Combating gambling addiction reaches primary care units.

The Municipal Health Department began adopting new measures in August to identify and treat gamblers and their families in Primary Care. Among the new actions is screening for gambling addiction during routine consultations, similar to the methods already used for depression and smoking. Now, in all consultations, two specific questions are asked about the patient's relationship with gambling, which are recorded in their medical record. If the user answers positively to either question, it triggers a warning sign indicating the need for specific care.

– The city of Rio was a pioneer among major Brazilian cities in combating the advertising and promotion of gambling. Now, the City Hall has also begun to act within the health network. Every consultation at the city's family clinics and municipal health centers now includes two questions about gambling. If a sign of a problem appears, it is entered into the medical record, and the team begins to monitor the person immediately – says the mayor of Rio, Eduardo Cavaliere.

In just one week of the new strategy, 22 people were identified who admitted feeling the need to gamble, representing almost 1% of the 3.070 patients who answered the questions during the consultation period. Fifteen people revealed that they had lied to their families to hide how much they spent on gambling.

The new strategy includes specific clinical assessment and an individualized therapeutic plan, according to the identified risk level, as well as support for family members, even when the gambler is unwilling to begin treatment. The treatments range from guidance in milder cases to specialized follow-up with a multidisciplinary team, and also psychosocial support in more severe cases.

– Gambling addiction is a public health problem. It enters our system in the form of anxiety, insomnia, depression, domestic violence, and debt that leads to illness affecting the entire family. Just as with smoking and depression, it is very difficult for someone with a gambling problem to seek help on their own. By instituting this screening, we stop waiting for patients to come to us with the problem of addiction and begin to actively offer support, expanding our capacity to identify cases and, consequently, to treat them – explains the municipal health secretary, Rodrigo Prado.

The new measures also include training for community health workers (CHAs) and other professionals in the units through special training on the subject offered by the Ministry of Health; and distribution of material with guidance for the population to seek help.

Units detected an increase in people seeking help.

The plan's development was motivated by the observation in Primary Care units of an increase in users seeking help from health teams due to health issues related to gambling addiction, whether by the gamblers themselves or by family members. This screening was already being done in mental health, with patients from psychosocial care centers, but the need to also do it in family clinics and municipal health centers was perceived.

For the planning of the new approach, a preliminary survey was conducted by the SMS Assistance Intelligence Center (NIA) with the support of a natural language model based on the network's electronic medical records. This survey identified 1.378 individuals with a history of reporting, either about themselves or a family member, suffering from situations suggesting gambling addiction. These users presented with anxiety, insomnia, and depression, as well as financial crisis within their families.

Within the 1.378 people identified in the preliminary survey, among those who admitted to being gamblers and sought help on their own, almost 60% were men (567). The median age was 37 years, and more than half (53%) were between 18 and 39 years old. Regarding the affected family members, the picture was reversed: 85% were women (276 out of 325), with a median age of 45 years and a concentration in the age groups above 40 years—largely wives and mothers of gamblers.

One piece of data stood out: 25 of the identified patients were under 18 years old. Of these, 22 were boys. Although gambling is prohibited for minors, the finding was consistent with the expansion of betting apps and quick-access gambling games via mobile phones among teenagers.

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September 1th, 2026

Appointments: community health workers (ACS) Primary attention bets public health addiction