Purpose - This report consolidates evidence on effective interventions, approaches and guidelines for addressing gambling and gaming addictions. It emphasises pharmacological and psychological treatments, particularly for  individuals with comorbid mental health conditions, other addictions, and those from marginalised groups. The  findings aim to support and inform the HSE National Social Inclusion Office, Addiction Services, in developing appropriate, evidence-based strategies for treating gambling and gaming addictions in Ireland.

Review questions:
• Question 1: What international and national guidelines are available with recommendations for the management and treatment of gambling and gaming addictions?
• Question 2: What interventions are effective in managing and treating gambling and gaming addictions?
• Question 3: How are these effective interventions evaluated in terms of service users’ and service providers’ satisfaction?
• Question 4: Do the interventions identified take into consideration the following:
   ■ service users with comorbid mental health problems?
   ■ other addictions, and
   ■ the needs of marginalised groups?
• Question 5: What are the facilitators or barriers identified in the literature to implementing these effective interventions?
• Question 6: How cost-effective are these interventions?

Conclusion: This review synthesises the evidence from international guidelines on the treatment and management of gambling and gaming addictions. Eighteen systematic reviews and meta-analyses were also narratively synthesised on the effectiveness of pharmacological and psychological interventions for treating gambling addiction, and nine were narratively synthesised on interventions for treating gaming addiction. 

The results revealed a variety of psychological and pharmacological interventions for treating gambling or gaming addiction among various populations. In general, CBT has a larger evidence base than pharmacotherapy for treating both gambling and gaming disorders. However, the evidence supporting the use of pharmacological interventions varied across different population groups. For gambling disorder, an opioid antagonist (naltrexone) was identified for use in patients who had multiple relapses following psychological interventions, with medications such as bupropion, MPH and ATM significantly improving the symptoms of gaming addiction, especially in patients who have co-occurring ADHD. There was significant heterogeneity across the included studies in relation to study designs, intervention characteristics, and screening and diagnostic tools, and this limits the ability to draw definite conclusions. Further high-quality studies are therefore required. Although the overall quality of the included systematic reviews was generally low, the findings align with the recommendations from the two high-quality international guidelines included. The findings reported in this evidence review provide individuals, clinicians and policymakers with empirical evidence that psychological and pharmacological interventions produce clinically meaningful reductions in both gambling and gaming disorder severity and symptoms.