Gambling Disorder Up 60% in States with Legal Sports Betting
Published:
,
01:44 p.m.
ET
A new study released by Epic Research this week adds real clinical data to something many of us in the addiction treatment field have suspected for a while: legal sports betting access and gambling disorder diagnoses are moving in the same direction. The findings come from millions of patient health records and offer one of the clearest pictures yet of what widespread sports betting access may be doing to public health.
A Quick History of Legal Sports Betting in the U.S.
For decades, sports betting was federally restricted outside of Nevada. That changed in May 2018, when the Supreme Court struck down the Professional and Amateur Sports Protection Act, opening the door for individual states to legalize it. States moved quickly. As of early 2026, sports betting is legal in 39 states plus Washington, D.C., and most of those states allow people to bet from their phones. Eleven states, including California and Texas, still have not legalized it in any form, though there are similar types of products available in those states nowadays too.
How the Study Measured these Impacts
Researchers reviewed records for more than 197 million U.S. adults with at least one healthcare visit between January 2018 and March 2026. They tracked how often patients received a documented gambling disorder diagnosis (using the standard medical billing codes for pathological gambling) each quarter, then compared states that had legalized sports betting to states that had not. They also broke the numbers down by age and sex.
It's worth noting the limits here too. Gambling disorder is widely under-recognized in healthcare settings, so these numbers almost certainly represent a floor, not the full picture. Researchers also can't pin the change to one specific law, largely since states legalized sports betting at different times.
Key Findings
In states with legal sports betting, the rate of diagnosed gambling disorder climbed from 3.0 per 100,000 patients in early 2018 to 4.8 in early 2026, an increase of about 61%. Meanwhile, states that never legalized sports betting saw their rate fall, from 3.1 to 2.2 per 100,000, a decrease of roughly 29%, over that same stretch.
Age and sex mattered too. Adults 30 to 49 had the highest overall diagnosis rate throughout the study, but the fastest growing group was adults 18 to 29, whose rate more than doubled. Men were diagnosed at higher rates than women across every age group, and that gap was largest among adults under 50.
It's worth noting a few things the study did not review or mention. Sex was recorded in the medical record as a binary, male or female, so the data does not break out nonbinary or transgender patients as their own group, even though gambling behavior in these populations is its own area of active research.
The study also did not review or mention other factors that can shape gambling risk, like co-occurring mental health or substance use diagnoses, race, socioeconomic status, or general health history. It looked specifically at gambling disorder diagnoses on their own. There is clearly more to learn here, but this study is a good step in the right direction.
Researchers point out that this pattern lines up with other national survey data showing more people searching for gambling addiction help in states where betting is legal. It's a meaningful signal, even if it can't prove cause and effect on its own.
How Gambling Disorder Is Diagnosed
Gambling disorder is officially recognized in the DSM-5 as a behavioral addiction. In its simplest form, it is when an individual continues to gamble despite the financial, emotional, or relational harm it's causing. There are nine criteria of gambling disorder, with at least four needed for a clinical diagnosis. A clinician typically looks for patterns like needing to bet more money to feel the same excitement, repeated unsuccessful attempts to cut back, gambling to escape stress, chasing losses, or lying to others about how much time or money is being spent.
Read more about how gambling addiction is diagnosed today.
Gambling Addiction Treatment in the U.S.
The good news is that recovery is achievable with the proper specialized treatment, and you don't need to wait until things feel completely out of control to ask for help. In fact, 85% of Birches Health clients have seen notable reductions in gambling-related symptoms after just nine sessions. (Full Clinical Outcomes and measurement methodology.)
Treatment programs generally include Cognitive Behavioral Therapy in a one-on-one setting and clinician-led online group therapy, which offers structured support and accountability in a confidential space. Financial wellness assistance and couples or family counseling are also available. Birches' specialized care addresses both the patterns that drive gambling and the real-world consequences that can come with it.
If you, a friend, or a loved one may be struggling with gambling behaviors of any kind, help is available now. You do not have to navigate gambling addiction alone.
Email: help@bircheshealth.com
Call: 833-483-3838
