Dr. James Sherer joins us to break down the sharp rise in gambling addiction fueled by online platforms and sports betting. From the mental health fallout to the addictive design of gambling apps, he unpacks what’s driving this crisis—and what can be done to stop it. Hear about the brain science behind the behavior, its impact on relationships, and where people can turn for real help.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:07):
I need to send it to myself real quick.
(00:48):
While you're just getting set up, I'm just thinking about how you guys have a newpresident and a new CEO, right?
At this point, you have a new CEO.
Okay.
Gotcha.
Okay.
(01:10):
Yeah, he's great.
Yeah, he's wrapping it up in May.
And then it's Tramisa Miskim in Rivera.
Yeah.
Gotcha, okay.
Okay, I'm ready.
Are you guys ready?
Mm-hmm.
(01:33):
Welcome to Mental Health Pathfinders.
As March Madness fuels a surge in sports betting, the growing accessibility of gamblingthrough websites and apps is driving a rise in addiction.
We'll discuss this issue with our guest today, Dr.
James Shearer, Deputy Chief Medical Officer at Carrier Clinic, which is part of theHackensack Meridian Health Network, and Chief Clinical Officer at Nostos.Health, offering
(01:58):
online group-based treatment for tech addictions.
Dr.
Shearer served on the APA's Presidential Working Group
on confronting addiction from prevention to recovery under past president Petros Lavounis.
Dr.
Shearer, thanks so much for joining us today.
Really appreciate it.
Thank you so much for having me, Aaron.
It's a thrill to be here.
Right, we can jump right into it because gambling apps and these online games, they areeverywhere right now.
(02:23):
You see them on commercials and on social media ads.
It seems like rewards or these constant notifications make it harder for people to stop.
How can this affect their mental health in the long run?
Well, I'll give you a really concrete example to start.
You know, I've run intensive outpatient programs in the past that have focused on helpingpeople with both substance use or addiction issues and mental health issues.
(02:47):
And one really troubling thing that I've noticed in the past couple months or years isthat some of the patients who are coming to these programs to get really intensive
treatment, you know, group for multiple hours a day, they're finding it difficult to focuson the treatment that they're getting because they're actually on their phones in groups
or while talking with their individual providers and gambling and betting.
(03:10):
And it's so addictive that even when they know that they might even be, you know, payingto receive a high level of mental health care treatment, they can't seem to put these
things down.
And so that's kind of an example.
That's a microcosm of the problem, you know, writ large.
If you can't put the gambling app down to focus when you are getting treatment, how areyou going to put the gambling app down when you're
(03:35):
supposed to be focusing on spending time with your family or at your job or doing any ofthe other things that we need to do.
These things have a way of kind of invading your normal life and really throwing thingsoff balance.
And I would think the other end of this too, I guess a lot of people feel incrediblystressed and anxious when they're losing money and they feel pressure to keep playing.
(03:56):
yeah, chasing losses is a big problem when it comes to gambling addictions of any kind,whether it's old school gambling in a casino, gambling on an app, maybe even gambling as
part of a video game like, like Roblox or Overwatch where there's loot boxes.
You know, people feel the need to throw good money after bad.
And it leads to people very quickly being in very large holes that they can't get out of,which then of course leads to despair and worsening of underlying chronic mental health
(04:25):
symptoms.
And since they're so focused on these apps, do you have concerns that they're kind ofputting their real life connections to the side, maybe sometimes even feeling lonely?
yeah, definitely.
That's actually one of the major symptoms of gambling disorder as outlined in the DSM iskind of, you know, failing to fulfill major role obligations.
(04:45):
As I mentioned before, you're not being the best father or mother that you could be.
You're not being the best employee that you could be.
You are not saving for retirement.
You are not, you know, watching out for yourself.
You're really kind of putting everything that you have financially, but also with regardsto your attention and emotional energy into these
apps and you kind of ride that wave of, you know, small wins if you have any, and thenusually much larger losses emotionally as well.
(05:16):
And that kind of follows you into your day.
I've had patients tell me, you know, after major losses that they feel that, you know, forweeks or months, and they're not able to enjoy things like one of their children's
recitals, for example, or a sporting event that they've been looking forward to or aconcert that they saved up for.
you know, those losses kind of taint their ability to enjoy life otherwise.
(05:39):
Yeah, people also talk about kind of getting a high from winning, you know, when they'reon these apps.
How does that work?
And it must make it harder to step away from them when they are in that zone.
yeah.
Yeah, I mean, these things are still coming into focus, but what we suspect is thatneurobiologically, neurochemically, the pathways involved in gambling are similar to those
(06:02):
involved in other substance use disorders.
And that is to say that there's a quote unquote final common pathway, which is mediated bydopamine.
And that pathway is old.
It's in a deep part of the brain.
And when you win, you get a spike in that dopamine pathway.
analogous to that which you might receive if you were to eat a really good meal or havesex or do some sort of illicit substance.
(06:29):
The neurobiological pathways that are involved are similar.
Because they're similar, those pathways can be hijacked by gambling the same way thatthose pathways can be hijacked by something like alcohol or opioids or so on and so forth.
And it becomes this thing that's hard to break.
The more you do it, the more it of gets entrenched in your brain and the harder it is todisrupt that.
(06:55):
It gets to the point where people really need an intensive level of treatment to try toget through that and normalize their life again.
Is there any documented effect on sleep caused by these kind of using these kind of apps?
That's a really good question.
You know, to be quite frank, I'm not sure off the top of my head.
I'm sure there is.
(07:15):
And just from my personal clinical experience, yes, because much like video games, muchlike social media, you know, these are things that are available 24 seven.
These are things that we find ourselves reaching for 24 seven.
We were all familiar with that phantom buzz sensation where you feel something buzzing inyour pocket.
(07:36):
You reach down, there's nothing there.
Maybe your phone is on the table.
that doesn't stop when you go to bed.
So whether it's social media addiction or gambling or video game addiction or online pornaddiction or what have you, I have patients that are reaching for their phones, reaching
for their tablets, reaching for their laptops way into the night, completely disruptstheir sleep schedule.
Now as to what that is exactly doing on like a scientific level, what segments of thesleep cycle are disrupted, I'm not sure offhand, but I'm sure that research is out there.
(08:08):
And I'm sure the financial end of this puts people in desperate situations often.
Do you often worry about your patients harming themselves?
yes, definitely.
I can give you a recent example of a patient I saw who came into the hospital experiencingsuicidal ideation with a plan after losing $100,000 on a single bet on a gambling app.
(08:29):
And this is someone who was a father who was able to hold down a job.
He actually worked in investment banking, very successful at his career and his lifeotherwise.
And even when it came to kind of gambling in the market, so to speak, he was very prudentand very cautious.
But when it came to gambling on apps, on, you know, betting on sports, that caution waskind of thrown to the wind.
(08:55):
And he was shocked that he lost a hundred thousand dollars in a single bet in a singleday.
And that required him to come into the hospital, receive emergency treatment, andeventually become hospitalized for a psychiatric reason.
That patient, you know, these are,
These are stories with happy endings.
That patient is doing much better now.
But, you know, it's really easy to kind of blink and then realize that you've lost maybemore money than you have.
(09:23):
And that's a great segue to talk about prevention and ways to get support.
What can help people who are struggling with gambling or gaming addiction or what some ofthe tools and resources that you have for some of these patients?
Sure.
So I think the most common one and probably the best place for most people to start isGambler's Anonymous.
Gambler's Anonymous is analogous to Alcoholics Anonymous or Narcotics Anonymous in thatit's a peer-led system with groups all across the country that allow people to kind of
(09:55):
approach healing through the lens of camaraderie in a non-judgmental kind of place, alongwith
accessing Gambler's Anonymous, a really great resource can be calling the Gambler'sHotline and putting yourself on a block list, you know, disallowing yourself from going to
(10:15):
casinos in a certain state, or perhaps even disallowing yourself from accessing gamblingapps.
If you're younger or, so for example, if your parents are willing to do this, or if maybeyou are in a relationship and your significant other is willing to do this, you can also
ask them to activate the parental controls on your phone.
and prevent you from accessing these applications.
(10:39):
If you've tried all that and that doesn't seem to be working, that's really when youshould be seeking the counsel of someone who's professionally, has professional experience
treating this.
That can be an addiction psychiatrist who can help you with maybe medications or specifictypes of therapies to address these underlying concerns.
(11:01):
or a higher level of group-based care, such as an intensive outpatient program, or evenonline professionally-led groups like we offer at no-stose.health to help you get through
some of the toughest parts of getting through this.
James Scherer.
We really appreciate you being here today.
Very timely information for everyone.
(11:23):
Thank you so much, I really appreciate the opportunity.
And to our listeners, can find more episodes like this on a range of mental health topicson APA's Medical Mind Channel, available on all major podcasting platforms.
I need to send it to myself real quick.
(00:48):
While you're just getting set up, I'm just thinking about how you guys have a newpresident and a new CEO, right?
At this point, you have a new CEO.
Okay.
Gotcha.
Okay.
(01:10):
Yeah, he's great.
Yeah, he's wrapping it up in May.
And then it's Tramisa Miskim in Rivera.
Yeah.
Gotcha, okay.
Okay, I'm ready.
Are you guys ready?
Mm-hmm.
(01:33):
Welcome to Mental Health Pathfinders.
As March Madness fuels a surge in sports betting, the growing accessibility of gamblingthrough websites and apps is driving a rise in addiction.
We'll discuss this issue with our guest today, Dr.
James Shearer, Deputy Chief Medical Officer at Carrier Clinic, which is part of theHackensack Meridian Health Network, and Chief Clinical Officer at Nostos.Health, offering
(01:58):
online group-based treatment for tech addictions.
Dr.
Shearer served on the APA's Presidential Working Group
on confronting addiction from prevention to recovery under past president Petros Lavounis.
Dr.
Shearer, thanks so much for joining us today.
Really appreciate it.
Thank you so much for having me, Aaron.
It's a thrill to be here.
Right, we can jump right into it because gambling apps and these online games, they areeverywhere right now.
(02:23):
You see them on commercials and on social media ads.
It seems like rewards or these constant notifications make it harder for people to stop.
How can this affect their mental health in the long run?
Well, I'll give you a really concrete example to start.
You know, I've run intensive outpatient programs in the past that have focused on helpingpeople with both substance use or addiction issues and mental health issues.
(02:47):
And one really troubling thing that I've noticed in the past couple months or years isthat some of the patients who are coming to these programs to get really intensive
treatment, you know, group for multiple hours a day, they're finding it difficult to focuson the treatment that they're getting because they're actually on their phones in groups
or while talking with their individual providers and gambling and betting.
(03:10):
And it's so addictive that even when they know that they might even be, you know, payingto receive a high level of mental health care treatment, they can't seem to put these
things down.
And so that's kind of an example.
That's a microcosm of the problem, you know, writ large.
If you can't put the gambling app down to focus when you are getting treatment, how areyou going to put the gambling app down when you're
(03:35):
supposed to be focusing on spending time with your family or at your job or doing any ofthe other things that we need to do.
These things have a way of kind of invading your normal life and really throwing thingsoff balance.
And I would think the other end of this too, I guess a lot of people feel incrediblystressed and anxious when they're losing money and they feel pressure to keep playing.
(03:56):
yeah, chasing losses is a big problem when it comes to gambling addictions of any kind,whether it's old school gambling in a casino, gambling on an app, maybe even gambling as
part of a video game like, like Roblox or Overwatch where there's loot boxes.
You know, people feel the need to throw good money after bad.
And it leads to people very quickly being in very large holes that they can't get out of,which then of course leads to despair and worsening of underlying chronic mental health
(04:25):
symptoms.
And since they're so focused on these apps, do you have concerns that they're kind ofputting their real life connections to the side, maybe sometimes even feeling lonely?
yeah, definitely.
That's actually one of the major symptoms of gambling disorder as outlined in the DSM iskind of, you know, failing to fulfill major role obligations.
(04:45):
As I mentioned before, you're not being the best father or mother that you could be.
You're not being the best employee that you could be.
You are not saving for retirement.
You are not, you know, watching out for yourself.
You're really kind of putting everything that you have financially, but also with regardsto your attention and emotional energy into these
apps and you kind of ride that wave of, you know, small wins if you have any, and thenusually much larger losses emotionally as well.
(05:16):
And that kind of follows you into your day.
I've had patients tell me, you know, after major losses that they feel that, you know, forweeks or months, and they're not able to enjoy things like one of their children's
recitals, for example, or a sporting event that they've been looking forward to or aconcert that they saved up for.
you know, those losses kind of taint their ability to enjoy life otherwise.
(05:39):
Yeah, people also talk about kind of getting a high from winning, you know, when they'reon these apps.
How does that work?
And it must make it harder to step away from them when they are in that zone.
yeah.
Yeah, I mean, these things are still coming into focus, but what we suspect is thatneurobiologically, neurochemically, the pathways involved in gambling are similar to those
(06:02):
involved in other substance use disorders.
And that is to say that there's a quote unquote final common pathway, which is mediated bydopamine.
And that pathway is old.
It's in a deep part of the brain.
And when you win, you get a spike in that dopamine pathway.
analogous to that which you might receive if you were to eat a really good meal or havesex or do some sort of illicit substance.
(06:29):
The neurobiological pathways that are involved are similar.
Because they're similar, those pathways can be hijacked by gambling the same way thatthose pathways can be hijacked by something like alcohol or opioids or so on and so forth.
And it becomes this thing that's hard to break.
The more you do it, the more it of gets entrenched in your brain and the harder it is todisrupt that.
(06:55):
It gets to the point where people really need an intensive level of treatment to try toget through that and normalize their life again.
Is there any documented effect on sleep caused by these kind of using these kind of apps?
That's a really good question.
You know, to be quite frank, I'm not sure off the top of my head.
I'm sure there is.
(07:15):
And just from my personal clinical experience, yes, because much like video games, muchlike social media, you know, these are things that are available 24 seven.
These are things that we find ourselves reaching for 24 seven.
We were all familiar with that phantom buzz sensation where you feel something buzzing inyour pocket.
(07:36):
You reach down, there's nothing there.
Maybe your phone is on the table.
that doesn't stop when you go to bed.
So whether it's social media addiction or gambling or video game addiction or online pornaddiction or what have you, I have patients that are reaching for their phones, reaching
for their tablets, reaching for their laptops way into the night, completely disruptstheir sleep schedule.
Now as to what that is exactly doing on like a scientific level, what segments of thesleep cycle are disrupted, I'm not sure offhand, but I'm sure that research is out there.
(08:08):
And I'm sure the financial end of this puts people in desperate situations often.
Do you often worry about your patients harming themselves?
yes, definitely.
I can give you a recent example of a patient I saw who came into the hospital experiencingsuicidal ideation with a plan after losing $100,000 on a single bet on a gambling app.
(08:29):
And this is someone who was a father who was able to hold down a job.
He actually worked in investment banking, very successful at his career and his lifeotherwise.
And even when it came to kind of gambling in the market, so to speak, he was very prudentand very cautious.
But when it came to gambling on apps, on, you know, betting on sports, that caution waskind of thrown to the wind.
(08:55):
And he was shocked that he lost a hundred thousand dollars in a single bet in a singleday.
And that required him to come into the hospital, receive emergency treatment, andeventually become hospitalized for a psychiatric reason.
That patient, you know, these are,
These are stories with happy endings.
That patient is doing much better now.
But, you know, it's really easy to kind of blink and then realize that you've lost maybemore money than you have.
(09:23):
And that's a great segue to talk about prevention and ways to get support.
What can help people who are struggling with gambling or gaming addiction or what some ofthe tools and resources that you have for some of these patients?
Sure.
So I think the most common one and probably the best place for most people to start isGambler's Anonymous.
Gambler's Anonymous is analogous to Alcoholics Anonymous or Narcotics Anonymous in thatit's a peer-led system with groups all across the country that allow people to kind of
(09:55):
approach healing through the lens of camaraderie in a non-judgmental kind of place, alongwith
accessing Gambler's Anonymous, a really great resource can be calling the Gambler'sHotline and putting yourself on a block list, you know, disallowing yourself from going to
(10:15):
casinos in a certain state, or perhaps even disallowing yourself from accessing gamblingapps.
If you're younger or, so for example, if your parents are willing to do this, or if maybeyou are in a relationship and your significant other is willing to do this, you can also
ask them to activate the parental controls on your phone.
and prevent you from accessing these applications.
(10:39):
If you've tried all that and that doesn't seem to be working, that's really when youshould be seeking the counsel of someone who's professionally, has professional experience
treating this.
That can be an addiction psychiatrist who can help you with maybe medications or specifictypes of therapies to address these underlying concerns.
(11:01):
or a higher level of group-based care, such as an intensive outpatient program, or evenonline professionally-led groups like we offer at no-stose.health to help you get through
some of the toughest parts of getting through this.
James Scherer.
We really appreciate you being here today.
Very timely information for everyone.
(11:23):
Thank you so much, I really appreciate the opportunity.
And to our listeners, can find more episodes like this on a range of mental health topicson APA's Medical Mind Channel, available on all major podcasting platforms.
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