substance-oriented behaviors. The American Psychiatric Association no longer attempts to differentiate the symptoms of abuse from the symptoms of dependence/addiction. Instead, a person with a substance use disorder may have relatively mild to severe symptoms of either or both of these problems, as long as those symptoms persist for an extended period of time and seriously disrupt that person’s life circumstances or sense of mental equilibrium. There are subtypes of SUD for alcohol and a wide variety of legal and illegal drugs and medications. Gender-Based Differences In the study published in Drug and Alcohol Dependence, researchers from Yale University and the Veterans Administration analyzed the impact of gender on the severity of any given individual’s gambling problems, as well the gender-related impact on that individual’s chances of developing various forms of substance use disorder. To make this analysis, they drew on information gathered from 34,006 adult participants in a large-scale project called the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The presence of gambling disorder (then known as pathological gambling) was detected using standard American Psychiatric Association criteria; the researchers also identified people at risk for developing gambling disorder. In addition, they recorded three-year substance use disorder histories for all of the participants. At the end of their analysis, the researchers found that, compared to people unaffected by gambling disorder or gambling disorder risks, men at risk for the condition or diagnosed with the condition have significantly higher chances of developing alcohol use disorder. They also found that men with gambling disorder, or at risk for the disorder, have substantially reduced chances of developing any substance use disorder related to the intake of prescription medications. In addition, the researchers found that, compared to people free from gambling disorder and gambling disorder risks, women at risk for the disorder or diagnosed with the disorder have significantly higher chances of developing nicotine use disorder. Significance and Considerations The authors of the study published in Drug and Alcohol Dependence believe that their findings demonstrate a need for gender-specific efforts to treat the effects of gambling disorder, as well as gender-specific efforts to prevent the disorder’s onset. Because of the study’s relatively narrow focus, the researchers did not attempt to determine the underlying factors that lead to such different substance-related outcomes in men and women affected by serious gambling problems. They believe that future researchers will need to address these factors before anyone has a full understanding of the connection between gender, problem gambling and substance use disorders.