Pathological gambling in methadone maintenance clinics where gambling is legal versus illegal

Lifetime potential and probable pathological gambling (PG) were assessed using the South Oaks Gambling Screen (SOGS) questionnaire. The prevalence between patients in methadone maintenance treatment (MMT) in Tel Aviv (Israel, gambling is illegal) and MMT patients in Las Vegas (NV, USA, gambling is legal) was compared. Urine toxicology and substance use was assessed as well. PG at MMT admission was higher in Tel Aviv (48/178, 27%) than in Las Vegas (19/113, 16.8%; p = .05). In Tel Aviv gambling mostly preceded opiate abuse (58.3%), while it followed opiate abuse in Las Vegas (66.7%, p < .001). Only 20.8% in Tel Aviv and 21.1% in Las Vegas were currently gambling. Multivariate analyses found older age on admission to MMT odds ratio (OR) = 1.05 (95% confidence interval [CI] 1.01-1.08), being male OR = 2.6 (95% CI 1.3-5.3) and being from the Tel Aviv MMT clinic OR = 2.5 (95% CI 1.3-4.9) to characterize PG. Detection of any drug in MMT admission urine specimens was unrelated to PG. Older age on admission to MMT, and male gender characterized PG in different MMT clinics, independent of the legal status of gambling. Low current PG rates for patients in both MMT clinics suggest that legality may not be relevant.