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In general, behavior analytic research in this area is growing There is evidence that the SSRI paroxetine is efficacious in the treatment of pathological gambling.
Pathological gambling was long considered by the American Psychiatric Association to be an impulse-control disorder rather than an addiction.
It has been observed that some pathological gamblers have lower levels of norepinephrine than normal gamblers.
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This phenomenon was initially described for alcoholism, but it has also been applied to pathological gambling. According to evidence from both community- and clinic-based studies, individuals who are pathological gamblers are highly likely to exhibit other psychiatric problems concurrently, including substance use disorders, mood and anxiety disorders, or personality disorders. Fifth, problem gamblers represent a chronic state of a behavioral spin process, a gambling spin, as described by the criminal spin theory.clarification needed New studies regarding this link show that norepinephrine is secreted under stress, arousal, or thrill, so pathological gamblers gamble to make up for their under-dosage. It has been observed that some pathological gamblers have lower levels of norepinephrine than normal gamblers. Evidence indicates that pathological gambling is an addiction similar to chemical addiction. 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The opioid antagonist drug nalmefene has also been trialed quite successfully for the treatment of compulsive gambling. Additionally, CBT approaches frequently utilize skill-building techniques geared toward relapse prevention, assertiveness and gambling refusal, problem solving and reinforcement of gambling-inconsistent activities and interests. This type of therapy focuses on the identification of gambling-related thought processes, mood and cognitive distortions that increase one's vulnerability to out-of-control gambling. One form of counseling, cognitive behavioral therapy (CBT) has been shown to reduce symptoms and gambling-related urges. Modeled after Alcoholics Anonymous, GA is a twelve-step program that emphasizes a mutual-support approach. The VGS has proven validity and reliability in population studies as well as Adolescents and clinic gamblers.citation needed

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From this view, men tend to gamble more and engage in higher-stakes bets because male reproductive success is often linked to risk-based competition, paralleling other risky activities like big-game hunting or physical aggression. For example, gambling can be understood as a form of "risky reward-seeking," where individuals overestimate potential gains—an inclination that modern gambling industries exploit. Some researchers propose that human gambling behavior reflects evolved tendencies toward risk-taking that historically conferred adaptive benefits. The study links problem gambling to a myriad of issues affecting relationships, and social stability. A comprehensive UK Gambling Commission study from 2018 has also hinted at the link between gambling addiction and a reduction in physical activity, poor diet, and overall well-being. Pathological gambling is similar to many other impulse-control disorders such as kleptomania.

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