When Evan Ozmat, a Ph.D. student in psychology at the University of Albany, first began counseling undergraduates about HIV and substance abuse, he expected to hear about their health issues. Instead, he heard about problem gambling.
“Since the beginning of the project three years ago, students have brought up, unprompted, gambling,” Ozmat says. “We started asking about it in every appointment and everyone has something to say. It’s everywhere.”
The majority of the gambling takes place on mobile phones, Ozmat says, largely—although not exclusively—on sports betting apps. Served up to students through ubiquitous ads that offer promises of “free” bets and easy wins, the apps sink their hooks deep into students, leading them to spend their financial aid money, lie to their parents, and ignore their studies so they can keep playing, he says. Students from low-income families are particularly vulnerable, as they lack the financial safety net to bounce back from losses.
”It almost feels like binge drinking or methamphetamines, where they are going on benders,” he says. “They’ll make bets and bets and bets and bets and then wonder, ‘how the hell did I get here?’”
Gambling addiction is a disorder recognized by the American Psychiatric Association, but students who don’t meet all the criteria for a clinical diagnosis can still struggle with gambling. It’s often correlated with other forms of addiction, as well as anxiety and depression, experts say, and problem gambler are at greater risk of suicide. Because it is legal, because it is aggressively promoted by corporations, because of its capacity for destruction, and because it is spreading so quickly, observers see parallels between gambling and opioid addiction.
“I look at the legalization of gambling like I look at the opioid crisis,” says Diana Goode, executive director of the Connecticut Council on Problem Gambling. “I think we’re only really seeing the beginning of what’s going to happen, especially with our kids with problems.” Since 2019, the number of people contacting the Connecticut council’s gambling hotline has doubled, and gamblers needing help are getting younger and younger.
“We used to think the problem gambler was a little old lady at the slot machine,” Goode said. “Now, it’s the 20-something male betting on sports. That is the new demographic of the problem gambler. And I would say 40% of our calls are from that demographic or about that demographic. Because it’s not just these kids that are calling, it’s their parents.”
One in 10 college students
One out of 10 college students is a pathological gambler, according to one meta-analysis conducted by professors at the University of Buffalo, far higher than the 2-5% of the U.S. general population estimated to have a gambling problem. Other studies place the number of student gambling addicts lower, but still higher than the overall population of pathological gamblers.
That Buffalo analysis looked at 18 separate surveys conducted between 2005 and 2013, before the widespread legalization of sports betting, which is “the largest and fastest expansion of gambling in our nation’s history,” according to Keith Whyte, the executive director of the National Council on Problem Gambling.
More recent statistics about the prevalence of problem gambling among you people since the advent of mobile sports betting are unavailable, in part because the wave of online sports betting has crashed onto colleges so suddenly. While college students have always gambled, whether playing poker or betting on sports with a bookie, the betting apps are finding unusual traction on campuses.
Another survey of 3,527 Americans between ages 18 and 22—mostly college students—released in April by the National College Athletic Association, shows how sports betting has become commonplace. Nearly 60% have bet on sports, and 4% do so daily. Almost 6% reported losing more than $500 in a single day.
Overall, education generally helps inoculate people against gambling addiction, with higher levels of education attainment associated with fewer instances of problem gambling. That’s not the case with sports betting, says Whyte. “The biggest increases in gambling participation have been among young, educated men,” he says. “The closer you are to college, the more likely you are to bet sports.”
While sports is the preferred vehicle for gambling among young people, other forms of betting or financial speculation are on the rise, as well. Students are also trading stocks, cryptocurrencies, and foreign exchange, and can exhibit the same addictive qualities as sports gamblers.
The common denominator among all these forms of betting are mobile phones. Gambling on a phone can combine the compulsive behavior created by social media—the constant pursuit of dopamine hits—with the addictive qualities of gambling. Perhaps more critically, it also eradicates the barriers of time and space that once were obstacles for gamblers, says Dr. James Sherer, a psychiatrist who treats addiction in New Jersey. “You don’t have to go to a casino, you don’t have to go to a bank, you don’t need to carve time out of your schedule, you can do it at work, you can do it in the middle of the night,” he says. Sports betting also allows for a constant stream of live, real-time wagers on events within a game, such as how many hits a baseball player will get, further engrossing the gambler.
And online gambling sites make use of the same tracking software as other sites, making sure gamblers are followed across the web by advertisements and enticements to keep betting.
“Because of the way advertising works these days, even if you are trying to avoid it, you are going to be served up more options and opportunities to re-engage in that behavior than if you were someone who never engaged in that behavior in the first place,” says Sherer, who serves on the American Psychiatric Association’s task force on addiction. “The second you really start to struggle, you are set for continued issues down the line.”
Mobile phones also means easy access to loans, via payday loan services and other sources, some of which will deposit funds into gambler’s accounts minutes after opening an account. “You can’t have a gambling addiction unless you have credit,” says Dr. Timothy Fong, a University of California, Los Angeles psychiatrist who specializes in addictions. “That’s what sustains it.”
The Supreme Court’s role
The modern age of sports gambling began in 2018, when the U.S. Supreme Court struck down a 1992 federal law that restricted sports betting to a handful of states and Native American tribal lands. The court ruled states were free to set their own regulations, and as a result, many state legislatures—seeing a new source of tax revenue—rushed to pass laws legalizing sports betting. More than 30 states now permit sports betting and most that allow it also permit online sports betting. Professional sports leagues, once ardently opposed to gambling for fear it would undermine the integrity of their games, have embraced this new reality, and sportscasts are blanketed with advertising for betting apps.
From January of 2021, through September of this year, the average monthly users of the most popular betting apps has soared 600%, to 16.3 million, according to internet data company SimilarWeb.
Spending on television ads for betting sites has also climbed, to $305 million through November of this year, up from $197 million for all of 2021, according to iSpot.TV, which tracks advertising. ISpot data also show betting ads are spreading from live sport broadcasts to reruns of shows like Friends and South Park as the industry seeks new potential gamblers
College students are particularly prone to falling into problem gambling due to what researchers Donald Nowak and Ariel Aloe, both at the University of Buffalo, call “the Five A’s:” The availability of betting opportunities, social acceptability of gambling, exposure to widespread advertising, access to spending money, and being at an age when young people experiment with risky behavior.
Fong, the UCLA doctor, also identifies a fear of missing out, or FOMO, as a prime condition for luring college students. Gamblers are enticed with teases and offers, all with the promise of hitting a huge score. It animates speculators on crypto currencies and stocks as well as gamblers.
“You have a chance to beat the bank, you have a chance to be spectacular,” Fong says of the gambler’s mindset. “Gambling is really good at playing on FOMO.”
“I was like a coke addict”
Josh, a 33-year old in Toronto who asked we not use his last name, began gambling as a teenager when he started playing lottery games, which paid off daily. He said he dropped them as soon as he discovered online gambling in his early 20s, and now “99% of the gambling I’ve done in the last five years has been on my phone.”
Sports betting apps, he says, vastly increased the options and opportunities. The sites pushed live betting, sucking him in deeper. “I’ve used like 1,000 different sites,” he says. “I knew nothing about the teams or even the sports sometimes. I was like a coke addict.” He would gamble using cryptocurrencies, which he said allowed for faster transactions. Even when he would take advantage of sites’ self-exclusion options —essentially banning himself—he would turn around and ask to be let back on. “I wish I had a casino gambling hobby,” he says. “You have to leave your house and go to the casino and bet. Now you can be sitting on the toilet and deposit an infinite amount of money.”
After racking up $200,000 in debt and contemplating embezzling to pay for his habit, he says he hit bottom about four months ago and hasn’t gambled since. He has handed over all his finances to his mother, who gives him a small allowance, and he no longer has the passwords to his own bank account. He’s been attending Gamblers Anonymous meetings and sees a therapist regularly but still he says “I worry about relapsing every day.”
Universities scramble to catch up
While Josh is in cognitive behavioral therapy, a common treatment for gambling addiction, he says he’s not convinced his therapist fully appreciates the depths to which he sank, or the power of the technology has over him.
Therapists who specialize in gambling addiction are a small sub-set, and clinicians with experience helping gamblers are rare on college campuses. Large universities have counseling departments, to help students with things like depression and anxiety, and they also employ professionals to deal with substance abuse. Gambling falls between the cracks and “doesn’t have a home,” says Jim Lange, the executive director of the Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery, at Ohio State University. Schools don’t usually ask about gambling on student welfare surveys, he says, and students who self-report gambling addictions are extremely uncommon, and probably not representative of the overall population.
Campuses may be slow to appreciate the problem in part because gambling addictions aren’t as visible as other disorders, Lange says. Without the same signs of erratic behavior or weight loss that can alert peers or professors to a substance abuse disorder, even close friends or partners of gambling addicts can miss the problem. In many cases, when college counseling services do become aware of problem gambling, it’s often because the student has other, more obvious mental health issues.
To address this gap in care, Lange and others formed a consortium of university substance abuse experts to try and develop best practices for educating and treating college students. About 20 experts convene once a month to discuss findings and new research.
Here and there, universities are beginning to experiment with programs modeled on what has worked with other destructive behaviors. At Towson University, outside Baltimore, for example, the staff at the student counseling center began preparing for a wave of problem gambling when legal sports betting launched in Maryland in 2022. With a small grant, the center began doing outreach to students and running public service ads about gambling addiction, based on what they knew worked for substance abuse. When they looked for examples of how other universities ran similar programs, they couldn’t find any. Addressing gambling among college students is so new, as far as they could tell, they were the first campus in the U.S. to run a campaign targeting problem gambling.
At the University of Albany, trained student “navigators” have spread out across campus, asking peers a few questions designed to ferret out risky behavior. If the students indicate they may have a problem, the navigators direct them to university resources. Originally part of a grant targeting HIV and substance abuse, questions about gambling have now been folded into the surveys, says Dolores Cimini, the Albany psychologist who leads the effort. The program vastly expands the school’s ability to screen students beyond just who shows up at the campus health center, Cimini says. “Our goal is to reach every student, through advisors or screeners.”
Treatment can be effective—when it’s available
Treatment for gambling can range from group sessions or a peer-led program like Gamblers Anonymous to one-on-one meetings with a psychologist, which can include cognitive behavioral therapy. On rare occasions it can result in admission to a residential treatment facility. Some private insurance plans will cover treatment, but not all. It can depend on the state, and whether state law mandates insurers cover all recognized disorders.
When help is available, it is effective. “Our treatment data show that a significant majority stop gambling or reduce their gambling, and improve their quality of life,” says Fong, from UCLA. “Left without treatment, we know people die. People kill themselves, people go bankrupt.”
While treatment availability remains a concern, college addiction specialists are more worried about how quickly mobile sports betting has outpaced public policy prescriptions for addressing problem gambling among young people. In most states, advertisements are required to contain a phone number or link to gambling hotlines, but the print is often small, or rushed through if it’s an ad on the radio or a podcast. As Goode, from the Connecticut gambling council, notes, how helpful is a small phone number on a highway billboard when cars rush by at 65 miles per hour?
And while online sites say they exclude underage gamblers, here’s evidence their efforts are ineffective. When the Massachusetts Gaming Commission last month asked mobile betting operators how many accounts of underage gamblers they detected over the last three months, some said zero and the rest put the number in single digits.
What’s really required, Fong says, is a national response undergirded by federal policy. That would include much more supervision of mobile betting operators, and a significant increase in federal research spending into gambling addiction, which vastly trails spending on other forms of addictions. Fong also favors tighter control on advertising
“We should be studying what those ads are doing to those people’s brains,” he says. “They’re supposed to be regulated, but no state is very aggressive about going after them.”
A total ban on online gambling would be counterproductive, Fong says, as it would just encourage a black market. And he notes most gamblers are not addicts, and bet responsibly and within their limits. There is also a social value in gambling, Fong says. It provides entertainment and generates economic activity. Done responsibly, it can even help young people explore their appetite for risk, much as going to a horror movie can help them explore fear. But with online sports betting, the equation is out of kilter, and the societal damage is quickly outweighing any benefits.
“The harm is happening for real right now and we don’t know what the next five to 10 years look like,” Fong says. “If we increased gambling by even half a percent, we’re talking about millions and millions of lives damaged.”