Sarah Yip, PhD, Explains the Complexities Between Cocaine and Gambling Addiction | The National Center on Addiction and Substance Abuse

Sarah Yip, PhD, Explains the Complexities Between Cocaine and Gambling Addiction

Sarah Yip, PhD, Explains the Complexities Between Cocaine and Gambling Addiction

Dr. Sarah Yip, Assistant Professor of Psychiatry at Yale School of Medicine, spoke during our Addiction Speaker Series about her work on the neurobiological features of cocaine use disorder and gambling disorder. We interviewed her about this very interesting and complex area of research. 

What’s the connection between cocaine and gambling addiction?

For many years, clinicians and researchers have described the similarities between people who have these disorders. Many of the symptoms of problem or pathological gambling parallel the addictive behaviors seen in people with cocaine use disorders, including loss of control, continuing behavior despite negative consequences, and urges or compulsions. This connection is now reflected in the classification of gambling disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) within the ‘Substance-Related and Addictive Disorders.’

This classification is based on clinical, neurological, and biological similarities between gambling disorder and substance addiction. Although the pleasure or “high” of gambling does not come from the ingestion of a chemical like cocaine, both disorders have similarities genetically, behaviorally, and in brain functioning.  In addition, people who have a gambling disorder are also at higher risk for having cocaine, alcohol, and tobacco use disorders. Therefore, comparing people who have gambling vs. cocaine addictions may help to separate the effects of cocaine as compared to aspects of addiction not dependent on substance use.

What’s the relationship between impulsivity and cocaine and gambling addiction?

Individuals with gambling disorder and with cocaine use disorder have elevated impulsivity.  Impulsivity is a personality or behavioral trait which decades of research have identified as an important vulnerability or risk factor for substance use and addiction. Continued research on the brain is needed to understand the complex relationship between different types of impulsive behaviors and the development of addictive behaviors and the maintenance of addictions. 

How does cocaine use and gambling addiction negatively affect the brain?

Our findings suggest that both cocaine use and gambling disorders involve alterations in white matter tissue which connects processing regions of the brain. However, reductions in prefrontal grey matter tissue (a part of the brain involved in planning and decision-making, among other things) are specific to cocaine use disorder. Still, we can’t make any definite conclusions about the effect of gambling and cocaine because we have not yet followed people with these addictions and their brain changes over a long enough period of time.

Are the effects of cocaine use and gambling addiction on the brain permanent?

At this point, we can’t make any conclusions about whether the effects of cocaine use and gambling addiction on the brain are susceptibility factors for, or consequences of, addiction. However, some studies have found associations between time of abstinence from cocaine and increased brain volumes. This would suggest that the brain has the ability to recover from the effects of addiction.

 

Sarah Yip, PhD 

Dr. Yip is an Assistant Professor of Psychiatry at Yale School of Medicine

 

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