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Yet, the same substance is unlikely to result in an energising effect when consumed home alone: the same person may feel relaxed positive , tired neutral or even melancholic or depressed negative. In line with the adversarial setting of court proceedings and the financial consequences that are at stake, 1 private operators and public monopolies have usually continued their quarrel outside the courtroom immediately after the release of a new ruling. Various factors have been identified that contribute to the development of addiction. Alcohol use disorder and tobacco use disorder are used as examples. Scholars regularly use this tripartide terminology. He described case studies of heroin users who had managed over many years to use heroin in a stable and controlled manner. Similar to substance-related disorders, impaired control criteria 3—5 of gambling disorder , social impairment criterion 8 and pharmacological criteria criteria 1—2 can be observed among gambling addicts as well. The past year 12 months is now expressly mentioned as the relevant diagnostic period. In view of inquiring the aforementioned aspects, This section opens with a few remarks on the alleged peculiar nature of gambling addiction, followed by an introduction to the notion of gambling addiction and the global epidemiology of this mental disorder. Kallick et al. Epidemiology is the field of research that attempts to determine the prevalence of a disorder namely, what proportion of the population has the disorder as well as the incidence that is, the number of new cases that appear in a given time period. They reflect situations of life where the compulsive nature of the addictive consumption or behaviour criterion 4 results in adverse consequences criteria 5, 6 and 9.

This chapter starts with a thorough introduction to gambling addiction according to the current state of research. The third national study was conducted by Gerstein et al.

Loss of Control.

This can be noticed in a social setting such as a reception or a dinner. At first sight, this must be surprising since gambling offers at that time were far less prevalent and limited to a few states. Finally, the diagnostic criteria of alcohol and tobacco use disorder 4, 5, 6 and 9 that do not find direct equivalents in the wording of the criteria regarding gambling disorder are characteristic of addiction in general. The next estimate was delivered by Shaffer et al. Similarly, if drug using was the only cause of addiction, addictive behaviors would be absent every time drug using was missing. Among the justification grounds pleaded in the gambling cases, the protection of consumers from gambling-related harm is an important, if not the central concern. The findings from the former can provide valuable information in situations where gaps of research regarding gambling disorder occur. The North American epidemiological data situation is the most solid globally and shows a highly interesting and relevant phenomenon. Other behavioural addictive disorders such as sex addiction, exercise addiction or shopping addiction will in the future be considered as potential additions to this category. Within one decade, the prevalence rates of gambling disorder have remained quite stable in spite of increased exposure to games of chance. If drug using were the necessary and sufficient cause of addiction, then addiction would occur every time drug using was present. Both the EU legislator and EU judiciary have repeatedly emphasised a peculiar or special nature of gambling. Scholarship has explained this phenomenon with the capacity of populations to adapt to the exposure to environmental factors see Sect. These findings were also confirmed by other studies. Behavior that is motivated by emotions ranging along the Craving to Compulsion spectrum. It explains the nature and mechanisms of this mental disorder. Shaffer expressed the object non-specificity of addiction as follows:. A necessary element of addiction is the loss of control over the consumption. This term is very likely to be used by ICD as well. For reasons of consistency, the present book uses these terms according to the aforementioned definitions. Shaffer offers a definition of addiction that embeds both substances and behaviours. Needs to gamble with increasing amounts of money in order to achieve the desired excitement. While the data situation regarding the prevalence of gambling disorder is poor in most countries, it is well established in the US and Canada. Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling. It first investigates whether substances cause addiction. Addiction is characterised by:. The epidemiological data situation in Europe is quite poor, with many countries featuring either one or even no study. These considerations already show that alcohol, a substance associated both with recreational and addictive consumption, does not have the same effect on every person and in every situation. It presents the manifold commonalities that exist between substance-related disorders and gambling disorder. Where researchers used well-developed instruments in Canada, they found rates similar to those reported in most US surveys. Even prior to the most recent revision towards DSM-5, the close relationship of substance-related addiction and gambling addiction was already evident from the diagnostic criteria. There can be no doubt that protecting consumers from gambling addiction is a highly legitimate motive that can justify restrictions to cross-border trade in gambling services. It may lower inhibitions and increase the willingness to engage in conversations with other guests. Notably, only two of eleven criteria must be fulfilled to meet the diagnosis for a mild alcohol or tobacco use disorder and only four of nine criteria to meet the diagnosis for a mild gambling disorder. Subsequently, the commonalities between gambling addiction and other forms of addiction are outlined. Dependence and addiction are often used as interchangeable terms in popular literature but their nature is significantly different. It is shown that the Court of Justice's — legally relevant! Therefore, it is the most frequently used term in this chapter, except where other terms seem to be more appropriate. The commonalities are illustrated by the diagnostic criteria of DSM-5 and an accumulation of empirical evidence. In other words, the prevalence rates from most recent years are similar to those found at the end of the s. Another remarkable fact is that some European countries, similar to the development in North America, have seen their rates stabilising over time, with some of them even showing decreased levels. Even though the agents objects of addiction are different, the diagnosed signs and symptoms are very similar Table 9. Apart from removing one diagnostic criterion and minor linguistic adjustments, the revision to DSM-5 did not significantly alter the diagnosis. Accordingly, Finally, the causes Sect. The exact wording of the criteria of gambling and substance-related disorders slightly differs, which has obvious reasons. These factors relate to the host subject , the agent object and the environment and interrelate in complex ways. The rates from the first US national study in 0. Until the beginning of the new millennium, a trend could be identified. The previous chapter also showed that the doctrine of the margin of appreciation is supposed to go hand in hand with judicial review. Why do some people manage to handle their alcohol consumption while others do not? If the two situations involve the very same person and the very same amount and kind of substance, why do they lead to different emotional experiences? Relies on others to provide money to relieve desperate financial situations caused by gambling. Is often preoccupied with gambling e. Most people have either tried alcohol in their lives or seen people drinking alcohol. Petry et al. The public health model of disease transmission illustrates the interplay of the various factors relating to host, agent and environment. This manual is the standard classification of mental disorders in the US 13 and is used globally by mental health professionals. This new categorisation is based on solid empirical evidence. It analyses in particular the political context of the early case law and it identifies passages in the jurisprudence that illustrate a subjective - moral rather than objective-scientific perspective on gambling-related risks. However, at the time of the DSM-5 revision, there was insufficient peer-reviewed evidence to define diagnostic criteria and course descriptions for these disorders. A committee of the National Research Council reanalysed these findings and found very similar rates. However, subsequent studies with large samples found significantly lower rates. In North America, several studies of high quality and large sample sizes have addressed the prevalence in the general population nationally. Diagnostic criteria of alcohol use disorder, tobacco use disorder, and gambling disorder according to DSM As Table 9. In the s, Zinberg showed that there was no direct causal link between drug consumption and drug addiction. Empirical evidence on substance-related disorders is older than on gambling disorder. Addiction was traditionally associated with drugs. The gambling behavior is not better explained by a manic episode. Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four or more of the following in a month period:. Subjects of the study had not developed the characteristic symptoms associated with addiction. The chapter also establishes that different standards of review have applied to different aspects of gambling regulation, with the most lenient review being applied to national choices of licensing models and the strictest to penalties and procedural requirements in licensing tenders. It should be noted that any other substance-related disorder could be used as well opioids, cannabis, inhalents, etc. Again, a diverging standard of review is noted. In order to facilitate the comparison, the commonalities are highlighted in the table. Research over several decades has established that the focus on the object fails to explain the nature and mechanisms of addiction. This term may refer to one who suffers from any drug addiction and sometimes to individuals with other compulsive problem behaviors. Finally, the different stages of the development of the disorder are explained. According to prevalent views, gambling and gambling addiction appear to be fundamentally different from other risks and therefore need a different, separate regulatory approach. These findings lay the ground to analyse the proportionality review: judicial views are contrasted with empirical findings. This section elaborates on the nature and mechanisms of gambling disorder and broadens the scope to the bigger concept of addiction. The participation in some form of gambling had clearly increased over time and so had the prevalence rates of gambling disorder.