Session 7: Gambling, Behavioral Addictions, and Hidden Risk in Justice Populations
March 10, 2026 | 12:00 p.m. ET | 75 minutes

Problem gambling and other behavioral addictions are significantly overrepresented among justice-involved populations, yet they remain largely unrecognized in most treatment courts and supervision settings. When left unidentified, gambling disorder can quietly undermine treatment engagement, destabilize recovery, fuel criminal behavior, and be misinterpreted by courts as irresponsibility or defiance rather than a treatable condition.

This session brings clinical clarity to a frequently overlooked issue. Participants will explore gambling disorder as a diagnosable behavioral addiction, examine the complex intersections between gambling, other mental health disorders, substance use, impulsivity, and criminal justice involvement, and identify why traditional substance use disorder (SUD) treatment models often fail to detect or address gambling problems.

Attendees will learn how to recognize key clinical indicators, apply appropriate screening tools, and understand evidence-informed treatment approaches that can be adapted for justice-involved settings. The session also addresses critical ethical considerations, particularly when courts misinterpret financially driven behaviors as willful misconduct rather than symptoms of an underlying disorder.

Learning Objectives

1. Describe gambling disorder as a diagnosable behavioral addiction and explain its relevance within justice-involved populations.
2. Identify the clinical overlap between gambling, mental health, substance use, impulsivity, and criminal behavior.
3. Explain why traditional SUD treatment approaches often fail to detect or address gambling problems.
4. Apply appropriate screening tools and clinical strategies to identify problem gambling in justice settings.

Presenter:

Sarah Nelson, Ph.D.
Sarah Nelson is the director of research at the Division on Addiction, Cambridge Health Alliance, and an associate professor in the department of psychiatry at Harvard Medical School. Dr. Nelson’s work covers many facets of addiction, including the relationship between psychiatric comorbidity and impaired driving, how best to develop community recovery environments for youth with substance use problems, and the distribution and determinants of gambling problems. She has led the development, implementation, and evaluation of the Computerized Assessment and Referral System (CARS) at impaired driving programs and courts across the country. Dr. Nelson’s gambling work has focused on predicting the development of gambling problems, improving screening and assessment of gambling problems, and evaluating gambling interventions such as voluntary self exclusion.