A nationwide shift in sports betting has led to a surge in gambling addiction, with millions seeking help. Since the 2018 Supreme Court decision in Murphy v. NCAA, which allowed states to legalize sports betting, the landscape has transformed.

What was once a niche activity limited to a single state is now a widespread industry, with 38 states hosting legalized sportsbooks. The impact of this rapid expansion has been profound, sparking concerns among public health experts and medical professionals.

The legalization of sports betting triggered an explosion in gambling activity. Total wagers soared from $4.9 billion in 2017 to $121.1 billion in 2023, with online platforms dominating the market. In 2023 alone, 94% of all sports bets were placed online.

“Sports betting has become deeply embedded in our culture,” said Matthew Allen, a third-year medical student. “From relentless advertising to social media feeds and in-game commentary, sportsbooks are now everywhere. What was once a taboo activity, confined to the fringes of society, has been completely normalized.”

This shift is reinforced by major gambling corporations investing heavily in online sportsbooks. Companies have rebranded to emphasize sports betting, betting apps are integrated into social media, and advertisements are unavoidable during televised sporting events.

Yet, while the industry enjoys soaring profits, public health experts warn that gambling addiction is an underrecognized crisis.

Gambling addiction is recognized in the Diagnostic and Statistical Manual of Mental Disorders, yet it remains overlooked in healthcare and public policy. Without formal surveillance or tracking, understanding the full scope of the problem has been difficult.

“Without systematic surveillance, we are flying blind while millions bet on sports,” said Kevin Yang, M.D., a third-year resident physician in the Department of Psychiatry.

To fill this knowledge gap, researchers analyzed aggregate Google search data, tracking queries related to gambling addiction from 2016 to 2024. The results revealed a striking increase in help-seeking behaviors.

Since the Supreme Court’s decision in 2018, searches for gambling addiction-related help, such as “am I addicted to gambling,” have increased by 23% nationwide. This translates to approximately 6.5 to 7.3 million searches for gambling addiction help since the ruling, with peak months reaching 180,000 searches.

State-by-state trends revealed that gambling addiction searches surged following the introduction of sportsbooks. Significant increases were recorded in Illinois (35%), Massachusetts (47%), Michigan (37%), New Jersey (34%), New York (37%), Ohio (67%), Pennsylvania (50%), and Virginia (30%).

“The significantly higher search volumes observed in all eight states make it virtually impossible that our findings occurred by chance,” said Atharva Yeola, a student researcher at the University of California San Diego Qualcomm Institute. “Statistically speaking, the probability of these results happening randomly is less than one in 25.6 billion.”

The researchers emphasized that these figures likely underestimate the real burden, as many individuals struggling with gambling addiction may not seek help online.

The accessibility and convenience of online sportsbooks have intensified the problem. Unlike traditional in-person betting, online gambling is available 24/7, making it easier to develop problematic behaviors. The study, published in the journal JAMA Internal Medicine, found that states introducing online sportsbooks saw a far greater increase in addiction-related searches than those with only physical locations.

In Pennsylvania, for example, searches related to gambling addiction rose by 33% in the five months before online sportsbooks launched. Once online platforms became available, the increase surged to 61%—a sustained trend that continued for years.

“This pattern highlights the amplified risks associated with the accessibility and convenience of online sports betting,” said Adam Poliak, Ph.D., assistant professor of computer science at Bryn Mawr College.

With betting now integrated into smartphones and apps, gamblers can place wagers with a single tap. This frictionless experience heightens the potential for addiction, especially among younger populations exposed to sports betting through social media and influencer promotions.

Despite the clear evidence of harm, gambling regulations have not kept pace with the rapid expansion of sports betting. Public health experts warn that action must be taken before the crisis worsens.

“The expansion of legalized sports betting to always be at arm’s reach has outpaced our ability to understand and address its public health consequences,” said Nimit Desai, a third-year medical student. “Our findings are a wake-up call for policymakers, healthcare professionals, and public health advocates to act now.”

Researchers recommend several interventions to mitigate gambling-related harms:

“Sportsbook regulations are lacking because the Supreme Court, not legislators, legalized them,” said John W. Ayers, Ph.D., the study’s senior author and vice chief of innovation in the Division of Infectious Disease and Global Public Health. “Congress must act now by passing commonsense safeguards.

History has shown that unchecked industries—whether tobacco or opioids—inflict immense harm before regulations catch up. We can either take proactive steps to prevent gambling-related harms or repeat past mistakes and pay the price later.”

With millions of people at risk, the need for regulation is urgent. Without intervention, the rapid expansion of sports betting could create an even larger public health crisis—one that will be much harder to contain in the future.