Ask the Expert: Jessica Nelson-Mitchell of Fairview Recovery Services

Jessica Nelson Mitchell of FairviewWe feature an expert in the mental health and substance use disorder field to answer questions. This issue is Jessica Nelson-Mitchell of Fairview Recovery Services. We asked her questions about compulsive gambling.

Q: What are some of the different ways that people gamble?

Many people associate gambling with the casinos, but gambling is much broader than that. There are many forms of legal and illegal gambling in Minnesota. Gambling can include, but is not limited to, poker, lottery games, raffles, sports betting, and even trading in the stock market. Minnesotans spend over a billion dollars a year on pull tabs alone. Not only do people gamble on the big game, but they may also gamble on the outcome of the coin toss that opens the game.

The prevalence of problem gambling is about 3 percent of the population, with as high as 5 percent among college males. Currently, sports betting has become popular among college age students; prior to that it was poker, or Texas hold’em.

Being able to gamble online and on our phones has increased the accessibility of gambling, especially in a pandemic. We are seeing an increase of gambling within video games with loot boxes and even in game casinos. Gamers are able to spend real money to win “in game prizes” which do not have value outside of the game itself.

Q: What are some signs that gambling has become problematic?

Problem gambling has many of the same patterns and behaviors as other addictions, such as increased tolerance, unsuccessful efforts to cut down or quit, a great deal of time is spent in the activity, and even the same type of withdrawal symptoms. Cross addiction is used to define when one addiction is then transferred to another addiction. It’s not uncommon for people entering into treatment from alcohol or other substances to continue gambling. We do encourage those in both early and long-term recovery to abstain from any forms of gambling due to an increased vulnerability to transferring those behaviors. Many people in recovery, and even recovery professionals, often don’t see gambling as an addiction because they are not ingesting a substance. But the brain is being triggered the same as if you were snorting cocaine.

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Q: Who is at risk for compulsive gambling?

Studies have shown that anyone who has a history of addiction is at risk for cross addiction. Research continues to show a genetic disposition to addiction in families, which includes gambling addiction. Those who grew up and were exposed to substance use addictions may make the decision not to use substances. However, they may not identify gambling as a possible addiction. Gambling is often referred to as a “hidden addiction,” because a family member is able to hide the amount of gambling, or the amount of money spent gambling, through lies and deception until the family is in dire straits, and the gambler has stolen, or is on the verge of suicide.

With the increase of gambling and real money spending in video games, we are seeing an increase in teens becoming compulsive gamblers. Quite often, they are being groomed in video games to need the dopamine hit they get from the in-game stimuli.

Q: What mental health disorders do you see within compulsive gamblers?

Most of our clients come in with anxiety and depression. There is also a higher rate of suicide with problem gamblers than with other addictions. It may be that the gambling increases the dopamine in the brain, as a reward, much the same way that cocaine or amphetamines do. Or it may be that suicide solves the financial problem that the gambler got themselves into. The amount of shame and guilt we see in problem gamblers is higher than other addictions. It’s not uncommon for clients to tell stories of leaving the casino with thoughts of suicide, as there is so much desperation after losing thousands of dollars, again.

Q: What are some of the current interventions and treatments available for people who struggle with compulsive gambling and helpful resources?

It’s important to know that treatment options are available in the state of Minnesota. Current treatments include inpatient, outpatient and individual counseling/therapy with state certified problem gambling treatment providers. The state of Minnesota, Department of Human Services, offers a grant to those who quality to help to pay the costs of treatment. The Department of Human Services website has a list of gambling treatment providers and are able to utilize this grant to cover the cost of treatments. Visit: https://getgamblinghelp.com or 1-800-333-HELP.

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Support groups are also available through Gamblers Anonymous. Many meetings are currently held online, although there are a few that are able to accommodate social distancing and are meeting in-person. Check the Gamblers Anonymous meeting directory online  to find the most accurate meeting information.

Q: What are some actions that a family member or friend can take if they are concerned about their loved one’s gambling?

It’s difficult to have a family member who is struggling and changes the dynamics of the family. There are resources for family members including utilizing the list of state certified treatment providers for individual counseling. A grant through the Department of Human Services is also available for family members to seek support regardless of if their family member or friend chooses to seek treatment. Gam-Anon is a great resource for support meetings as well.

Money can often be a trigger for problem gamblers. Limiting access to cash and setting up additional financial blockades will help to reduce the urge to gamble and the damage caused if the gambler does gamble. If the gambler is willing, True Link offers a credit card specifically for people in recovery to limit access to cash and the ability to spend money gambling.


Jessica Nelson-Mitchell is a state of Minnesota Gambling Treatment Provider and a Licensed Alcohol and Drug Counselor. She is currently working towards her Masters Degree in Marriage and Family Therapy. She has been providing support to individuals and families in a variety of environments, including inpatient and outpatient settings within substance use disorders and she currently works as the family counselor in the outpatient Gambling Treatment Program at Fairview Recovery Services.

If you have a question for the experts, or you are an expert interested in being featured, please email phoenix@thephoenixspirit.com. Experts have not been compensated for their advice.

Last Updated on March 8, 2021

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