Gambling issues are escalating. Experts emphasize immediate action is essential.

Over the past six years, gambling issues have intensified due to the legalization of sports betting and the availability of 24/7 online casinos. Researchers suggest that immediate intervention is necessary — and there are feasible approaches available.

This conclusion was reached by a group of public health and gambling specialists convened during a Zoom discussion led by WBZ-TV reporter Laura Haefeli, and organized by the Studio at the Harvard T.H. Chan School of Public Health.

Engaging in betting on elections and stocks has become routine, stated Timothy Fong, co-director of the UCLA Problem Gambling Studies Program. While gambling has been an aspect of human activity for thousands of years, Fong indicated that this current wave “is not only widespread … it has altered our physical and mental frameworks.”

A convergence of the gambling, technology, and finance sectors has enabled this phenomenon, according to Shekhar Saxena, an adjunct professor of global mental health at the Chan School. “Technology ensures a fluid experience; the gambling sector renders it appealing; and the finance sector facilitates instant monetary transactions,” he noted. The result is a situation that “is increasingly perilous.”

At present, wagering on sports at casinos or racetracks is permitted in 38 states and Washington, D.C., with at least 27 allowing online betting. Experts trace this expansion back to a Supreme Court ruling in 2018 that invalidated a federal law prohibiting legalized sports betting in most states.

Additionally, seven states permit online casino games, while Nevada exclusively allows poker.

The National Council on Problem Gambling approximates that around 2.5 million adults in the U.S. encounter severe difficulties, with another 5 to 8 million experiencing considerable challenges. The situation may be deteriorating, as gambling addiction helplines have reported an increase in requests for assistance, coupled with younger callers.

Industries, especially those involved in sports betting, are targeting the youth demographic, remarked Lia Nower, director of the Center for Gambling Studies and co-director of the Addiction Counselor Training Certificate Program at the Rutgers University School of Social Work.

“The most vulnerable groups include emerging adults and teenagers,” she stated. Referring to an impending study, the school’s associate dean for research highlighted how various tactics, such as presenting gambling as “sweepstakes,” allow the industry to skirt age restrictions to attract fresh and younger bettors.

Other well-established risk factors include low educational attainment and economic hardships, explained Victor Ortiz, director of the Massachusetts Office of Problem Gambling Services. However, he noted that this landscape is evolving. “Increasingly, we are observing that individuals with higher socioeconomic status and education levels are also becoming susceptible. We’re receiving inquiries from individuals in significant distress who don’t fit the typical profile of our callers.”

The experts assert that the issue is worsened by the ever-present nature of online gaming. Nower conjured an image of individuals “lying in bed [gambling] while their significant others are asleep.”

“Online gambling is a matter of public health and demands a public health approach,” Ortiz stated.

Initially, Fong argued that reframing gambling issues as a “gambling disorder” is a critical step toward resolution. Clearly distinguishing it as a mental health disorder with biological, psychological, and social dimensions helps diminish the stigma often associated with those struggling to manage their gambling habits.

This also aids the public in understanding that, similar to other disorders, medication and psychotherapy can be beneficial and reconnect individuals with their families and communities. “When you pursue treatment,” he noted, “you will achieve much better outcomes.”

Implementing regulations to tackle the issue is the next logical step, experts concur.

“We require a federal presence similar to that for tobacco, alcohol, and other addictive substances,” Nower asserted. Specifically, she emphasized the necessity for regulations mandating online applications to incorporate an “opt-out” system for various controls.

At present, users must actively opt-in to access controls designed to limit aspects such as time spent on the platform and money spent. That setting should be the standard setup, she argued.

The recent growth of online gambling has resulted in researchers, public health authorities, and lawmakers scrambling to catch up.

“We lack advocacy organizations and, unlike substances, there is no ongoing monitoring of gambling-related health issues, such as gambling-related suicides, so we lack public health statistics comparable to those available for alcohol and tobacco,” remarked Nower. “Moreover, there’s a significant amount of shame, preventing families from coming forward.”

“Responsible gambling is a narrative that companies love to promote,” Saxena added. “That shifts the accountability onto the individual.”

This is particularly troublesome due to the stigma surrounding gambling disorder, he explained. By framing the matter as a public health issue rather than one of personal control, it requires “discussing the environmental factors, the types of incentives that are present.”

“While individuals do bear some responsibility, the surrounding context — the technological landscape, the social setting, and the economic climate in which individuals exist — is what truly matters,” he emphasized.