Chronic pain and physical illness change more than the body — they reshape mood, routine, and the way people cope with everyday life. For some Australians living with long-term conditions, gambling can quietly become a form of pain relief — a way to escape physical discomfort, fear, or boredom.
But when gambling becomes a coping mechanism, the overlap between chronic illness and gambling addiction can create a powerful and dangerous cycle. At HARP, we often see this intersection — where the body’s suffering fuels behavioural dependence, and the addiction in turn worsens physical and emotional wellbeing.
The Overlooked Connection
Most people associate gambling harm with financial stress or impulse control — not with physical illness. Yet research increasingly shows a strong link between chronic medical conditions and gambling disorder.
A large cross-sectional study in Finland found that individuals with gambling disorder were twice as likely to have chronic pain, arthritis, or metabolic conditions compared to the general population. Another US-based analysis of veterans reported that those with gambling disorder had significantly higher rates of chronic back pain, migraine, and cardiovascular disease.
Even more strikingly, the National Institutes of Health (NIH) notes that chronic pain alters the same reward and stress circuits in the brain that drive addictive behaviour. When gambling temporarily activates dopamine pathways, it can mimic the same relief mechanisms that painkillers once offered — making it feel emotionally “medicinal”.
Why Chronic Illness Increases Gambling Risk
1. Pain, Fatigue, and Escapism
Living with persistent discomfort changes how people seek pleasure. Gambling — especially electronic gaming machines or online betting — provides fast distraction, sensory stimulation, and a brief escape from physical awareness.
The more severe or unpredictable the pain, the more attractive this mental “timeout” becomes. Unfortunately, the relief fades quickly, while losses and shame increase stress — a known amplifier of pain intensity.
2. Medication and Neurochemistry
Certain medications used to manage Parkinson’s disease, restless legs syndrome, or chronic pain can influence dopamine transmission — occasionally leading to impulse control disorders, including compulsive gambling.
Drugs like dopamine agonists (e.g. pramipexole, ropinirole) and opioids (e.g. oxycodone, morphine) can alter reward sensitivity and decision-making, lowering inhibition. This biological vulnerability, combined with emotional distress, sets the stage for addictive behaviour.
3. Isolation and Reduced Mobility
Physical illness often shrinks social worlds. People may stop working, travelling, or engaging in community life. Gambling — whether at a club, casino, or online — becomes one of the few accessible forms of stimulation.
Older adults or those with limited mobility may spend long hours alone, where online gambling platforms offer both entertainment and connection — but at high emotional cost.
4. Emotional Toll and Depression
Chronic illness is frequently accompanied by depression or anxiety. Studies suggest that 30–50% of people with long-term pain experience clinical depressive symptoms. Gambling, in this context, may serve as an emotional anaesthetic — providing fleeting relief, distraction, and the illusion of control.
Over time, though, it compounds distress: financial stress worsens health anxiety, and sleep disruption from late-night gambling can intensify pain and fatigue.
5. The “Reinforcement Trap”
Gambling creates rapid reward cycles that exploit the brain’s reward deficiency — a phenomenon also present in chronic pain. When pain or fatigue increases, gambling feels more appealing; when gambling leads to guilt or financial loss, stress rises, worsening pain perception. It becomes a self-reinforcing feedback loop.
When the Body and Mind Collide: A Realistic Picture
Consider someone managing osteoarthritis, insomnia, and loneliness in retirement. Physical pain disrupts sleep; lack of sleep worsens pain. A casual habit of online pokies begins to fill long nights. Wins bring dopamine spikes that dull pain for a moment; losses trigger stress and guilt. Soon, the nightly distraction becomes a dependency — one that adds financial strain and emotional exhaustion on top of physical suffering.
This isn’t a moral failing. It’s a neuro-behavioural pattern born from real suffering. Understanding that connection is the first step toward breaking it.
How Gambling Harms Physical Health
The interplay goes both ways: gambling addiction doesn’t just result from chronic illness — it can worsen physical health in its own right.
- Sleep disruption: Late-night gambling or stress-related insomnia impairs recovery and increases pain sensitivity.
- Medication neglect: Some gamblers forget or delay medication adherence when caught up in gambling sessions.
- Financial trade-offs: Money meant for health appointments or prescriptions may go toward gambling.
- Stress physiology: Chronic cortisol elevation from gambling-related anxiety can aggravate inflammation, blood pressure, and immune suppression.
- Nutrition and inactivity: Sedentary screen-based gambling combined with poor diet habits reduces physical resilience.
The result is a dangerous convergence — where both conditions amplify each other’s impact.
Treatment Needs to Be Integrated, Not Separate
Many people with this dual burden fall through the cracks of standard care: medical clinics treat pain but not addiction, while addiction programs may overlook physical illness. At HARP, we bridge that gap.
Our integrated treatment for gambling and physical health comorbidities includes:
- Comprehensive health assessment: Screening for pain, medication use, sleep, and chronic illnesses during intake.
- Liaison with GPs and specialists: Coordinating treatment plans that safely manage medications and withdrawal risks.
- Pain and stress management therapy: Teaching non-pharmacological pain-coping skills such as mindfulness, breathwork, pacing, and movement therapy.
- The 5i Program and relapse prevention: Addressing cognitive distortions (“I deserve a break,” “It helps my pain”) with structured behavioural change.
- Holistic rehabilitation: Exercise physiology, nutritional guidance, relaxation therapies, and restorative sleep support.
- Emotional health care: Trauma-informed therapy to process grief, frustration, or loss of independence.
Our clinicians understand that gambling addiction in the context of illness is not about thrill-seeking — it’s about relief. Treatment must therefore replace gambling’s “pain-relief” function with sustainable, healing alternatives.
Let’s HARP Fight with You
When living with chronic illness or pain, the mind often seeks relief wherever it can find it. Gambling may offer that momentary escape — but it quickly becomes another burden to carry.
The good news? Healing is possible. By addressing both the physical and emotional roots of the behaviour, recovery becomes not just about stopping gambling, but about rebuilding health, purpose, and self-compassion.
If you or someone you love is living with chronic pain or health challenges and noticing signs of gambling distress, HARP is here to help — with programs that understand both sides of the struggle.
References:
