The International Classification of Diseases (ICD) is the text produced by the World Health Organization that summarises all the medical issues they recognize.

《国际疾病分类》（ICD）由世界卫生组织编制，汇总了已经确认的所有医学问题。

When the latest version, the ICD-11, was produced, the section concerning addictive disorders included a category for addictive behaviours. It's now medically recognised that people can become addicted to specific actions and not just substances. Chief among these behaviours is gambling.

最新版本ICD-11发布时，有关成瘾障碍的章节纳入了成瘾行为这一分类。如今，医学界已经认识到，人们不但会对某些物质，还会对特定行为上瘾。这些行为中最主要的是赌博。

Gambling addiction is undoubtedly a real thing and a big problem. Hence,the UK government is bringing in measures to hopefully curb, or at least reduce, the harm it does.

毫无疑问，赌博成瘾确有其事，而且问题不小。因此，英国政府采取措施，希望能够遏制或者至少减少赌博造成的危害。

But how do people end up addicted to gambling? And why is it often so dif.ficult to treat compared to more 'typical'substance-based addictions?

可是，人们是如何沉下赌博的？与更“典型”的物质成瘾相比，为什么赌博成瘾往往如此难以治疗？

The 'how' is relatively straightforward. The primary appeal of gambling is essentially obtaining large amounts of money for next-to-no effort. When it comes to making decisions, the human brain is constantly weighing up effort against potential reward. If something ends up being heavily skewed towards the latter (for example, paying a small amount of money to receive a large amount in return), we tend to really approve of it.

相对来说，“为何沉迷赌博”的答案并不复杂。从根本上讲，赌博的主要吸引力在平几乎不费吹灰之力就能获得大把金钱。人类大脑在做决定时会持续权衡付出的努力与潜在的回报。如果某件事情的最终结果大大偏向后者（例如，花少量金钱获得可观回报），我们往往会非常认可这件事。

There's also the fact that the human brain is complex enough to recognise money as significant, in the biological sense, even though it's technically an abstract concept. Our brains also prioritise novelty and unpredictability.

还有一个事实是，人类大脑错综复杂，足以从生物学意义上认识到金钱的重要性，尽管严格讲金钱其实是一个抽象的概念。再者，大脑会优先考虑新颖独特与不可预测的事物。

All this together means that gambling can, and does, have the same effect on the brain's reward system as certain drugs and substances. An addiction develops, with all the subsequent consequences for the individual.

总而言之，赌博可以——而且确实会——对大脑的奖励系统产生与某些药物和毒品相同的影响。成瘾会不断加剧.带给个体一切后续影响。

This doesn't happen for everyone who gambles, of course. A lot of people don't gamble at all. Many people are instinctively averse to risk or loss, which are unavoidable aspects of gambling.But other people aren't sensitive in this way and are far more willing to em brace gambling as a pastime.

当然，并不是每个赌博的人都会上瘾。很多人根本不赌博。很多人出于本能对风险或损失感到厌恶，而风险或损失在赌博中不可避免。而有些人在这方面并不敏感，更乐意将赌博视为一种消遣。

But while the similarities between our brains' responses to gambling and drugs can explain why gambling is so often addictive, it's the differences beween them that can make a gambling addiction particularly difficult to treat.

然而，虽然大脑对赌博和毒品的反应相似，可以解释为什么赌博常常令人上瘾，但正是这两者之间的差异使得赌瘾特别难治。

As a gambling addiction lacks any biological substance, it's easier to miss or hide. As a result, some evidence suggests that 90 per cent of gambling addictions go unreported and untreated.

由于赌博成瘾不依赖任何生物物质，所以更容易被忽视或隐藏。由此，一些证据表明，90%的赌博成瘾隐而未报，也未获治疗。

Also, the lack of any specific substance underpinning gambling addiction means there's nothing to 'take away',so to speak. Even for long-term, chronic drug addictions, there's the option of removing the drug (going 'cold turkey')and allowing people's brains and bodies to adjust to the absence. Granted, this is often a deeply unpleasant-even dangerous-option. But it's still an option.

此外，赌博成瘾缺乏任何特定的物质支撑，因此在治疗过程中可以说没有什么可“戒除”。即使是长期、慢性的药物成瘾，也可以选择停用（“突然戒断”）药物，让大脑和身体适应这种缺失。诚然，这通常是一个很不愉快——甚至非常危险——的选择，但毕竟是一种可选方案。

That isn't the case with gambling.It's an action, not a substance. As long as someone has money and autonomy,it's extremely difficult to deny them access to gambling. Even if you could,that still may not make any difference,thanks to how gambling is experienced.

对赌博而言，情况并非如此。赌博是一种行为，而不是一种物质。只要一个人有钱,并且可以自己做主，就很难阻止他去赌博。即使能阻止，也可能起不到什么实际作用，因为赌博的体验方式与药物成瘾不同。

The nature of gambling means it isn't expcrienced as a direct 'stimulation= reward' process, the sort that applies to drug taking and underlies the fundamental learning processes of classical conditioning (a key aspect of how addictions take hold in the first place).

赌博的本质意味着它并不是一种直接的“刺激一回报”过程。“刺激=回报”过程适用于吸毒，可构成“经典条件反射”（在成瘾行为形成初期起关键作用）这种基本学习过程的基础。

Such relatively simple processes can also be simple to unlearn. If the stimulation stops producing a reward, then the association undergoes 'extinction'in the brain. Do this with the source of an addiction and it loses its power over you. Due to the profound complexity of the human brain, achieving this is rather difficult, but it at least provides something to work toward.

这种相对简单的过程也可以很容易就忘掉。如果刺激不再产生回报，那么两者之间的关联就会在大脑中“消失”。掐掉成瘾的源头，它就会失去对人的控制。由于人脑深邃复杂，实现这一点相当困难，但至少提供了一些努力方向。

Consider this, however. If an alcoholic found that only one random drink in 20 contained any alcohol, while others made them nauseous, it would presumably become a lot easier to kick the habit. But that doesn't work with gambling, because that's already how gambling is experienced.

但再想想这个问题。如果一个酒鬼发现20杯饮料中只有一杯随机含有酒精，而其他饮料恶心得让人想吐，那么该酒鬼成功戒酒的可能性会大得多。可是，这个方法对赌博不会起作用，因为赌博本身就是碰运气。

The rewards of gambling occur via a variable reinforcement schedule. You never know when you're going to win and losing is unavoidable. But as long as you win often enough, you keep at it.And an addiction to the behaviour occurs.

赌博的回报是通过可变的强化程式来实现的。你永远不知道何时会赢，而输是不可避免的。但只要你经常赢，而且赢的次数足够多，你就会坚持下去，然后就会对这种行为上瘾。

Knowing the negative outcomes of gambling is already a part of the process. It's like trying to treat an alcoholic by making them pay for their own drinks; they invariably already are.

了解赌博的负面结果已经成为上瘾的一部分。这就像试图通过让酗酒者自己付酒钱来使他们戒掉酒瘾，而他们本来就是自己花钱买酒。

These are just some of the reasons gambling addictions are such thorny problems to tackle, medically. That means it's imperative to work on reducing exposure to gambling and the occurrence of addictions in the first place.We've got to even the odds somehow.

以上只是从医学角度说明，赌博成瘾为何如此棘手。这意味着，必须首先努力减少赌博现象并尽力防止赌博成瘾的发生。我们必须去改变。

（译者单位：上海工程技术大学外国语学院）