Sir: Lottery sales to date exceed £30 billion. Thirty million Britons play regularly and the game has nationwide status. For most the game is harmless fun. Despite one million winners each week, statistics do not tally those with psychosocial problems.

Pathological gambling is described as “frequent repeated episodes of gambling that dominate… life to the detriment of social, occupational, material and family values and commitments” (World Health Organization, 1992). Studies suggest that 5% of Lottery players are pathological gamblers and 80% of Britons consider the game to be ‘addictive’.

Recently, a small player group randomly selected from replies to a newspaper advertisement described a symptom cluster similar to obsessive—compulsive disorder, anecdotally named lottery-compulsive disorder (LCD). LCD involves repetitive obsessions or compulsions to play the Lottery, which are irresistible owing to fears of the players' ‘numbers coming up’. Despite acknowledging these impulses to be irrational, they are unable to resist. The gaming process may develop to interfere with social functioning, whether by ensuring the ticket purchase has priority over other activities, wasting time or financial implications. LCD may involve ritualistic behaviour, for example in the way the player chooses numbers, buys tickets or repeatedly checks numbers.

Psychiatric implications of lotteries are widely accounted in the USA, where a proactive stance is adopted towards problem players. Most states spend at least $1 million per year on funding gambling helplines, education, publicity, gambling treatment programmes and promoting the ‘play responsibly’ campaign. By comparison, the UK is lamentable in its efforts, and research, treatment and public education is notable by its paucity. The Lottery Commission promises £250 000 over 5 years towards a study on problem gambling. Although this may console some critics, it seems a mediocre pledge, representing less than one-thousandth of profits. With the Lottery already funding counselling for winners and a daily retailer hotline, it seems reasonable in terms of costs and practicalities to afford similar services to Lottery losers under the criteria of the ‘good causes’. Only then can we regard the National Lottery as an innocuous family game and avert mental health disorders such as LCD.