RESEARCH QUESTIONS
What is the prevalence of pathological gambling (PG) in substance use counselors? Does PG impact physical and mental health in substance use counselors?

PURPOSE
Research has infrequently investigated the prevalence and effects of a mental disorder in individuals who provide mental health treatment. Individuals with a history of a substance use disorder are likely to experience other psychiatric disorders and the presence of co-occurring disorders negatively impacts the course of both disorders, treatment outcome, and long-term prognosis. However, studies have typically investigated co-morbid depression and anxiety disorders, not PG. The present study examined the prevalence of PG among substance abuse counselors and investigated reports of mental and physical health according to PG status.

HYPOTHESIS
Substance abuse counselors with disordered gambling would have increased mental and physical health problems compared to non-problem gambling substance abuse counselors.

PARTICIPANTS
Participants were 328 substance abuse counselors. Of these 268 (32% males; average age = 43 years) were non-problem gamblers, 21 (57%; average age = 46 years) were problem gamblers, and 39 (77% males; average age = 48 years) were pathological gamblers (PGs).

PROCEDURE
Participants were approached by a staff member at a regional continuing education workshop and asked to complete a three-page anonymous self-report questionnaire of demographics, gambling behaviours, physical health and mental health.

MAIN OUTCOME MEASURES
The South Oaks Gambling Screen (SOGS) assessed lifetime gambling problems. Participants were classified as non-problem, problem, or pathological gamblers according to SOGS scores of 0–2, 3–4, and 5 or higher, respectively. Past two months gambling frequency and intensity as well as interest in participating in an evaluation for gambling problems and learning about problem gambling or ways to reduce gambling was also assessed. The Short Form-12v2 Health Survey (SF-12v2) assessed mental and physical well-being including: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health.
KEY RESULTS
Compared with non-problem gamblers, problem and pathological gamblers were more likely to be male than female. Problem and pathological gamblers were also more likely to be African-American. The three groups also differed by age with PGs being older than non-problem gamblers, while problem gamblers were similar in age to both other groups. The groups also differed by gambling frequency and amounts of money spent in the past two months. Problem and pathological gamblers were more likely than non-problem gamblers to express an interest in participating in an evaluation for gambling problems, and learning about problem gambling or ways to reduce gambling. Neither gender nor ethnicity was associated with physical or mental health. Older age was related to poorer physical health and mental health. After taking into account these demographic characteristics, as hypothesized physical health was associated with classification as non-problem gambler, problem gambler or pathological gambler. Contrary to the hypothesis, mental health was not associated with gambling status classification.

LIMITATIONS
The study was conducted at a regional continuing education conference and does not represent a national sample of substance abuse counselors. The study was conducted via self-report measures and had a potential for response bias, as individuals may not have wanted to disclose a gambling problem. The survey did not collect information about substance abuse recovery status, a factor that may have been associated with the higher prevalence rate of disordered gambling in this sample.

CONCLUSIONS
Elevated rates of problem and pathological gambling were found among substance abuse counselors and the pathological gamblers reported poorer physical health compared to their counterparts without gambling problems. Given the high rates of PG in substance abuse counselors and their patients, substance abuse counselors should be educated about gambling behaviour, its associated consequences, and the co-morbidity between gambling and substance use disorders.