The 2026 gambling reforms regulate the industry. They don’t reach the people who are already addicted. A treatment perspective on what’s still missing and why it’s important.
Over the past year, the UK Gambling Commission has rolled out the biggest programme of regulatory change the industry has seen in two decades. Online slot stakes were capped at £5 per spin for over-25s and £2 for younger adults. Autoplay was banned. Mixed-product bonuses were prohibited. And this month, Remote Gaming Duty doubled from 21% to 40%, with mandatory affordability checks now rolling out across every licensed operator. These are real protections, and for people whose gambling is still within the regulated system, they will make a difference.
In the same period, a coroner in Cheshire found that a severe gambling disorder contributed to the death of Ellen Mulvey, a 44-year-old woman from Macclesfield. She had self-excluded through Gamstop, the mechanism the UK provides for people who recognise they have a problem and want the industry to stop letting them in.
It covers every UKGC-licensed operator. It does not cover the offshore platforms that sit outside UK regulation — some of which, her family believe, actively target people who have already asked to be blocked.
Her gambling disorder was diagnosed after she died. That is the detail I keep coming back to. Not the regulatory failure, not the offshore operators, but the fact that a condition serious enough to contribute to someone’s death was only identified once it was too late to treat it.
What makes gambling different from the addictions we usually talk about
I run the clinical work at Abbington House, where we treat drug addiction, alcohol addiction, and gambling addiction within the same residential model. The therapeutic patterns are similar across all three: compulsive behaviour despite consequences, shame, secrecy, isolation, and usually something sitting underneath that the addiction has been managing. Anxiety, trauma, depression, a need for escape that found the wrong outlet.
But gambling is different in one way that changes everything else: it is invisible. When someone is drinking heavily, the evidence accumulates in their behaviour, their health, their presence. The people around them can see something is wrong even if nobody says it out loud. Drug use follows the same pattern eventually. The body tells the story whether the person wants it to or not.
Gambling leaves no trace on the body. There is nothing to smell, nothing to see, no physical deterioration that forces the conversation. A person can lose tens of thousands of pounds from their phone while sitting next to their partner on the sofa, and nobody knows until the debt surfaces or something worse happens. In my experience, the people who reach us for gambling treatment have usually been living with the addiction in complete silence for years. Their partners didn’t know. Their GPs didn’t know. By the time it becomes visible, the damage is often more severe than what we see with substances, precisely because there were no early warning signs anyone could act on.
Where the system breaks down
The reforms that have come through over the past year are focused on the product, how gambling is offered, how much someone can stake, and how operators check affordability. All of that matters, and I don’t want to diminish it. But from where I sit, the gap that costs lives is not in how the product is regulated. It is in how the person is identified and treated once the addiction has already taken hold.
There is no routine screening for gambling in primary care. GPs ask about alcohol as a matter of course. Drug use comes up in mental health assessments. Gambling almost never does. A person could walk into their GP surgery with anxiety, depression, financial distress, and relationship breakdown — every one of which is a common consequence of gambling addiction — and leave without gambling ever being mentioned. The screening tools exist. They are simply not part of standard practice, and most GPs have had no training in gambling disorder.
Self-exclusion, as Ellen Mulvey’s case shows, only works within the licensed market. Gamstop cannot follow someone to an offshore platform. The technology to restrict access to unlicensed sites exists — ISP-level blocking is already used in countries including Italy and Australia — but the UK has not implemented it comprehensively. The result is that the people with the most severe addictions, the ones who have already exhausted every self-help mechanism the system offers, are the ones with the least protection.
And the treatment infrastructure itself is thin. The statutory gambling levy introduced in April 2025 generates £100 million a year for research, prevention, and treatment, which is a start. But for most people with a severe gambling disorder, the only realistic route to residential treatment is private and self-funded. The NHS pathway exists, but it is limited in scope and geographic coverage. If you compare that to the treatment infrastructure for alcohol or drug addiction, the disparity is stark.
What I think needs to happen
I treat gambling addiction. I am not the right person to design gambling legislation. But there are things I see every week that tell me where the system is failing, and they are not complicated to understand.
Self-exclusion needs to mean what people think it means. If someone asks to be blocked from gambling, that should follow them beyond the operators who happen to hold a UK licence. Ellen Mulvey did what the system told her to do, and the system could not protect her once she moved beyond its boundary. That boundary is the problem.
GPs need to ask about gambling the way they ask about drinking. Not every patient and not every appointment, but as part of the screening conversation when someone presents with anxiety, depression, debt, or relationship distress. The connection between those presentations and gambling is well established clinically. It is just not acted on in primary care.
And gambling needs to be understood — culturally and clinically — as an addiction, not as a behaviour problem with a softer name. The language the industry uses is part of the issue. “Problem gambling”, “Responsible gambling.” These phrases frame the harm as a matter of individual responsibility and keep it in a category that sounds manageable. The people I treat are not experiencing a problem. They are living with a compulsive disorder that has destroyed their finances, their relationships, and their mental health. The clinical reality mirrors substance addiction in almost every way. The only difference is that nobody had to break the law to develop it, and the product that caused it is advertised during every football match in the country.
What treatment looks like
Gambling addiction responds to treatment. The same therapeutic approaches that work for drug and alcohol addiction — trauma-informed therapy, group work, structured residential stays, continuing aftercare — work for gambling. At Abbington House, we treat it within the same model because the underlying patterns are the same. The substance or behaviour on the surface is different. What is sitting underneath it usually is not.
If you or someone close to you is living with a gambling addiction, it can be treated. It does not matter that it is legal, and it does not matter that nobody else knows. What matters is that the pattern has become something you cannot stop on your own, and that is enough to talk to someone about it.
The National Gambling Helpline (0808 8020 133) is free, confidential, and open 24 hours. Gamblers Anonymous runs meetings across the UK and online. If you want to talk about what residential treatment involves, you can call us.
