Problem gambling - aetiology, identification and management.

BACKGROUND: Gambling is a mainstream activity across Australia, with increasing accessibility. It is also a significant public health issue, with around 395 000 Australians experiencing harm from problem gambling. OBJECTIVE: This article reviews current evidence relating to the classification and prevalence of problem gambling in Australia, why problems develop, and how to assess and manage gambling presentations within primary care. DISCUSSION: People affected by problem gambling are not a homogenous group in terms of course or onset. Screening is important, especially where financial problems are present or when there are other conditions that commonly co-occur (such as depression, anxiety, substance use disorders and nicotine dependence). Effective management involves a nonjudgemental and empathic approach, which may include referral to telephone or online services, face-to-face problem gambling programs, financial counselling, psychological and pharmacological interventions.