America’s newest addiction? Sports betting is rewiring patients' brains
Industry Buzz
I’m treating guys who would never be caught dead in a casino.
—James Whelan, PhD, clinical psychologist, The Atlantic
Do you or your patients spend a bit of your hard-earned cash on sports betting? You’re not alone. Placing wagers on which team will win, or which horse will make it to first place, is fun, so what’s the big deal?
According to researchers, it might be America’s newest addiction.
A growing problem
Sports betting was previously illegal under federal law, but since 2018, most states have legalized it. And in those that haven’t, there are ways to get past the legalities.
The Atlantic reports that about half of American men under 50 have registered with an online sportsbook—a physical or digital place where people can place their bets.[] They’ve spent a lot of money, too. Nearly $150 billion has been spent on sports wagers in 2024 alone. For context, in 2017, this number sat at around $4.9 billion.
US researchers writing in JAMA Internal Medicine emphasize the need for public health efforts to understand and address the potential harms associated with this rapid uptick in sports betting.[] They note that national online searches for “gambling addiction help” increased 23% since the law changed.
“The results of this time series study suggest that access to sportsbooks, sports wagers, and potential help-seeking for gambling addiction increased substantially and highlight the need to address the health implications of sportsbooks, including recognition and treatment of gambling problems and their broader societal implications,” the authors concluded.
Alison Tarlow, PsyD, Chief Clinical Officer at Boca Recovery Center in Boca Raton, FL, says that part of the allure of sports betting is that everyone can get involved in a game. “While only the athlete or team can be the winner in a sporting event, betting allows for anyone to get involved in the drama and anticipation,” she says. “Placing money on a potential winner makes the sporting event that much more exciting,” she adds.
Why it's a dopamine trap
The history of betting can be traced back to the ancient world during the Olympic games. Essentially, this desire has deep human origins.
While Dr. Tarlow doesn’t necessarily believe sports betting is a mental health epidemic, she says it can become addictive. “The behavior itself triggers parts of the brain that are linked to dopamine receptors, and so whether a winner or loser, there is an urge or craving to try again. For some people, those behaviors can become out of control,” she explains.
Today’s sports betting has mutated into something far more insidious than the casual wager of decades past—it’s become a machine built to hijack attention and accelerate addiction.
Once limited to slow-burn outcomes like the final score of a game, betting now happens in seconds, with phone apps inviting users to gamble on micro-moments—coin tosses, free throws, or even how long the national anthem will last. That rapid-fire loop encourages the hallmark spiral of problem gambling: chasing losses with bigger bets, faster bets, until the line between entertainment and compulsion disappears.
Madelyn Lunder, LMSW, a psychotherapist at Madison Square Psychotherapy in New York, says the uptick in sports betting may also be rooted in other issues, such as economic instability and increasing social isolation.
“Therapists, mental health counselors, or psychologists can help by screening for these patterns early, educating individuals on how gambling impacts the brain, and incorporating different interventions based on their needs to treat underlying issues that fuel the behavior.”
Related: Could Ozempic treat gambling addictions?