Gambling in America has deep cultural roots and exists today as a widely available and socially accepted recreational activity. Over 80 percent of American adults now report having gambled sometime during their lifetime on casino games, lotteries, sports betting, horse racing and off-track betting, and other gambling activities. It is estimated that in 1997 they had collectively wagered more than $551 billion. Presently, gambling in some form is legal in all but 3 States, casinos or casino-style games are available in 21 States, and 37 States have lotteries. Although the recent institutionalization of gambling appears to have benefited economically depressed communities in which it is offered, gambling has social and economic costs. Two major concerns of public health and other public officials are whether the number or proportion of pathological gamblers in the United States is increasing and the possible effects of pathological gambling on individuals, families, and communities. The Committee on the Social and Economic Impact of Pathological Gambling was to identify and analyze the full range of research studies that bear upon the nature of pathological and problem gambling, highlighting key issues and data sources that can provide hard evidence of their effects. This book examines the diverse and frequently controversial issues surrounding the definition of pathological gambling, its co-occurrence with disorder such as alcoholism and drug abuse, its social characteristics and economic consequences for communities, and treatment approaches and their effectiveness, from Gambler’s Anonymous to cognitive therapy to pharmacology. In summation, the book describes the current scientific knowledge about the definition, extent, nature, effects, and treatment of pathological gambling. Tables, references and appendixes A-F