Between 2018 and 2021, three major events transformed gambling in the United States: the expansion of legal sports betting, increased internet gambling, and the COVID-19 pandemic. These changes coincided with a rise in problematic gambling behavior, with pandemic impacts being the most significant.

Key findings show that prohibition is ineffective at reducing gambling problems, especially with widespread internet access. Instead, comprehensive prevention, awareness, and treatment programs are essential, along with proper regulation beyond basic financial oversight.

Risk factors for problematic gambling include:

• Young age
• Participation in multiple gambling activities
• Sports and fantasy sports betting
• Poor gambling literacy
• Misconceptions about gambling as a money-making method

Young adults represent the highest-risk demographic, showing both elevated problematic play and misconceptions about gambling mechanics and recovery potential. The data also reveals a concerning connection between frequent investment trading and problematic gambling behavior.

Lottery participation remains significant, with 90% of gamblers playing at some point, making it a crucial channel for problem gambling awareness and prevention efforts.

Critical needs identified:

• Improved public understanding of gambling disorders
• Reduced stigma around seeking treatment
• Better awareness of available resources
• Collaboration between gambling experts and communications professionals
• Integration of investment activity screening in treatment practices

Gambling in America spans all demographics, with no group immune to potential problems. Rather than viewing it as a personal or moral failing, problem gambling requires recognition as a serious public health issue demanding comprehensive solutions involving:

• Government at all levels
• Gambling industry
• Medical professionals
• Legal experts
• Educational institutions
• Financial sector
• Non-profit organizations
• Recovery community

As gambling continues to evolve, ongoing research and adaptive public policy are essential to address these changing realities effectively.

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