If you have ADHD, you may wonder why stopping gambling feels harder than it should.
People with ADHD symptoms are over four times more likely to develop problem gambling than the general population, with 22.2% meeting problem gambling criteria compared to 5.66% overall in a 2025 national study.
This article explains the specific ways ADHD increases gambling risk and what treatment options can help.
What is ADHD and Gambling Disorder?
ADHD is a neurodevelopmental condition marked by patterns of inattention, hyperactivity, and impulsivity that affect daily functioning. The condition persists into adulthood for many people, though symptoms may shift from obvious hyperactivity to internal restlessness and executive function challenges.
Gambling disorder is classified as a behavioral addiction in both DSM-5 and ICD-11. The World Health Organization defines it as persistent gambling behavior characterized by impaired control, increasing priority of gambling over other activities, and continuation despite harmful consequences. The disorder shares neurobiological features with substance use disorders, particularly in reward processing and impulse control systems.
How Common is ADHD and Gambling Together?
The overlap between ADHD and gambling problems appears consistently across clinical and population studies. In one Australian clinical sample, 24.9% of treatment-seeking gamblers screened positive for ADHD, significantly higher than the 14% community benchmark. These individuals showed higher gambling severity, greater motor impulsivity, and more cluster B personality traits.
A 2025 Japanese study of 29,268 adults found that individuals with ADHD symptoms were nearly four times as likely to meet criteria for problem gambling. Importantly, this association held even after accounting for other risk factors, and online casino use emerged as the strongest predictor in both groups.
A systematic review examining neurodevelopmental disorders and gambling found comorbidity rates ranging from 2.4% to 62.55% across 57 studies, with ADHD dominating the literature. The authors noted shared features including impulsivity, emotion dysregulation, and cognitive distortions as common therapeutic targets.
Why Does ADHD Increase Gambling Risk?
ADHD can heighten gambling vulnerability through impulsivity, emotion dysregulation, and cognitive distortions that reinforce risky choices and persistent play:
Impulsivity and Delay Discounting
ADHD involves a core difficulty with impulse control and a preference for immediate rewards over delayed ones. This manifests as steep delay discounting, where the value of future outcomes drops sharply compared to immediate gratification. Gambling offers exactly that immediate reinforcement through rapid play cycles, frequent wins, and constant stimulation.
This impulsive decision-making can lead to chasing losses, where someone continues gambling to recover money immediately rather than walking away. Research shows this pattern distinguishes more severe gamblers and aligns with the impulsive choice profiles common in ADHD.
Emotion Dysregulation
People with ADHD often struggle with managing emotions, especially when distressed. A study of gambling disorder patients found that ADHD symptoms associated with difficulties across multiple emotion regulation domains, including trouble controlling impulses when upset, limited access to effective coping strategies, and poor emotional clarity.
This creates a problematic cycle where negative emotions trigger gambling as a coping mechanism, which in turn generates more stress, shame, and financial strain. The gambling provides temporary escape or excitement but worsens underlying emotional problems.
Cognitive Distortions
Cognitive distortions are inaccurate beliefs that maintain gambling behavior, such as the illusion of control or the gambler’s fallacy. While not everyone with ADHD has high levels of distortions, research using cluster analysis shows that gambling severity peaks when both impulsivity and distorted cognitions are elevated.
A French clinical cohort established a practical threshold on the Gambling Attitudes and Beliefs Scale, with scores of 37 or higher indicating problematic levels of distortions in clinical assessment. This suggests tailored cognitive therapy may benefit some but not all individuals with ADHD and gambling problems.
Online Gambling Poses Unique Risks for ADHD
Digital gambling environments exploit ADHD vulnerabilities in specific ways. The 2025 Japanese study found that all gambling types except lottery mediated the relationship between ADHD symptoms and problem gambling, with bicycle racing and online casinos showing the strongest effects.
Online casinos feature continuous play with minimal delays between bets, 24/7 access from any location, personalized inducements and bonuses, and immersive audiovisual feedback. These design features align perfectly with ADHD-related impulsivity and reward sensitivity, making it difficult to pause or stop.
The WHO emphasizes that gambling can threaten mental health and drive poverty, with harmful gambling generating a disproportionate share of industry revenue. Smartphone-enabled gambling increases exposure, and voluntary “responsible gambling” tools typically show poor uptake and limited effectiveness when not mandatory.
Gambling Subtypes and Where ADHD Fits?
The Pathways Model originally proposed three routes to problem gambling: behaviorally conditioned, emotionally vulnerable, and antisocial-impulsivist. A 2022 revision using latent class analysis confirmed three pathways but removed ADHD symptoms from the discriminating factors, suggesting ADHD functions as a transdiagnostic risk amplifier rather than defining a specific subtype.
Key pathway features:
- Pathway 1 (Behaviorally Conditioned): Driven primarily by reinforcement history and learned patterns; cognitive distortions vary. ADHD-related inattention may facilitate rapid conditioning.
- Pathway 2 (Emotionally Vulnerable): High emotion dysregulation, trauma history, and mood or anxiety disorders; gambling serves coping functions. ADHD emotion dysregulation aligns with this profile.
- Pathway 3 (Antisocial-Impulsivist): Marked by high impulsivity, antisocial traits, risk-taking, and sensation-seeking; lower trauma and mood symptoms. ADHD likely overlaps significantly here.
Understanding which profile fits best helps tailor treatment, though many people show mixed features. The common thread is that ADHD increases vulnerability across all three pathways by intensifying impulsivity, emotion dysregulation, or sensitivity to immediate rewards.
Treatment Approaches That Address Both Conditions
Effective treatment must address both ADHD and gambling disorder simultaneously rather than treating them as separate problems. NICE guidance recommends routine screening for gambling harms in high-risk groups and profile-tailored interventions.
Psychological Therapies
Cognitive-behavioral therapy forms the foundation of gambling treatment. CBT helps identify triggers, challenge distorted beliefs about luck or control, develop alternative coping strategies, and practice response delay when urges arise. For people with ADHD, sessions work best when shortened to 30 to 40 minutes, using visual aids and checklists, and breaking homework into small, immediate tasks.
Motivational interviewing resolves ambivalence about change by exploring personal values and linking gambling reduction to meaningful goals like relationships, education, or financial stability. This approach respects the person’s autonomy while building internal motivation.
Dialectical behavior therapy skills, particularly distress tolerance and emotion regulation modules, help manage the intense feelings that often trigger gambling in people with ADHD. Learning to ride out urges without acting, identify emotions accurately, and use healthy coping strategies reduces reliance on gambling for emotional relief.
ADHD Medication and Integrated Care
Treating ADHD itself can indirectly reduce gambling risk by improving impulse control and executive function. Stimulant medications like methylphenidate and non-stimulants like atomoxetine are standard ADHD treatments. When used as part of integrated care for gambling, they may improve engagement and reduce impulsive responding, though direct effects on gambling urges require monitoring.
Some specialists also consider medications like naltrexone for gambling disorder itself, particularly when psychological therapy alone is not enough. Any medication strategy should pair with behavioral therapy and practical harm reduction tools.
Telehealth and Digital Support
The COVID-19 pandemic accelerated telehealth adoption, revealing benefits for ADHD care including reduced travel barriers, flexible scheduling, and continuity during disruptions. These same advantages apply to gambling treatment, where shame and stigma often prevent people from seeking in-person help.
Digital CBT programs adapted for ADHD can include push notifications for homework reminders, brief video modules, and gamified reinforcement for skill practice. Remote coaching focused on organizational skills and time management reduces the unstructured time that can trigger gambling.
Harm Reduction and Environmental Controls
Practical protective measures include setting deposit and time limits on gambling platforms, using multi-operator self-exclusion programs, installing blocking software on devices, and arranging optional third-party financial oversight. These tools compensate for impulsive choice tendencies by creating friction and delay before gambling can occur.
Clear, personalized limits aligned with lower-risk guidelines give concrete targets. For example, setting a weekly spending cap and automated lockouts after reaching it, or scheduling specific times when gambling apps are blocked.
Prevention: Reducing Exposure and Risk
While treatment helps those already struggling, prevention strategies can reduce new cases, particularly among young people with ADHD. Policies that restrict youth-appealing gambling advertising, enforce robust age verification online and in retail settings, limit gambling venue density near schools, and regulate bonus inducements show promise based on parallel evidence from tobacco and alcohol control.
A 2025 study in Korea found that adolescent suicide rates decreased after stricter youth-targeted alcohol controls, including retail stores posting age restrictions. Though not gambling-specific, the finding suggests visible, enforced age boundaries and reduced availability can prevent serious harms in vulnerable adolescents.
School and campus policies that ban gambling promotions, refuse sponsorships, and integrate screening and referral into student health services normalize help-seeking and reduce exposure to inducements.
Warning Signs and When to Get Help?
You may benefit from professional support if you notice patterns like gambling more often or with higher stakes than intended, repeated unsuccessful attempts to cut back or stop, preoccupation with gambling that interferes with work or relationships, gambling when distressed or to escape problems, or lying to hide gambling activity.
For people with ADHD, additional red flags include impulsively gambling during hyperfocus episodes, using gambling to self-medicate boredom or restlessness, or noticing gambling interferes with ADHD management strategies like medication adherence or routine structure.
Screening tools like the Problem Gambling Severity Index and the Adult ADHD Self-Report Scale can quickly identify risk levels. Many treatment centers now offer bidirectional screening, checking for gambling problems in ADHD clinics and ADHD symptoms in gambling services.
Finding Integrated Support
Recovery works best when treatment addresses both ADHD and gambling within a coordinated care plan. Look for programs that offer ADHD-adapted therapy formats, have experience with dual diagnosis, provide flexible scheduling including telehealth, and integrate medication management with behavioral therapy.
Family involvement often strengthens outcomes, providing supportive monitoring, helping establish boundaries, and reducing isolation. Peer support groups can also normalize the recovery journey and offer practical strategies from others with similar experiences.
If you or someone you care about is struggling with ADHD and gambling, know that effective help exists. Starting with an honest conversation with a primary care provider or reaching out directly to a specialized treatment center can open doors to assessment and personalized treatment planning.
Taking the first step can feel hard, but integrated care makes recovery possible. Connect with our professionals who understand both conditions and can help you build the skills, structure, and support you need. Reach out for Summit’s Gambling Addiction Treatment and we will address your ADHD and addiction together.
