Millions of Americans have sought gambling addiction information since the U.S. Supreme Court let states legalize sports betting by striking down the Professional and Amateur Sports Protection Act (PASPA) in 2018. A new study JAMA Internal Medicine published Feb. 17 found the number of Americans looking for gambling addiction help and information increased in recent years, along with the expansion of sportsbooks and online wagering.
“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,” John Ayers, study senior author, said in a news release.
Ayers is deputy director of informatics at the University of California San Diego Altman Clinical and Translational Research Institute and a scientist at UCSD’s Qualcomm Institute.
In sports wagers, the total rose from $4.9 billion in 2017 to $121.1 billion in 2023. Of the total $121.1 billion, online users placed 94% of the wagers.
Observing general internet searches related to U.S. gambling addiction, the study found searches for phrases such as “Am I addicted to gambling?” increased 23% cumulatively between 2018 and 2024. Numerically, this means 6.5 to 7.3 million searches, peaking at 180,000 monthly, according to the study.
Matthew Allen, a third-year medical student and co-author, commented gambling and sports betting are now completely normalized: “Sports betting has become deeply embedded in our culture. From relentless advertising to social media feeds and in-game commentary, sportsbooks are now everywhere.”
Meanwhile, in New Jersey, Ohio, Pennsylvania, Michigan, Virginia, and Massachusetts, searches for terms related to gambling addiction increased between 30% and 67% from 2016 to 2024.
Online sports betting poses higher gambling addiction risk than retail
The study also determined online sports betting is a more significant driver in gambling addiction searches than retail sports wagering. Looking at states like Pennsylvania, gambling addiction searches surged 33% after retail sports betting launched. However, the state also saw gambling addiction searches spike 61% when online sportsbooks went live.
Overall, as more U.S. states permit online and retail sports betting, gambling addiction search increases may continue. Missouri legalized sports betting in 2024, and is expected to launch later in 2025.
“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 another co-author, Dr Kevin Yang. “Without systematic surveillance, we are flying blind while millions bet on sports.”
Co-author Nimit Desai, a third-year medical student, stated the study should be a “wake-up call for policymakers, healthcare professionals and public health advocates to act now.”
