A top psychiatrist says gambling is a silent public health crisis – that has gone out of control.

Professor Colin O’Gara said: “This is not a condition of will,” as he explains how the brains of gambling addicts are wired differently. The consultant psychiatrist and head of addiction services at St John of God Hospital added: “This is not pull-your-socks-up territory.

“It is not a personality disorder or somebody who’s more malignant than another person, or lesser than another person, or less intelligent or more intelligent, it’s not about that.”

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In new podcast, The Gambler, he said gambling addiction in Ireland is a silent public health crisis affecting an estimated 130,000 people.

Prof O’Gara added: “It has been buried under the carpet for a long period of time, because you can’t come out and say that you suffer from this. There’s such a misunderstanding in terms of this is an illness. But hopefully the public will get a better understanding, and we’ll have less stigma and better help and acceptance of people with this disease.”

With the proliferation of online and phone gambling, he said the rate of addiction is “out of control”.

He welcomed the recent appointment of Anne Marie Caulfield as CEO designate of the Gambling Regulatory Authority of Ireland and the prospect of legislation – but said the task is mammoth.

Prof O’Gara added: “We’re so far behind the curve now that we’re really playing an incredible catch-up.”

In recent months, the ESRI said around 3.3 per cent of the population are problem gamblers scoring eight or more on the Problem Gambling Severity Index – 130,000 people.

Around seven per cent of the population or 279,000 people report multiple problematic behaviours with gambling or are moderate-risk gamblers. While 155 or 590,000 are low-risk gamblers but had at least one negative behaviour or experience with gambling in the last 12 months.

In the podcast, he dispels the myths around the addiction which was only classified as a disease back in 1984. He said scans of the brains of people with problem gambling addiction show a biological reaction when gambling cues are put on a projector in front of the person.

Prof O’Gara added: “You can watch what happens to their brain circuitry. Those key risk-processing areas in the orbitofrontal cortices, or ventromedial prefrontal cortex, are dopamine-rich areas that we know are dysfunctional in people who suffer from gambling disorder.

“This is a biologically driven brain disorder, rather than a deficit of will or a deficit in personality.”

In The Gambler, which tells the story of convicted conman Patrick Sheedy, a successful Limerick businessman who racked up 100 convictions when he turned to crime to service his compulsive gambling addiction. Prof O’Gara said the diagnosis of a gambling addiction usually follows a crisis GP referral made in the wake of a “massive bombshell” in the person’s life.

He added: “There has been maybe theft that’s been found out. There’s been an audit that has happened in a business, or some sort of debt has been called in, they can’t pay it, or the mail has been opened, or something has come to light where the person is in big trouble.”

While people may have an inkling of an addiction to drink or drugs, he says: “With gambling, the lights can be completely out.” Prof O’Gara added: “These are married couples who have no idea that their spouse is gambling. The level of deception and manipulation there is profound.

“In 99 per cent of cases, nobody has an idea of what’s going on. The whole means of continuing with this illness is that you deceive and you manipulate. But of course, it’s the disease.”

He said the addiction is “an exhausting lifestyle that just wears people down”.

Prof O’Gara added: “It’s not something you can switch on and off. This is 24/7 full-blown preoccupation.” He’s had patients who resorted to only eating from the fruit bowl or biscuit jar at work. He said: “They’re effectively malnourished because they do not have money to pay for food, or they will prioritise gambling over food.”

Chasing the high of their first win can also lead to the person suffering from depression, self-harm, and suicidal thoughts. In the criminal justice system, the professor believes gambling addiction should be treated as a medical condition. Prof O’Gara added: “Addiction is a medical disability, and gambling disorder is a medical disability, and people with disabilities have the right not to be discriminated against.”

• The Gambler, a new eight-part podcast series presented and produced by Ian Maleney and Nicola Tallant, is out now.

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