While OMT can be used also for addictive conditions related solely to licit prescription opioid analgesics, OMT in this region traditionally has included mainly patients addicted to heroin or other illicit opioids, and typically with a high degree of severity in their clinical picture. In OMT, patients who fulfil diagnostic criteria of opioid dependence receive daily maintenance treatment with methadone, buprenorphine, or buprenorphine-naloxone, according to the evidence-based principles for the treatment of opioid dependence. The OMT facility, named Solstenen, constitutes a privately owned facility connected to the public insurance system. Patients were included from two types of settings in three cities, which address distinct types of substance use disorders 1) an out-patient facility of the Malmö Addiction Centre (MAC), Sweden, treating substance use disorders related to alcohol or to the misuse of prescription drugs, typically opioid analgesics or sedatives such as benzodiazepines or similar pharmaceuticals, and 2) an out-patient department for opioid maintenance treatment (OMT) located in two units, in Lund and Helsingborg, respectively.

This region has a regional clinical facility for inpatient and outpatient treatment of substance use disorders in the regional capital city of Malmö, and outpatient facilities mainly for opioid maintenance treatment in several other cities, including the second and third largest cities of the region, Lund and Helsingborg. The Skane region has a population of around 1.3 million inhabitants. The study was carried out in 20 in specialized treatment centres for substance use disorders in the Skane region in southern Sweden. The present study is based on self-report data on lifetime history of problem gambling in patients treated in specialized substance use disorder treatment. For these reasons, the present study aimed to address the prevalence of lifetime problem gambling in two specialized substance use disorder treatment facilities, treating alcohol and prescription drug use disorders, and opioid dependence, respectively. The relationship between problem gambling and substance use disorder calls for active screening for problematic gambling behaviours in patients treated for substance use disorders, but this issue also calls for research addressing problem gambling across specific substance use disorder groups. In the review summarizing prevalence rates of problem gambling in substance-using populations, patients in opioid maintenance treatment (OMT) for opioid dependence tended to demonstrate somewhat higher rates of problem gambling, including the highest prevalence of lifetime problem gambling of 53 percent in a waiting room survey addressing a convenience sample of methadone-treated patients. Also, in the study by Cunningham-Williams and co-workers, illicit drug use, in contrast to alcohol, was a risk factor of problem gambling within a sample of substance users. Langenbucher demonstrated a larger difference in drug dependence symptoms between problem gamblers and non-problem gamblers than for alcohol dependence symptoms between these groups, and it has been suggested that polydrug use may be more common in substance users with problem gambling than among non-problem gamblers in this group. ĭespite an overall knowledge of an increased risk of problem gambling in patients with substance use disorders, few studies have specifically addressed differences in problem gambling prevalence across substance types. In a more recent study from a methadone maintenance facility, as many as 46 percent of patients fulfilled criteria of past-year gambling disorder. constantly well above prevalence rates reported from the general population. Across types of substance use disorders and across study methodologies, in a review paper from 2014, the prevalence of problem gambling ranged from less than 10 percent to around 50 percent, i.e. Likewise, an increased prevalence of problem gambling has been demonstrated in samples of substance use disorder patients a review and meta-analysis by Cowlishaw and co-workers demonstrated comorbidity with pathological gambling or the wider concept of problem gambling in 14 and 23 percent of substance users, respectively. In patients diagnosed with pathological gambling, substance use disorders have been described to represent some of the most prevalent co-morbidities a meta-analysis reported that 21 percent and seven percent of pathological gambling patients may meet criteria of a current alcohol use disorder and drug use disorder, respectively. The link between disordered gambling and substance use disorders, as defined in diagnostic systems such as in the DSM-5 or preceding diagnostic manuals, is well established in the literature.

Prevalence of pathological gambling