Perceptions of problem gambling among methadone maintenance treatment clients and counsellors

Problem gambling is highly prevalent and rarely treated among clients who attend methadone maintenance treatment programs (MMTPs). Compared with those of the general population, rates of gambling disorder have been found to be elevated among individuals receiving methadone maintenance treatment. Our study aims were to (a) develop a clearer understanding of the gambling experience of clients and counsellors at a methadone clinic and (b) gain insight into the current treatment options and obstacles to treatment in the clinic. Semi-structured interviews focusing on gambling issues were conducted with 8 clients and 8 counsellors at an MMTP located in an urban area. Participants were asked questions to gain an understanding about their perspectives on, treatment options for, and treatment barriers to problem gambling in the clinic. Data were coded by 4 investigators by using a constant comparison, open coding approach. The findings revealed important differences between clients and counsellors: Opinions differed on the definition of problem gambling, obstacles to treatment, and optimal treatment settings. Clients and counsellors also agreed on some elements, including the negative impact that problem gambling can have on recovery from substance use. This examination of responses of counsellors and client feedback provides a useful mechanism to better understand problem gambling in MMTPs. In addition, the findings have important clinical implications, including a need for more effective screening and treatment in MMTPs and to provide substance use counsellors with training related to problem gambling.