Multi-operator Self-exclusion as a Harm Reduction Measure in Problem Gambling: Retrospective Clinical Study on Gambling Relapse Despite Self-exclusion

Anders Håkansson; Gunny Åkesson

doi:10.2196/37837

Multi-operator Self-exclusion as a Harm Reduction Measure in Problem Gambling: Retrospective Clinical Study on Gambling Relapse Despite Self-exclusion

JMIR Ment Health. 2022 Aug 19;9(8):e37837. doi: 10.2196/37837.

Authors

Anders Håkansson^{1

2}, Gunny Åkesson^{1

2}

Affiliations

¹ Clinical Research Unit, Competence Center Addiction, Malmö Addiction Center, Region Skåne, Malmö, Sweden.
² Division of Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.

PMID: 35984678
PMCID: PMC9440409
DOI: 10.2196/37837

Abstract

Background: Voluntary self-exclusion from gambling is a common harm reduction option for individuals with gambling problems. Multi-operator, nationwide self-exclusion services are rare, and a system introduced in the highly web-based gambling market of Sweden is a rare and recent example. However, where web-based casino gambling and web-based betting are the predominate gambling types in those seeking treatment, the risk of breaching one's own self-exclusion through overseas web-based operators may also be high.

Objective: This study aims to assess the prevalence of a nationwide Spelpaus ("gambling break") self-exclusion and the prevalence of gambling despite self-exclusion in patients seeking treatment for gambling disorder in 2021.

Methods: Health care documentation of recent treatment seekers (January 1 through September 1, 2021, N=85) in a Swedish treatment facility was reviewed for data regarding problematic gambling types reported, history of self-exclusion, and history of breaching of that self-exclusion.

Results: Common problem gambling types were web-based casino gambling (49/74, 66%) and sports betting (19/74, 26%). The majority who participated in this study (62/85, 73%) were men. All women reported web-based casino gambling. Self-exclusion through Spelpaus was common (60/74, 81%). Among self-excluders, gambling despite self-exclusion was common (41/60, 68%), most commonly on unlicensed gambling websites.

Conclusions: The nationwide, multi-operator self-exclusion service of Sweden appears to reach many patients with a gambling disorder. However, the remaining gambling options in an web-based gambling setting present a major challenge despite self-exclusion. The recent data calls for further treatment efforts and potential improvements in services aiming to help voluntary self-excluders abstain from gambling.

Keywords: abstain; addiction; behavioral addiction; gambling; gambling disorder; harm reduction; prevalence; problem gambling; self-exclusion; web-based gambling.