NYC's First Gambling Medicine Clinic

You Don't Have a
Willpower Problem.
You Have a Brain
Chemistry Problem.

Vantara Health uses proven medication, expert therapy, and structured programs built specifically for gambling disorder — not repurposed from a general addiction clinic.

This doesn't get better on its own. Most people wait years. You don't have to.
~40%Urge reduction with naltrexone
Same weekFirst appointment available
$0Your first consultation

Clinical Summary

RCT-Validated
Primary medicationNaltrexone / Vivitrol
Urge reduction vs placebo~40%
Most patients notice resultsWithin weeks
Co-occurring AUD / OUDAlso treated
AppointmentsSame-week
InsuranceMost major plans
Our Position

We are one of the only clinics in NYC using medication as first-line treatment for gambling disorder.

General addiction programs prescribe naltrexone for alcohol and opioids. They rarely consider it for gambling. Our protocols are built around the neuroscience of impulse control and reward system dysfunction — the same biology underlying gambling, alcohol, and opioid disorders.

Our approach is aligned with American Society of Addiction Medicine (ASAM) standards and evidence-based protocols from published clinical research. This is not an experimental practice. It is an underdeployed one — and we are changing that in New York City.

ASAM-Aligned Clinical Protocols

Evidence-based treatment standards from the American Society of Addiction Medicine, applied to gambling and impulse control

RCT-Validated Pharmacotherapy

Naltrexone and Vivitrol prescribed based on peer-reviewed randomized controlled trial data — not off-protocol guesswork

Physician-Supervised, Queens-Based

All protocols supervised by a board-certified Addiction Medicine physician — licensed, insured, and HIPAA-compliant

The Problem

Most programs weren't built for gambling.

General addiction clinics hand gambling patients a workbook and a helpline number. Therapists unfamiliar with naltrexone. Referrals to 12-step programs designed for a different condition. The result is predictable.

80%
of people with gambling disorder never receive any professional treatment

Gambling disorder shares the same opioid reward circuitry as substance addiction. Which means naltrexone — the medication proven to reduce alcohol and opioid cravings — works the same way for gambling. The science has been there for two decades. What was missing was a clinic built around it.

Without treatment: Gambling disorder progresses. Debts compound. The average person waits 7 years before seeking help — years in which the problem materially worsens. There is no benefit to waiting.

FeatureGeneral ClinicVantara
Gambling specialty✗ Rarely✓ Always
Naltrexone first-line✗ Rarely offered✓ Standard care
Integrated AUD / OUD care✗ Variable✓ Full integration
Same-week telehealth✗ Usually not✓ Always
Insurance accepted✗ Hit or miss✓ Most plans
Concierge / executive track✗ No✓ Yes
Free 2-Minute Screener

Do I have a gambling problem?

Based on the validated South Oaks Gambling Screen. Anonymous. No login. Immediate, scored results.

Gambling Disorder Screener

Question 1 of 6
Select an answer to continue

This screener is informational only. Only a licensed clinician can diagnose gambling disorder.

Process

Three steps to a different life.

No waiting rooms. No referral runaround. No bouncing between providers.

01
Day 1

Free Private Consultation

Thirty minutes with a specialist who focuses on exactly this. We listen, assess using validated clinical tools, and tell you honestly what we can do — no pressure, no sales pitch, no commitment.

30 min · free · same-week · telehealth or Queens clinic
02
Week 1

Your Personalized Plan

Medication, therapy, and program selection — coordinated by one clinical team around your specific situation. No bouncing between providers. Everything in one place.

Includes: medication eval · therapy match · program placement
03
Ongoing

Sustained Clinical Support

Monthly check-ins, medication adjustment, messaging between appointments. A team that knows your name and tracks your progress — not just for 30 days, but for as long as you need.

Most patients notice reduced urges within weeks of starting medication
What We Treat

Reward system disorders. All of them.

Gambling, alcohol, and opioid disorders share the same underlying brain circuitry. We treat the system — not just the behavior that brought you in.

Medication-Assisted Treatment

Naltrexone blocks the opioid receptors that drive the reward response — whether the trigger is a slot machine, alcohol, or an opioid. The same mechanism. The same medication. Applied with clinical precision to your specific condition.

Naltrexone (oral)Vivitrol (monthly)Suboxone / BuprenorphineAlcohol use disorder

Therapy & Behavioral Support

CBT (gold standard for gambling disorder), Motivational Interviewing, and family therapy — from licensed clinicians who specialize in impulse control. Telehealth sessions available evenings and weekends.

CBTIndividual sessionsFamily therapyPeer groups

Structured Programs

The Vantara Reset (12-week flagship for gambling disorder), Dual Diagnosis Program (gambling + alcohol or opioids), Executive Track (concierge, fully private), and B2B programs for employers and casinos.

12-Week ResetDual DiagnosisExecutive TrackEAP / Casino
The Neuroscience

Why medication works
for gambling.

Gambling disorder is not a willpower deficit. It is a DSM-5-recognized behavioral addiction driven by the same opioid reward pathways as substance use disorders. When someone wins a bet, dopamine floods the brain through opioid receptors — the same pathway naltrexone blocks.

Multiple randomized controlled trials demonstrate clinically significant reduction in gambling urges and behavior with naltrexone and Vivitrol. A 2024 network meta-analysis identified these as the highest-evidence pharmacological options in the field. This is not experimental. It is under-deployed.

NYC's Casino Era Begins Now

Resorts World NYC opens full table games in 2026. Hard Rock Metropolitan Park at Citi Field targets 2030. Bally's Bronx adds a third venue. The infrastructure of gambling is expanding across the five boroughs. Vantara Health exists to ensure the infrastructure of treatment expands with it.

~40%reduction in gambling urges vs. placebo in randomized controlled trials
#1most evidence-supported pharmacotherapy for gambling disorder (2024 NMA)
Weeksmost patients notice meaningful reduction in urges after starting naltrexone
80%of those with gambling disorder never receive professional treatment
Programs

Start here. Build from there.

Most patients begin with the Vantara Reset. Everything else is an upgrade path.

Start Here

The Vantara Reset

12 Weeks · Intensive Outpatient

NYC's most comprehensive outpatient gambling disorder program. Weekly clinician check-ins, bi-weekly CBT therapy, monthly Vivitrol injections, peer group sessions, and financial recovery planning. Built to create lasting change — not a 30-day pause.

Weekly medication management visits
Bi-weekly individual CBT therapy
Monthly Vivitrol injection at Queens clinic
Peer support group sessions
Financial recovery planning referrals
Progress monitoring + urinalysis
One family session included
Integrated · Ongoing

Dual Diagnosis Program

For patients with gambling + alcohol use disorder or gambling + opioid use disorder. Fully integrated medication and therapy — one team managing the full complexity, without referrals out.

Naltrexone or Suboxone management
Integrated addiction psychiatry support
Co-occurring disorder therapy
Concierge · Cash Pay

Executive Track

Complete discretion for patients who require it. Private billing, dedicated coordinator, separate scheduling, and priority access — one trusted clinical relationship, total confidentiality.

Private, discreet billing options
Dedicated care coordinator
Priority scheduling, evening hours
Life After Treatment

What changes when
the compulsion quiets.

Recovery isn't just stopping gambling. It's the reclamation of everything the addiction was consuming — money, sleep, relationships, self-respect. Here's what patients describe at 3, 6, and 12 months.

Financial life

Before

Debt accumulating weekly. Credit cards maxed. Hiding statements. Lying about where money went.

After 6 months

Debts mapped and being paid down. No new losses. First savings account opened in years.

Sleep & mental health

Before

3am sessions. Racing thoughts about losses. Anxiety, shame, and depression as constants.

After 3 months

Sleeping through the night. Anxiety measurably lower. Mood stabilizing. Energy returning.

Relationships

Before

Lying to spouse, parents, kids. Missing events. Isolation. Trust completely eroded.

After 12 months

Honest conversations happening. Family therapy in progress. Trust in active repair.

Sense of self

Before

Identity consumed by gambling. Planning the next session. Believing this is just who you are now.

After treatment

"I walked past a betting terminal and felt nothing. That had never happened in four years." — actual patient.

NT
Nikolas Tsihlas, PA-C Founder & Lead Clinician
Queens, New YorkTelehealth statewide · In-person clinic opening 2026
The Founder

Built by someone who saw the gap — and got angry about it.

"I managed care for patients with complex addiction histories who were actively in treatment. I kept watching gambling disorder get treated as an afterthought — or not treated at all. Patients who needed real medical intervention were getting handouts and hotlines. That shouldn't exist. So I built what should."

— Nikolas Tsihlas, PA-C · Founder, Vantara Health

Nikolas Tsihlas is a New York State licensed Physician Assistant with a clinical background managing patients with active substance use disorders and complex treatment histories. Watching patients with gambling disorder — often with co-occurring alcohol or opioid issues — fall through the cracks of a system not designed for them drove him to build something different.

Vantara Health is that something. A clinic built around the neuroscience of reward system dysfunction — not a general addiction program repurposed for a different disease. Located in Queens, where the gambling landscape is about to change dramatically.

Pain Management & Addiction Care

Clinical background managing patients with complex addiction histories and active treatment needs in NYC

Addiction Medicine Certified

SAMHSA buprenorphine-trained · AOAAM-aligned · DEA-registered · NY State licensed PA-C

Physician-Supervised Practice

All protocols supervised by our Medical Director, board-certified in Addiction Medicine (ABAM)

Patient Stories

Real outcomes. Real people.

★★★★★
0 gambling episodes at 3 weeks
"The only place in NYC that actually understood what I was going through medically. They explained the neuroscience, started naltrexone, and within three weeks I stopped. Not reduced — stopped."
M.T. · 38 · Queens · Gambling + alcohol
★★★★★
Nightly betting → zero urges in 5 weeks
"I was skeptical medication could help gambling. Five weeks into naltrexone, I walked past a sports betting terminal and felt nothing. That had literally never happened in four years."
R.A. · 44 · Manhattan · Sports betting, daily
★★★★★
12 weeks: first honest conversation in years
"One Vivitrol shot a month and the compulsion just quieted. Combined with the CBT, I'm finally having honest conversations with my wife. I wish I'd found this two years ago."
D.L. · 51 · Bronx · Online gambling + opioid use
Pricing

Transparent. Accessible. No surprises.

Most care is billed through insurance. Here's exactly what to expect before you book.

Insurance / Medicaid

Standard Care

$0–50 / visit copay

Most services are covered under behavioral health benefits. We verify your coverage before your first appointment — zero financial surprises.

Initial evaluation (often $0)
Monthly medication management
Individual therapy sessions
Vivitrol (often $0–150 with coverage)
Most Flexible
Cash Pay

Self-Pay

$149 / month

No insurance required. Flat, transparent pricing — for speed, privacy, or patients whose plans don't cover behavioral health.

Initial eval: $299 one-time
Monthly med management: $149
Therapy sessions: $175 each
Vivitrol: at-cost injection
Concierge

Executive Track

$2,500 / month

Everything included. Complete discretion. All medication management, unlimited messaging, dedicated coordinator, private billing — one relationship, total privacy.

All medication management
Unlimited provider messaging
Dedicated care coordinator
Private billing options
Free Clinical Guide

"What Gambling Disorder Actually Is —
And Why Willpower Isn't the Answer"

A plain-language clinical guide covering the neuroscience, the medications that work, and what real treatment looks like. Written by our clinical team. No fluff, no dogma.

✓  Check your inbox. The guide is on its way. One follow-up about next steps — nothing else, ever.

No spam. Unsubscribe anytime. Your email is never sold or shared.

For Employers & Casinos

Your workforce is already gambling.
Does your organization
have a plan?

Sports betting is on every phone. Three casinos open in NYC by 2030. Gambling disorder costs employers through lost productivity, absenteeism, theft driven by debt, and accelerated turnover — and it's the most financially destructive behavioral health condition in the modern workplace.

For gaming operators, a credible clinical referral partner is legally prudent and strategically valuable — demonstrating responsible gaming commitment, reducing liability, and building community trust before opening day.

Casino Partnership Opportunity

All three NYC casino licensees are required to fund responsible gambling programs. Vantara Health is available to serve as your clinical referral partner — branded, professional, HIPAA-compliant treatment access for players who need it.

Employee EAP Program

Priority clinical access for employees. Flat-rate contracts from $5,000/year. Integrates with major EAP platforms or runs standalone.

Workplace Screening

Anonymous, validated screening tools for HR deployment. Identify at-risk employees before a crisis — legally and compassionately.

Casino Responsible Gaming Partner

Branded clinical referral integration for gaming operators. Help players who need it. Reduce liability. Demonstrate commitment.

Manager Training

Train HR and management to identify warning signs and respond legally, compassionately, and before escalation.

Most major insurance accepted — including Medicaid & Medicare

Medicaid
Medicare
Blue Cross Blue Shield
Aetna
United Healthcare
Cigna
Oxford
Self-Pay Available
Questions

Everything you need to know.

Is gambling disorder a real medical condition?
+
Yes. Gambling Disorder is recognized in the DSM-5 as a behavioral addiction with the same neurological profile as substance use disorders. It is not a moral failure. It is a brain condition that responds to treatment — including medication. The sooner it's addressed, the better the outcomes.
Does insurance cover gambling disorder treatment?
+
Most major plans cover medication management, psychiatric evaluation, and therapy under behavioral health benefits. We verify your benefits before your first appointment — no financial surprises. We accept Medicaid, Medicare, BCBS, Aetna, United, Cigna, Oxford, and others.
What is naltrexone and is it safe?
+
Naltrexone is an FDA-approved medication with over 30 years of safety data. It blocks opioid receptors in the brain, reducing the dopamine reward that drives gambling urges. Non-addictive. Non-sedating. The most common side effect is mild, temporary nausea in the first week, which typically resolves on its own.
What is Vivitrol?
+
Vivitrol is the injectable, extended-release form of naltrexone. One injection lasts 30 days — ideal for patients who don't want to manage a daily pill. We administer Vivitrol in-person at our Queens clinic. Covered by most insurance plans.
Is my treatment completely private?
+
Absolutely. Protected by HIPAA. Nothing shared with employers, family, or anyone else without your written consent. Our Executive Track offers additional confidentiality including discreet billing under a separate practice name if needed.
Do I have to come in person?
+
Most care is delivered via secure telehealth — video visits from wherever you are. The only in-person requirements are Vivitrol injections at our Queens clinic and any ordered lab work. Everything else available remotely across New York State.
Do you also treat alcohol and opioid use disorder?
+
Yes. Gambling, alcohol, and opioid disorders share the same underlying reward system circuitry — and we treat all three. Naltrexone and Vivitrol for alcohol and gambling; Suboxone (buprenorphine/naloxone) and Vivitrol for opioid use disorder. Many patients have co-occurring conditions, and we manage them as one integrated plan.
How quickly can I be seen?
+
Most patients are seen within 3–5 business days. Medication can often be initiated at or immediately after the first full evaluation. Same-week availability is our standard. This problem does not improve with time — and neither should your wait.

Take the first step.
It's free. It's private.
It's today.

This doesn't get better on its own. Most people wait years before getting help. You don't have to be one of them. Gambling disorder is a medical condition. Medication-assisted treatment works.

Free consult · Same week · Most insurance accepted · Telehealth statewide · 100% HIPAA-private

Vantara Health / Alcohol Use Disorder Treatment NYC
Alcohol Use Disorder Treatment in New York City

Naltrexone & Vivitrol for
Alcohol Use Disorder
in NYC

Evidence-based medication-assisted treatment for alcohol use disorder — including naltrexone (oral) and Vivitrol (monthly injectable). Same-week telehealth appointments. Most insurance accepted. Queens-based clinic serving all of New York State.

Alcohol Use Disorder Treatment at Vantara Health

Vantara Health provides medication-assisted treatment (MAT) for alcohol use disorder in New York City via telehealth and in-person at our Queens clinic. Our clinical team uses FDA-approved medications — naltrexone and Vivitrol — alongside therapy and structured support to help patients reduce or stop drinking.

Naltrexone for Alcohol Use Disorder

Naltrexone is an FDA-approved, non-addictive medication that reduces the rewarding effects of alcohol by blocking opioid receptors in the brain. When alcohol becomes less rewarding, the drive to drink diminishes. It is available as a daily oral pill or as Vivitrol — a once-monthly injectable that removes the need for daily adherence.

  • FDA-approved for alcohol use disorder since 1994
  • Reduces alcohol cravings and the reward response to drinking
  • Non-addictive and non-sedating
  • Most common side effect: mild nausea in the first week, typically resolving on its own
  • Available oral (daily) or injectable (Vivitrol, once monthly)

Why Vantara Health for Alcohol Use Disorder?

Most primary care physicians are not trained in addiction medicine. Most addiction treatment programs focus on residential care. Vantara Health fills the gap — providing outpatient, telehealth-accessible MAT for AUD in New York, with same-week appointments, insurance billing, and integrated therapy.

Many of our AUD patients also have co-occurring gambling disorder or opioid use disorder. We treat all three conditions under one integrated clinical plan — so patients don't have to navigate multiple providers and fragmented care.

Insurance Coverage for Alcohol Use Disorder Treatment

Medication management for alcohol use disorder is covered by most major insurance plans, including Medicaid and Medicare, under behavioral health benefits. We verify your coverage before your first appointment. Cash pay options are also available starting at $149/month.

Ready to start?

Free 30-minute consultation. Same-week availability. Most insurance accepted.

Medications we prescribe

Naltrexone (oral, daily) · Vivitrol (injectable, monthly) · Suboxone for co-occurring OUD

Insurance accepted

Medicaid · Medicare · BCBS · Aetna · United · Cigna · Oxford · Self-pay available

Vantara Health / Suboxone Treatment NYC
Suboxone & Opioid Use Disorder Treatment in NYC

Suboxone Treatment
in New York City
— Telehealth Available

Buprenorphine/naloxone (Suboxone) and Vivitrol for opioid use disorder. Same-week telehealth appointments across New York State. Most insurance accepted including Medicaid. Queens-based clinical team with addiction medicine supervision.

Suboxone Treatment at Vantara Health

Vantara Health provides outpatient medication-assisted treatment (MAT) for opioid use disorder in New York City via telehealth and in-person at our Queens clinic. Our clinical team prescribes Suboxone (buprenorphine/naloxone) and Vivitrol (injectable naltrexone) as part of an integrated treatment plan that includes therapy and clinical monitoring.

What Is Suboxone?

Suboxone is a combination of buprenorphine — a partial opioid agonist — and naloxone, an opioid antagonist. It reduces withdrawal symptoms and cravings, blocking the effects of other opioids without producing a significant high at therapeutic doses. It is the gold-standard first-line pharmacotherapy for opioid use disorder, endorsed by SAMHSA, CDC, NIH, and ASAM.

  • Reduces withdrawal symptoms and opioid cravings
  • Blocks the rewarding effects of opioids
  • Can be initiated via telehealth without prior in-person visit
  • Covered by Medicaid, Medicare, and most commercial insurance
  • Available as a sublingual film or tablet taken once daily

Vivitrol for Opioid Use Disorder

For patients who have completed detoxification and want a non-opioid option, Vivitrol (injectable naltrexone) provides 30-day opioid blockade in a single monthly injection. It is ideal for patients with high relapse risk in specific periods or those who prefer not to take a daily medication. We administer Vivitrol in-person at our Queens clinic.

Co-occurring Gambling or Alcohol Disorder

Many patients with opioid use disorder also struggle with gambling disorder or alcohol use disorder. Vantara Health treats all three under one integrated plan — reducing the complexity and fragmentation of seeking care from multiple providers. This is one of our core clinical differentiators.

Start treatment this week

Suboxone can be initiated via telehealth. Same-week appointments. Most insurance accepted.

Medications we prescribe

Suboxone (buprenorphine/naloxone) · Vivitrol (naltrexone injectable, monthly) · Naltrexone oral for co-occurring AUD

Insurance accepted

Medicaid · Medicare · BCBS · Aetna · United · Cigna · Oxford · Self-pay available

Vantara Health / Naltrexone Therapy NYC
Naltrexone Therapy in New York City

Naltrexone for Gambling,
Alcohol & Impulse Control
in NYC

Naltrexone and Vivitrol prescribed for gambling disorder, alcohol use disorder, and opioid use disorder in New York City. Telehealth appointments available statewide. Most insurance accepted. Evidence-based protocols from an addiction medicine-supervised clinical team.

What Is Naltrexone?

Naltrexone is a non-addictive, FDA-approved opioid antagonist medication. It works by blocking opioid receptors in the brain — receptors that mediate the reward and pleasure response to alcohol, opioids, and behavioral stimuli like gambling. When the reward signal is blocked, the urge to drink, use, or gamble diminishes significantly over time.

What Conditions Does Naltrexone Treat?

  • Alcohol Use Disorder — reduces cravings and the pleasurable effects of drinking (FDA-approved)
  • Opioid Use Disorder — blocks opioid effects and reduces relapse risk (FDA-approved, available as Vivitrol injectable)
  • Gambling Disorder — reduces gambling urges and frequency in clinical trials (~40% reduction vs placebo) — off-label, evidence-based
  • Co-occurring reward system disorders — many patients have gambling + alcohol, or gambling + opioids; naltrexone addresses the shared underlying circuitry

Naltrexone vs. Vivitrol: What's the Difference?

Naltrexone oral is a daily pill. Vivitrol is the extended-release injectable form of naltrexone — one injection provides 30 days of opioid receptor blockade. Vivitrol eliminates the need for daily adherence and is ideal for patients in high-risk periods or who prefer a longer-acting option. We administer Vivitrol in-person at our Queens clinic.

Naltrexone for Gambling Disorder in NYC

Vantara Health is one of the only clinics in New York City that prescribes naltrexone as first-line treatment specifically for gambling disorder. Most addiction clinics use naltrexone for alcohol and opioids but do not apply it to gambling. Our protocols are based on published randomized controlled trials and aligned with American Society of Addiction Medicine standards.

Getting Naltrexone in NYC

We offer same-week telehealth consultations for naltrexone prescriptions across New York State. After a clinical evaluation, most patients can receive a naltrexone prescription sent to their local pharmacy within 24–48 hours. Vivitrol injections require an in-person visit to our Queens clinic. Most insurance plans cover naltrexone for AUD and OUD; coverage for gambling disorder varies by plan and diagnosis coding.

Get a naltrexone prescription this week

Telehealth evaluation, same-week. Prescription sent to your pharmacy. Most insurance accepted.

Available forms

Naltrexone oral (daily pill) · Vivitrol (once-monthly injection, in-person Queens clinic)

Conditions treated

Gambling disorder · Alcohol use disorder · Opioid use disorder · Co-occurring reward system disorders

Free Consultation

Get Control Back Today.

30 minutes. No commitment. No judgment. Same-week availability. Tell us what's going on — we'll tell you exactly what we can do.

Your Information
About Your Situation
Please complete all required fields and check the consent box.

You're all set.

Our team will reach out within one business day to confirm your appointment. Most patients are seen within 3–5 business days.

What happens next

  • We contact you within 1 business day
  • We confirm your appointment and verify insurance if needed
  • You receive a secure video link for your consult
  • Your clinician listens, assesses, and explains your options

What to expect

Your free 30-minute consult is a conversation, not a sales pitch. We use validated tools (SOGS, AUDIT, PHQ-9) to understand your situation and tell you honestly what we can do.

Privacy guarantee

Everything you share is protected by HIPAA. Nothing shared with employers, family, or anyone else without your written consent.

Executive Track

Need complete discretion? Note it in the form above. Private billing, dedicated coordinator, separate scheduling — $2,500/month.

In crisis right now?

National Problem Gambling Helpline:
1-800-522-4700
24/7 · Free · Confidential