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Gambling, screens, buying: addiction without a substance exists — and is treated.
No substance, no physical withdrawal — and yet the same mechanisms: an invasive craving, a loss of control, and often a financial or family situation already damaged by the time the call is made. At the Espoir Clinic in Tunis, behavioural addictions are treated in their own right. A caregiver answers at any hour on +216 52 247 043.
Recognising the problem
- Gambling: stakes that rise to find the same sensation again, other people's money going in, lying that settles in, and the idea of “winning it back” that digs the hole deeper.
- Screens and gaming: nights that disappear, work or studies that come loose, irritability the moment it is cut, withdrawal from everything else.
- Compulsive buying: buying relieves, then crushes — then starts again.
- In all three cases: no physical withdrawal, but irritability, restlessness and an invasive craving when stopping.
The care at the clinic
- Cognitive-behavioural therapy: identify the situations and thoughts that precede the behaviour, and build another response — in advance and in writing.
- Concrete exposure and control measures: access to money, to apps, to places — practical decisions, taken early, that protect while the deeper work takes effect.
- Treating the shame: it is part of the disorder, it delays the call by years — and it is treated with it.
- Working with the family: the family has often discovered the damage before the person; it is part of the solution.
The programme runs over several months, as an outpatient or in day hospital. A depression or an anxiety often accompanies the disorder — they are treated at the same time, under the same roof.
The questions people don’t dare ask
Is an addiction without a substance a real addiction?
Yes. The same reward circuits are at play, the same invasive craving, the same loss of control — and often the same family and financial damage. It is treated with the same therapeutic tools, adapted to the behaviour rather than a substance.
Do I need to be admitted?
Usually not: care happens as an outpatient or in day hospital, over a programme of several months. A stay can be discussed when a depression or another difficulty comes on top.
Gambling has dug debts — where do I start?
By saying it, once, to someone whose job this is. Shame is part of the disorder and is treated with it; the concrete measures — access to money, limits, a trusted third party — are put in place from the very start of care.
The information on this page is general and does not replace a medical consultation. No treatment decision should ever be made from this site.
If they refuse to talk about it: They refuse treatment: what can we do?
Is a substance also involved? alcohol · cannabis · cocaine and stimulants.