Gambling involves wagering something of value, often money, on an event that is random and unpredictable. It requires three elements: consideration, risk, and a prize. It can be conducted in a variety of settings, including commercial and private gambling establishments and home games. Gambling may also be conducted with materials that have a value, but are not money, such as marbles or collectible game pieces (for example, trading cards).

While most people gamble in moderation, some experience problems and develop gambling disorder, which is defined in the Diagnostic and Statistical Manual of Mental Disorders as an enduring pattern of pathological gambling. The social and emotional consequences of this problem can be severe and long-lasting, and include family breakdown, financial ruin, and even suicide. Those who suffer from gambling addiction are also at high risk for alcohol or drug abuse, which can have serious and even life-threatening consequences.

A growing role exists for evaluating patients with gambling disorders in a general medical setting. However, the importance of this evaluation is dependent on the extent to which a patient’s gambling behavior negatively affects their well-being. The current debate focuses on the best methodological and theoretical framework for studying gambling’s impacts.

Some researchers have focused on the negative impacts of gambling, using a cost-of-illness perspective similar to that used in studies of drugs and alcohol. This approach assigns monetary value to intangible harms, but overlooks the positive benefits of gambling, such as relaxation. Others have employed a public health framework, which focuses on identifying costs and benefits and examines how they affect gamblers’ quality of life, in particular their significant others.