Gambling, Alcohol and Other Addictions

Problems rarely travel alone - and treating only one can leave the door open

Two problems wearing one coat

When Jabu finally stopped gambling, he was blindsided by how much more he started drinking. The two had always gone together - a few drinks lowered his guard and led to bigger bets, and the stress of losses sent him back to the bottle. Treating the gambling alone had left half the problem standing.

Gambling problems often travel alongside alcohol, substance use or other compulsive behaviours. Understanding the link, and treating the whole picture, is key to lasting recovery.

What it is

Co-occurring conditions are when gambling harm exists alongside another problem - most commonly alcohol or substance use, but also smoking, compulsive shopping or gaming, and mental-health conditions like depression and anxiety. These problems feed one another, which is why addressing only one can leave the door open for relapse. Effective recovery looks at the whole person.

Common signs

• Drinking or using substances while gambling, or to cope with losses

• One behaviour increasing when you cut down another

• Using gambling, alcohol or substances to escape the same difficult feelings

• Several habits that each feel hard to control

• Low mood, anxiety or trauma sitting underneath it all

If you or someone you know is having thoughts of self-harm or suicide, please reach out now: Suicide Crisis Helpline 0800 567 567, or SAPS 10111 in an emergency. You are not alone, and help is available 24 hours a day.

Why it happens

Different addictions act on the same reward pathways in the brain, so one can prime and strengthen another. Alcohol and some substances lower inhibition and judgement, making risky betting more likely; the stress and shame of gambling losses then drive more drinking or using. Often, all of them are attempts to cope with the same underlying pain - stress, loneliness, depression, anxiety or trauma.

This is why treating one problem in isolation can simply hand the role over to another. Recovery works best when it addresses the whole pattern and the feelings underneath it.

Self-help tools

• Be honest about all the behaviours, not just the one that feels most urgent

• Notice how they connect - which one triggers another, and when

• Reduce access to all of them at once where you can

• Treat the underlying stress, mood or trauma, not only the surface habits

• Get professional support - co-occurring problems are hard to untangle alone

How we can help

We look at the whole picture, not one piece of it:

• Confidential screening for gambling, mood and substance use

• Free counselling that addresses the connected problems together

• A warm referral to specialist addiction and mental-health services, including SANCA

When to seek support

Reach out if gambling comes with drinking, substance use or other habits you find hard to control, or if low mood, anxiety or trauma sit underneath them. Treating the whole picture gives you the best chance of lasting freedom. If you ever feel unsafe, call the Suicide Crisis Helpline on 0800 567 567.

Try this (2 minutes)

Map the chain. On a piece of paper, write the behaviours you want to change - gambling, drinking, anything else - and draw arrows showing how one leads to another (for example, stress to drink to bet to loss to stress). Seeing the chain on paper helps you spot the one link where, with support, you can break the whole cycle.

Free South African support

• National Responsible Gambling Programme - 0800 006 008

• Suicide Crisis Helpline - 0800 567 567

• Suicide Crisis Helpline - 0800 567 567

• Gamblers Anonymous South Africa - support groups nationwide

References

American Psychiatric Association, 2013. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association.

World Health Organization, 2019. International Classification of Diseases, 11th Revision (ICD-11): Gambling Disorder. Geneva: World Health Organization.

National Responsible Gambling Programme, n.d. Help for Problem Gambling. [online] Available at: https://www.responsiblegambling.org.za [Accessed June 2026].

South African Depression and Anxiety Group (SADAG), n.d. Helplines and Resources. [online] Available at: https://www.sadag.org [Accessed June 2026].

This article offers general information and support. It is not a substitute for professional medical or psychological advice, diagnosis or treatment. If you are in crisis, contact the Suicide Crisis Helpline on 0800 567 567 or SAPS on 10111. Your information is handled in line with POPIA; health information is treated as Special Personal Information.