Study reveals surge in sports betting and gambling addiction help seeking

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University of California - San DiegoFeb 17 2025

A new study, published in JAMA Internal Medicine and led by researchers from the University of California San Diego Qualcomm Institute and School of Medicine, reveals a dramatic increase in sports betting and gambling addiction help-seeking since the landmark Murphy v. NCAA Supreme Court decision in 2018 paved the way for states to legalize sports betting.

"When the Supreme Court legalized sportsbooks - a venue where people can wager on various sports competitions - in Murphy v. NCAA, public health experts paid little attention," said the study's senior author John W. Ayers, Ph.D., who is vice chief of innovation in the Division of Infectious Disease and Global Public Health, deputy director of informatics at UC San Diego Altman Clinical and Translational Research Institute (ACTRI), and Qualcomm Institute scientist. "Now, sportsbooks have expanded from a single state to 38 states, with hundreds of billions of wagers, mostly online, coinciding with record-breaking demand for help with gambling addiction as millions seek help."

Unprecedented growth in sports betting

Since the 2018 Supreme Court ruling, the study documents staggering growth in the sportsbook industry:

The number of states with operational sportsbooks grew from 1 in 2017 to 38 in 2024.
Total sports wagers skyrocketed from $4.9 billion in 2017 to $121.1 billion in 2023, with 94% of wagers during 2023 placed online.

Sports betting has become deeply embedded in our culture. From relentless advertising to social media feeds and in-game commentary, sportsbooks are now everywhere. What was once a taboo activity, confined to the fringes of society, has been completely normalized."

Matthew Allen, third-year medical student

The researchers note these trends are projected to grow, in no small part due to the industry's investment in sportsbooks as the future of gambling, as evidenced by Caesars Entertainment's rebranding to Caesars Sportsbook and Casino.

A public health blind spot

"Despite gambling addiction as a recognized disorder in the Diagnostic and Statistical Manual of Mental Disorders, it remains largely overlooked in healthcare and public health with no formal ongoing surveillance," said Kevin Yang, M.D., a third-year resident physician in the Department of Psychiatry. "Without systematic surveillance, we are flying blind while millions bet on sports."

To fill this gap, the research team analyzed aggregate Google search trends for queries that mentioned gambling, addiction, addict, anonymous or hotline, from January 1, 2016, through June 30, 2024.

"Many people struggling with addiction don't openly discuss it, but they do turn to the internet for answers," said Davey Smith, M.D., professor of medicine and director of ACTRI. "By analyzing search trends, we can gain real-time insight into the true scale of gambling addiction in the U.S."

Record levels of gambling addiction help seeking

Parallel with the growth in sportsbooks, internet searches for help with gambling addiction, such as "am I addicted to gambling", have cumulatively increased 23% nationally since Murphy v. NCAA through June 2024. This corresponds with approximately 6.5 to 7.3 million searches for gambling addiction help-seeking nationally, with 180,000 monthly searches at its peak.

By state, the opening of sportsbooks consistently corresponded with increased demand for gambling addiction help seeking. Illinois (35%), Massachusetts (47%), Michigan (37%), New Jersey (34%), New York (37%), Ohio (67%), Pennsylvania (50%) and Virginia (30%) all experienced significant increases in gambling addiction-related searches following the opening of any sportsbooks in their state.

"The significantly higher search volumes observed in all eight states make it virtually impossible that our findings occurred by chance," said Atharva Yeola, a student researcher in the UC San Diego Qualcomm Institute. "Statistically speaking, the probability of these results happening randomly is less than one in 25.6 billion."

Online sportsbooks drive even greater risk

The study found that online sportsbooks had a substantially greater impact on gambling addiction help-seeking than traditional brick-and-mortar sportsbooks. For example, in Pennsylvania:

The introduction of retail sportsbooks led to a 33% increase in gambling addiction help seeking searches during the five months before online sportsbooks launched.
When online sportsbooks became available, searches surged 61%-a significantly greater and more sustained increase that persisted for years

"This pattern highlights the amplified risks associated with the accessibility and convenience of online sports betting," added Adam Poliak, Ph.D., assistant professor of computer science at Bryn Mawr College.

Policy and public health reforms needed

"The expansion of legalized sports betting to always be at arm's reach has outpaced our ability to understand and address its public health consequences," said Nimit Desai, a third-year medical student. "Our findings are a wake-up call for policymakers, healthcare professionals and public health advocates to act now."

To mitigate the risks posed by the expansion of sports betting, the researchers recommend the following interventions be explored:

Increased funding for gambling addiction services using sportsbook tax revenues to ensure accessible, evidence-based treatment programs.
Enhanced advertising regulations similar to those implemented for tobacco and alcohol to restrict where products can be advertised and who can be targeted.
Clinical training programs for healthcare professionals to improve gambling addiction diagnosis and treatment.
Stronger safeguards for online sportsbooks, including betting limits, age limits, enforced breaks and restrictions on credit card use for gambling.
Expanded public awareness campaigns highlighting the risks and warning signs of gambling, reducing stigma and encouraging early intervention.
Ongoing data sharing and research collaborations, uniting regulatory bodies, healthcare providers and regulators to assess the effectiveness of interventions and refine policies in real time.

"Sportsbook regulations are lacking because the Supreme Court, not legislators, legalized them," concluded Ayers. "Congress must act now by passing commonsense safeguards. History has shown that unchecked industries-whether tobacco or opioids-inflict immense harm before regulations catch up. We can either take proactive steps to prevent gambling-related harms or repeat past mistakes and pay the price later."

Source:

University of California - San Diego

Journal reference:

Yeola, A., et al. (2025). Growing Health Concern Regarding Gambling Addiction in the Age of Sportsbooks. JAMA Internal Medicine. doi.org/10.1001/jamainternmed.2024.8193.

Posted in: Medical Research News | Healthcare News

Tags: Addiction, Alcohol, Diagnostic, Healthcare, Medicine, Opioids, pH, Psychiatry, Public Health, Research, Therapeutics, Tobacco

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There’s psychological research revealing that gambling addicts

Frank Sterle says:

February 17, 2025 at 10:07 PM

There’s psychological research revealing that gambling addicts intentionally, though on a subconscious level, play games of chance until they lose everything. Gambling addicts are known for this kind of defeatist behavior in order to subconsciously feel justified in their post-large-monetary-loss self-flogging of their own psyches. (This formidable symptom of a gambling addiction can reach an extreme, one example having been aptly demonstrated in the film Owning Mahowny).

Thus, I’m left somewhat discouraged by the prevalence of fellow human beings who in contented-conscience procure and retain employment involving the exploitation of gambling addicts. While one might expect such disgracefulness from privately-owned casinos, one would expect better from a government-owned and -operated lotteries/games entity, which in my province comes in the form of British Columbia Lottery Corporation.

Unfortunately, it’s using the weaknesses of its more ‘loyal’ consumers, especially those with obsessive-compulsive tendencies. It tokenly offers gambling-addiction-withdrawal counselling services — as well as their ads’ quite insufficient “Know your limit, play within it” and/or “If you gamble, use your GameSense … 19+”. But it all hardly suffices for the significant and often irreparable financial damage done to addicts and their families.

And then there was/is BCLC’s audaciously and hypocritically self-serving “jackpot disentitlement rule” aspect of the formal “voluntary exclusion [request]” policy that falls under the Gaming Control Act. It enabled both publicly and privately owned lottery/gaming entities to withhold, ergo confiscate, sizeable winnings from addicts who had signed onto the ethically inexcusable agreement (presumably since then amended in compliance with the court’s ruling).

However, those large-profit gambling interests would permit themselves to keep any and all betting losses suffered by addicts who had signed the “voluntary exclusion [request]” form but still managed to access the casino.

A lawyer representing two plaintiffs who had their large winnings withheld by BCLC, though later ordered by a court to be rightfully handed back over to the plaintiffs, said that he had hoped the ruling would have retroactively ordered all such withheld winnings to be returned to their gambling-addict owners, regardless of the exclusionary agreement. “The lottery corporation had no right to withhold the winnings as a penalty [while] they’re taking both the losings and the winnings.”

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Meanwhile, most of us self-medicate in some form or another (besides

Frank Sterle says:

February 17, 2025 at 10:11 PM

Meanwhile, most of us self-medicate in some form or another (besides caffeine), albeit it’s more or less ‘under control’. And there are various forms of self-medicating, from the relatively mild to the dangerously extreme, that include non-intoxicant-consumption habits, like social media overuse, chronic shopping/buying, gambling, or over-eating (including highly sugar-saturated products).

If such self-medicating forms are anything like drug intoxication or addiction, it should follow that: the greater the induced euphoria or escape one attains from it, the more one wants to repeat the experience; and the more intolerable one finds their non-self-medicating reality, the more pleasurable that escape will likely be perceived. In other words: the greater one’s mental pain or trauma while not self-medicating, the greater the need for escape from one's reality, thus the more addictive the euphoric escape-form will likely be.

With food, the vast majority of obese people who considerably over-eat likely do so to mask mental pain or even PTSD symptoms. I utilized that method myself during much of my pre-teen years, and even later in life after ceasing my (ab)use of THC or alcohol. Though I don’t take it lightly, it’s possible that someday I could instead return to over-eating.

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