‘You Can Gamble Yourself into the Grave’: Is the U.S. Staring Down the Barrel of a Gambling Addiction Crisis?

Monthly Issue Passions & Pitfalls in American Sports Betting

Ryan Pitcher began gambling on sports when he was 17 years old, visiting betting shops in his hometown of Lincoln, England, to place small wagers on English soccer matches.

“It wasn’t problematic by any stretch,” he says. “I felt in control.”

One day, Pitcher tried his luck at a “fixed odds betting terminal,” an electronic machine that allows players to bet on simulated games of roulette and slots, as well as virtual horse and dog races. In 20 minutes, Pitcher says, he won more than 1,000 pounds, around US$1,300.

“That was a monthly wage for me back then,” he says. “From that moment, I was hooked.”

Over time, Pitcher says, he developed a gambling addiction that led him to lie and steal, ruin close relationships, and run up ruinous amounts of debt. Now 34 and in recovery since March 2020, he says that legal sports betting played a central role in his habit.

In 2015, Pitcher says, he spent hours sitting on the edge of a overpass near his home, sobbing and contemplating suicide. “That’s how much I wanted to stop,” says Pitcher, who hosts the gambling addiction recovery podcast All Bets Are Off. “And I just couldn’t.”

For decades, sports betting in the United States has been tightly controlled, outlawed outside of Nevada sports books, and treated as taboo by entities such as the National Football League. But no longer. In the wake of a 2018 Supreme Court ruling that overturned a federal ban, sports betting has become legal and operational in 30 states and the District of Columbia – which means roughly 178 million Americans are free to take the NFL’s Arizona Cardinals and the over.

Business is booming. Across sports media, gambling advertising and related content are ubiquitous, while partnerships between teams and betting companies – like the Arizona Cardinals opening a sportsbook on stadium grounds with online gambling operator BetMGM – have become commonplace. According to the American Gaming Association, an industry trade group, Americans wagered at least $53.96 billion with legal sports books in 2021, generating $4.13 billion in revenue and $672 million in taxes; if all 50 states eventually allow sports gambling, revenues are expected to surpass $19 billion annually.

As the country goes all in, however, people who study and treat problem gambling fear the industry’s rapid growth is sowing the seeds of a coming public health crisis: an explosion of compulsive wagering connected to sports, fueled not only by expanded access and shifting cultural mores but also by technology that makes betting itself arguably more addictive than ever before.

“This is a major, major issue, and we all need to take it extremely seriously,” says Jim Maney, executive director of the New York Council on Problem Gambling, a nonprofit that advocates for increased public awareness of and support services and treatment for problem gambling. “We see the families, and we listen to the stories, and we hear the suffering that is going on. And we are not as a society or a state or an industry doing nearly enough of what needs to be done.”

‘There Was Just No Control’

Pitcher didn’t gamble exclusively on sports. But he did wager heavily on thoroughbred racing, greyhound racing, and soccer – day after day, morning until night, first at betting shops and later through his mobile phone. His bets got bigger and more frequent and increasingly elaborate, funded by credit cards and payday loans and whatever, he says, he could “steal and scam off people.”

“I’d be buzzing around like a blue-bottle fly does, needing to get on to the next bet,” Pitcher says. “In the U.K., dog races go off every four or five minutes from about 11 a.m. to 9 p.m. And I couldn’t just be on a single bet. I had to have a forecast, I had to have a tricast, a treble, a Yankee. If I was on a horse at one o’clock, I needed to be on a horse at 3 o’clock.

“And it was the same with [soccer] betting. There was just no control.”

Classified as an addiction by the American Psychiatric Association, problem gambling is characterized by a preoccupation with wagering, a need to bet frequently or with increasing amounts, “chasing” losses, lying to hide one’s betting activity, and an inability to cut back or stop gambling – even when it causes significant and mounting problems in daily life.

Imaging studies have shown that gambling activates the brain’s reward system the way drug and alcohol use does and that problem gamblers experience nearly the same elevated levels of the neurotransmitter dopamine – which is associated with reward-seeking behavior – when winning and losing money. Researchers also have found that problem gamblers suffer high rates of substance abuse, as well as mental health issues such as anxiety and depression.

“Some of those problems are caused by the gambling, and with some of them the gambling may be a means of escape,” says Keith Whyte, executive director of the National Council on Problem Gambling, a U.S. nonprofit that advocates for programs and services to help people with gambling problems. “Things like depression, stress, anxiety – if you’ve lost more than twice your average annual income gambling, it wouldn’t be surprising if you’re stressed, anxious and depressed, right?

“The other thing is the physical symptoms. People with gambling problems often have high rates of heart disease, high blood pressure, stroke, up to and including high rates of suicidal behavior. So this is not just losing money. It’s not even being stressed about losing money. You can gamble yourself into the grave.”

Related: Americans Are Becoming More Educated and Experienced With Sports Betting As More States Make It Legal

Most people who gamble will not develop a disorder, but some will. Just how many is unclear. The federal government does not monitor or track gambling addiction. Nor do any states except Massachusetts, where a statewide survey found that men, African-Americans, and people without a college education are at greater risk.

According to Whyte, the studies and surveys that have been conducted – mostly at the state and international levels, and often funded by the gaming industry – suggest that roughly 5 percent of Americans who gambled in the past year meet the criteria for problem gambling. But because problem gamblers tend to hide their addictions, he says, “it’s a guesstimate, no question. And we don’t have a good idea for the percentage of problem sports gamblers on the national level.”

What experts do know about sports betting is concerning. A 2018 review of more than 140 gambling studies and reports concluded that the rate of problem gambling among sports bettors is at least twice as high as the rate among bettors in general – and that problem rates are even higher for sports gamblers who bet online.

In Pennsylvania, help line calls to the state’s Council on Compulsive Gambling reportedly remained flat in 2020, likely because the coronavirus pandemic shut down in-person gambling for one-third of the year. However, calls from people describing sports betting as their primary problem increased 66 percent.

Last March, an extensive national survey commissioned by Whyte’s organization found that sports bettors reported far more signs of problem gambling – including “lied to hide gambling” and “relied on others to pay debts or bills” – than non-sports bettors, and that younger bettors appear to be at higher risk of developing problems.

All of the above troubles Maney, a former drug addiction rehabilitation program director who has worked on problem gambling in New York State for almost 25 years. Earlier in his career, he says, most of the people he saw in treatment were “middle-aged White men who gambled on the horses” at racetracks. But as casino and lottery betting expanded, he says, the gaming industry “found a niche for everyone.”

Today, Maney says, legal sports betting is poised to expand the pool of potential problem gamblers – and fast. When New York began allowing online sports books to operate in the state in January, for example, 1.2 million customer accounts were created in 10 days.

In turn, this could be particularly harmful for young adults, who in the National Council on Problem Gambling’s survey were at the highest risk of addiction of any age group. Research compiled by the International Center for Responsible Gaming, a nonprofit that funds scientific research on gambling addiction and is primarily funded by the gambling industry, has found that most adults with a gambling problem started at an early age; that teenagers and young adults are more impulsive and at higher risk for developing gambling disorders than adults; and that an estimated 6 percent of American college students have a serious gambling problem.

“With sports gambling, we’re starting to see [problems] hit a younger population than we’ve dealt with before,” says Michelle Hadden, assistant executive director for the New York Council on Problem Gambling.

‘A Whole Different Intoxicating Cocktail’

Once upon a time in the U.K. – that is, the early 2000s – legal sports betting worked something like this: you walked or cycled or drove to a betting shop. You placed your wagers. You likely paid with cash. You went home to watch the events you had gambled on – soccer matches, perhaps, which would take place over the course of an entire weekend. Afterward, you went back to the betting shop to collect any winnings.

“It was really drawn out spatially and temporally,” says Darragh McGee, a professor at the University of Bath who studies sports gambling, focusing on how online betting affects young men. “And the betting shops were these kind of marginalized, smoky back rooms behind frosted glass where you never knew what was inside. For the most part, these were stigmatized as places for old men. Young people weren’t really interested in those spaces.”

That was then. Today, McGee says, sports gambling in the U.K., as well as his home country of Ireland, has become “a whole different intoxicating cocktail” in which addiction risk and other gambling harms are being fueled not only by increased access to wagering but also by shifts in how and why people bet on sports.

Start with smartphones. Sports gamblers who use mobile devices have higher rates of problem gambling than those who don’t. That’s no coincidence. Smartphones and their software are purposefully designed to hold our attention and keep us coming back for more. Wagering with virtual money or online credits is akin to betting with chips in a physical casino: It has a disinhibiting effect, which can result in larger and more frequent bets.

Most importantly, mobile technology means that sports gamblers can now wager all day, every day, on games and matches taking place across the planet. There are also more ways to bet than ever before, both before and during contests: on how many corner kicks will be taken in a soccer match, on whether three different teams will all cover the point spread, on whether the next serve in a live tennis match will be an ace or a fault.

The result? The traditional delay between risk and reward in sports gambling has been erased, replaced by a kind of digital slot machine. Research has linked this kind of rapid and impulsive gambling with increased addiction risk, and a 2018 study of regular sports bettors in Australia found that 78 percent of those who made wagers during live play could be classified as problem gamblers – compared to roughly 29 percent of those who didn’t make live bets.

“Most of my harm was through my phone,” says Pitcher, the podcast host in recovery. “It was just there all the time, and everything was so rapid – always on the move, hundreds of markets, always on your mind, going 100 miles per hour. You’re being sold cross-products and different promotions, too. And that is just lethal. Lethal.”

In the U.K., McGee says, the sports and gambling industries have become deeply intertwined – particularly since the country lifted a ban on television and radio advertising for casinos, betting shops, and online gambling sites in 2007. Over the next six years, spending on gambling ads increased 600 percent. Today, there are betting company logos on soccer jerseys; gambling ads on the electronic billboards around pitches; podcasts and broadcasts sponsored by companies like SkyBet. A 2018 study found that gambling logos or branding were on screen for 71 percent to 89 percent of the time during BBC broadcasts of Premier League matches – even though, as journalist David Conn pointed out, the BBC does not carry actual advertising.

All of this can be devastating for problem gamblers. Paul Merson, a former English soccer star who lost an estimated $9.6 million betting, told The Guardian that “people are virtually telling you on the [television] you can’t watch [soccer] without gambling. Imagine what it triggers in me? Even when I’m driving in the car at seven in the morning and an advert comes on for the prices of a football match in 13 hours’ time, that’s a major trigger. They’ll give the odds on Man United and something in my brain goes: ‘That ain’t bad.’”

For Pitcher, watching and wagering became indistinguishable. His Saturday ritual went something like this: wake up, go with friends to the betting shop, buy some beer on the way back, spend the rest of the day watching soccer together at someone’s house. Some of the men could bet responsibly. Others couldn’t. But nobody thought to simply not gamble at all.

“We’d all have our betting slips out on a Saturday, and that is what we lived for,” Pitcher says. “Betting, meeting up, and socializing. It’s very much a lad culture. Lads do it all the time.”

McGee calls this “gamblification of sports” – a blurring of the lines between commercial and cultural environments in which betting is considered part and parcel of fandom itself. For a study published in the Journal of Public Health, McGee conducted a series of in-depth interviews about sports gambling with 32 men ages 18-35 in England and Northern Ireland. One confessed that he dealt drugs to recover money that he lost betting on sports. Others said they could no longer enjoy watching games they hadn’t placed bets on.

All of the men in the study, McGee says, “considered the fact that gambling had become deeply normalized in sport problematic.”

“That’s the great success of the sports gambling industry in the U.K.,” McGee says. “You have a generation of sports fans who were raised to see gambling as a normal part of sports, many of whom can’t just watch the game for what it is anymore.”

‘Hold My Beer’

Europe’s sports betting boom has inspired an ongoing backlash. In Spain, gambling companies are no longer permitted to advertise on the fronts of soccer jerseys or inside stadiums. In Germany, an umbrella organization for soccer team fan groups has called for a ban on gambling ads, a freeze on new gambling sponsorship deals with teams and organizations, and a commitment for half of the money from existing sponsorships to be spent on addiction prevention.

The U.K. is considering an overhaul of its gambling laws, which a House of Lords committee says have gone “horribly wrong.” In an extensive report on the social and economic impact of betting, the committee estimated that 340,000 of the country’s adults are problem gamblers, faulted “lax regulation” for contributing to that number, and proposed a series of reforms, including:

• Banning gambling sponsorships in sports.
• Adopting a mandatory industry levy to fund addiction treatment.
• Establishing an independent regulator to evaluate the addiction and harm potential of individual gambling products.
• Implementing stricter controls on “free bets,” bonuses, and other inducements to gamble.
• Requiring gambling companies to limit players’ monthly losses, work with banks to make sure that people are gambling within their means, and share data with each other to identify and intervene with customers who show signs of problem gambling.

Whether the U.K. adopts all or any of these measures remains to be seen. Inside and outside the country’s Parliament, there is a growing sense that problem gambling is a public health issue, one that costs society an estimated $2.3 billion a year.

However, addressing that issue arguably means less money for gambling companies – and governments, too. Mobile, in-game betting has been linked to higher addiction risk. It’s also the most popular and lucrative form of sports wagering, accounting for an estimated 30 percent to 50 percent of bets in the U.S. and 70 percent in Europe. Similarly, research suggests that problem and at-risk gamblers account for a disproportionate share of industry profits – roughly 43 percent of online gambling in the U.K. and up to 60 percent in dog racing.

Flutter, a major U.K. gambling company, reportedly saw its stakes decline after voluntarily instituting safer gambling measures. Entain, another international gambling firm, reported a revenue drop because of stricter betting regulations in Germany and the Netherlands.

“If you’re a government and you’ve balanced your budget on gambling, it’s harder to regulate it,” Maney says.

In the U.S., McGee says, sports gambling is still in a “honeymoon phase” marked by rapid growth and cultural enthusiasm. Betting companies see a large and largely untapped market. State lawmakers see a new source of tax revenue. Leagues and teams see a way to make more money and drive deeper fan engagement.

 

Meanwhile, problem sports gambling is largely an afterthought, viewed less as a preventable industrial harm than as a regrettable individual failing. In a national survey, more than half of American adults attribute gambling problems “at least in part to moral weakness or lack of willpower,” while half said people with gambling problems “are to blame for their problems.”

The federal government places an excise tax of 0.25 percent on all sports bets placed with commercial sportsbooks. None of that money, an estimated $50 million, is spent on problem gambling research or treatment. Many states devote a portion of their gambling tax revenues to addiction prevention and treatment. But those funds are relatively tiny when compared to the size of the betting market.

In New York, Maney says, the state Office of Mental Health has an annual budget of more than $2 billion – and spends $5.7 million on problem gambling services. “With the legalization of sports betting, they’ll be putting another $6 million into that,” he says. “We believe that is not even close to what will be needed. When the market matures, [the state] projects a billion dollars in sports betting losses every year. Six million dollars is 0.06 percent of that.”

Compared to the U.K., McGee says, the U.S. is in the middle of what he calls a “hold my beer” moment for sports gamblification. Legalization is happening at a breakneck pace. Gambling companies are furiously competing for customers, spending hundreds of millions of dollars on the same sort of advertising and betting inducements that the British Parliament may crack down on. A new Global Sport Institute national snapshot poll conducted in partnership with OH Predictive Insights found that engaged sports fans tend to be more enthusiastic about sports gambling, and that legalized betting may lead those fans and bettors to watch and attend more sports.

In England, McGee says, professional teams can’t become licensed bookmakers themselves—it’s seen as a conflict of interest, and something that would cross moral and cultural lines. In the U.S., by contrast, the Washington Football Team has a betting permit issued by the state of Virginia, and has partnered with FanDuel on a mobile sportsbook.

Two years ago, the University of Colorado broke with the National Collegiate Athletic Association’s longtime anti-gambling stance by entering a five-year, $1.6 sponsorship with betting company PointsBet, a deal in which the school’s athletic department will receive $30 for every new bettor who registers with the company using a promo code associated with Colorado athletics.

“Even in a gambling saturated culture like the U.K., that would be unthinkable,” McGee says. “There would be a moral outcry against the idea that a university is incentivizing gambling on its campus, let alone taking a cut.

“Everything’s happening so rapidly in the U.S. that I think, for several years to come, people won’t really grasp the scale of the transformation. And then there will come a moment where it's like, ’s__t, how did we get here? How did this happen?”

Despite his addiction, Pitcher doesn’t believe that sports gambling should be made illegal. But he does believe it should be strongly regulated to reduce harm and taxed to provide adequate funding for problem gambling research, prevention, and treatment. Americans, he says, have a chance to learn from mistakes made in other countries and create a safer framework right now – safeguarding bettors from future addictions. “Basically, all the answers have already been given,” he says. “Use that, build on it, and implement it.”

And if that doesn’t happen?

Pitcher laughs. “Then it’s going to be a mess,” he says. “A f—king bloodbath.”