Gambling addiction has soared since the legalization of sports betting in most American states, reveals a new study.
Researchers found 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 gambling on sports.
Since the ruling, researchers from the University of California San Diego Qualcomm Institute and School of Medicine found a “staggering” growth in the sportsbook industry.
The number of states with operational sportsbooks grew from one in 2017 to 38 last year while total sports wagers skyrocketed from US $4.9 billion in 2017 to $121.1 billion in 2023, with 94% of wagers during 2023 placed online.
Study senior author Professor John W. Ayers said: “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.
“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.”
Co-author Matthew Allen, a third-year medical student, said: “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,” Allen said.
The research team warned that the 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.
Co-author Dr Kevin Yang said: “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.
“Without systematic surveillance, we are flying blind while millions bet on sports.”
The research team analyzed aggregate Google search trends for queries that mentioned gambling, addiction, addict, anonymous or hotline, from January 1, 2016, through to the end of June last year.
Co-author Professor Davey Smith said: “Many people struggling with addiction don’t openly discuss it, but they do turn to the internet for answers.
“By analyzing search trends, we can gain real-time insight into the true scale of gambling addiction in the U.S.”
Parallel with the growth in sportsbooks, internet searches for help with gambling addiction, such as “am I addicted to gambling”, have cumulatively increased 23% in the US since Murphy v. NCAA through to June 2024.
That corresponds with around 6.5 to 7.3 million searches for gambling addiction help-seeking in the US with 180,000 monthly searches at its peak, according to the findings published in JAMA Internal Medicine.
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.
Atharva Yeola, a student researcher in the UC San Diego Qualcomm Institute, said: “The significantly higher search volumes observed in all eight states make it virtually impossible that our findings occurred by chance.
“Statistically speaking, the probability of these results happening randomly is less than one in 25.6 billion.”
The study also 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
Co-author Dr Adam Poliak, Assistant Professor of Computer Science at Bryn Mawr College, Pennsylvania, said: “This pattern highlights the amplified risks associated with the accessibility and convenience of online sports betting.”
Co-author Nimit Desai, a third-year medical student, said: “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.
“Our findings are a wake-up call for policymakers, healthcare professionals and public health advocates to act now.”
To reduce the risks posed by the expansion of sports betting, the research team has drawn up a series of recommendations.
These include increased funding for gambling addiction services using sportsbook tax revenues to ensure accessible, evidence-based treatment programs, and enhanced advertising regulations similar to those implemented for tobacco and alcohol to restrict where products can be advertised and who can be targeted.
The team also called for stronger safeguards for online sportsbooks — including betting limits, age limits, enforced breaks and restrictions on credit card use for gambling.
Prof Ayers added: “Sportsbook regulations are lacking because the Supreme Court, not legislators, legalized them.
“Congress must act now by passing common-sense 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.”
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