Gambling Addiction: How to Recognize a Problem and Get Help

From Las Vegas casinos to friendly poker nights to the rise of mobile sports betting, gambling is a common activity among adults in the United States. But this popular hobby can turn into an addiction with symptoms and effects similar to those of substance use disorder.

Kyle Faust, PhD, is a Mass General Brigham clinical psychologist specializing in digital addiction and gambling and the director of the Digital Addiction and Gambling Treatment Program at Massachusetts General Hospital. In this article, he breaks down what gambling addiction is, how to tell when it’s a problem, and what treatments may help.

What is gambling addiction?

Gambling disorder—the medical term for gambling addiction—is a condition recognized by the American Psychiatric Association based on a set of criteria. These standards help your care team understand if you have a problem and if so, how severe it is.

Gambling disorder includes:

• Needing to gamble with increasing amounts of money in order to achieve a higher level of excitement
• Being restless or irritable when trying to cut down or stop gambling
• Making repeated unsuccessful attempts to control, cut back, or stop gambling
• Preoccupation with gambling—having frequent thoughts of gambling, thinking about the next time you’ll be able to gamble, thinking of ways to get money back gambling
• Gambling when experiencing distress or to escape problems
• Returning to gambling quickly to try to win money back if you lose, which is also known as chasing losses
• Lying or concealing the fact that you’re gambling or the extent of your gambling
• Harming or losing a serious relationship, job, or educational opportunity due to gambling
• Relying on others to provide money to relieve desperate financial situations caused by gambling

“Gambling disorder is categorized as mild, moderate, or severe depending on how many of the criteria a person meets,” Dr. Faust explains. “If they meet four or five, that’s considered more mild. If they meet six or seven, that’s moderate. Eight or more is considered a severe case.”

If you or a loved one meet any of the criteria, consider speaking with a mental health professional. Dr. Faust notes, “If they meet even one or two criteria, that is an indication that gambling is starting to become an issue. You want to address gambling struggles as soon as possible.”

Problem gambling is common

According to the National Council on Problem Gaming (NCPG), 3 in 5 U.S. adults have gambled in the past year. In Massachusetts, where Dr. Faust treats patients, the Massachusetts Problem Gambling Helpline reports 83,000 people are problem gamblers and another 390,000 are at-risk gamblers.

Rates of problem gambling are higher in people with substance use disorder and in those with other mental health conditions. Research has shown that 96% of people with gambling disorder also have a psychiatric disorder, including mood disorders, anxiety disorders, or impulse-control disorders.

Mobile sports betting

The legalization of online and mobile sports betting has made gambling more easily accessible and common. While people used to have to go to a physical location to gamble, players can place bets anytime, anywhere thanks to the apps on their mobile phones.

Mobile sports betting allows for a wider range of betting options, including live in-game betting that encourages bettors to place wagers on things like who scores the next goal or the call of the next pitch in baseball. Sports betting apps also rely on tactics like free promotions or VIP status to encourage players to bet more often and in higher amounts.

The research on mobile sports betting shows that instant access, microbetting, and instant rewards are contributing to problem gambling behavior and gambling harm. The rate of problem gambling is twice as high for sports bettors as it is for gamblers in general. For online sports bettors, almost a third of them met criteria for problem gambling.

In 2025, Americans spent almost $16.7 billion on sports betting, a 22.8% increase from the previous year. Spending on traditional gaming—physical locations of casinos—increased only 2.3% in the same timeframe.

The Massachusetts Problem Gambling Helpline reported a 121% increase in the number of calls after online sports betting was legalized. More research is needed on the impact of sports betting on gambling disorder rates but the NCPG reports that the aggressive promotions and the focus on ease of placing bets, “free play,” and “risk-free” bets are making it more difficult for problem gamblers to control their habit.

Dr. Faust is already seeing the impact on the patients he treats. “Many of the patients I work with find themselves constantly hooked and triggered by the promos, and that makes them far more likely to gamble,” he says. “So many people find themselves particularly susceptible to these types of advertisements.”

Who does gambling disorder affect?

Problem gambling encompasses any gambling habits that cause stress and harm in a person’s life. Gambling disorder is an official diagnosis based on a standard set of criteria.

Anyone can develop gambling disorder but there are factors that may make it more likely, including:

• Having a substance use disorder
• Having a psychiatric disorder
• Having a parent or family member with problem gambling (while it’s not known if gambling disorder is hereditary, the social aspect of being around a problem gambler can have an influence)
• Being in a community or culture where gambling is common

Dr. Faust explains the influence of the social aspect of gambling, “They see it as normal behavior. ‘Oh, everyone I know gambles, so it’s not a big deal.’ The friendship network can have an impact. Family can have an impact, especially if someone grew up with a parent that gambled frequently.”

Being in a sports-focused environment like New England can contribute. The social aspect plays a role, as does the amount of advertising potential gamblers are exposed to. “Major sporting events tend to be a time when sports betting apps spend more money on advertising and promos,” notes Dr. Faust. “If you’re watching the games, it’s coming up frequently. If you’re seeing the stadiums during many sports games, they’ve got a bunch of sports betting advertisements.”

Men—particularly young men—are more likely to develop problem gambling disorder than women. People with lower incomes may be more likely to gamble because of the bigger impact of a win on their financial situation.

Heavy online sports bettors, however, tend to be higher income, educated, single males, and consider sports betting to be a skill, not luck.

The rise of sports betting is impacting young men more than other groups. Male callers to the Massachusetts Problem Gambling Helpline increased 56% when sports betting was legalized. A study in New Jersey found that 10% of men age 18-30 meet problem gambling criteria, compared with only 3% of the general population.

Professional sports players also may be at a higher risk. While no studies of U.S. professional sports players are available, a study in Europe reported 57% of professional athletes betting on sports in the past year and 8% showing problem gambling behaviors.

“The desire to make money is probably one of the biggest reasons people start gambling,” says Dr. Faust. “Sometimes it can also be an effort to connect with family members or friends, to not feel left out. Also, as people are in more desperate financial situations, they become more likely to look for easy answers, even though the odds of making money via any type of gambling is extremely low.”

Treatment for gambling disorder

If you or a loved one experiences problem gambling behaviors, there are treatments available. Your primary care provider (PCP) can refer you to mental health professionals that specialize in problem gambling, like Dr. Faust and the team at the Digital Addiction and Gambling Treatment Program.

Treatment is tailored to your individual needs, and can include:

• Individual therapy—particularly cognitive behavioral therapy (CBT) customized for gaming disorder—helps you change problem behaviors.
• Medication management treats conditions you have that may contribute to problem gambling behavior, such as substance use disorder or ADHD.
• Family or couples counseling can help you stay focused on recovery and build a support system.
• Residential treatment—where you stay on site and participate in individual and group therapy—helps with more severe gambling disorder.

“There isn’t an FDA-approved medication specifically for gambling disorder,” says Dr. Faust. “But certain medications designed to reduce cravings in substance use disorders have some research supporting their benefits in also reducing cravings to gamble.”

It’s often a family member or significant other that notices the problem behavior before the person with a gambling problem. Dr. Faust notes, “Unfortunately, some people don’t notice that their gambling is starting to become an issue, especially if they find ways to rationalize their gambling, such as telling themselves that they can’t have a problem because they have friends that gamble far more often than they do.”

Free resources for people with gambling disorder

“There are many free resources, particularly in Massachusetts, for people with gambling disorder. There are also resources for loved ones worried that someone they know might be struggling with gambling,” Dr. Faust says.

Helplines and support groups include:

• Massachusetts Problem Gambling Helpline. Available 24/7, even on holidays. Trained operators answer questions about problem gambling, ask screening questions to better understand your concern, and connect you to referrals for treatment and recovery support services.
• Substance Abuse and Mental Health Services Administration (SAMHSA). A nationwide 24/7 free helpline for assistance finding treatment, local support groups, or other resources. Call 1-800-662-HELP (4357) or text your zip code to 435748 (HELP4U).
• Gambler’s Anonymous. A network of members supporting each other through gambling addiction. They provide free local meetings and other resources to assist in recovery.
• SMART Recovery. Self-Management and Recovery Training (SMART) is an evidence-informed approach to overcoming addictive behaviors, including group meetings, a mobile app, and resources to help maintain motivation and cope with urges and cravings in recovery.
• Massachusetts Gaming Commission Voluntary Self-Exclusion Program. This free program allows people to block themselves from playing at Massachusetts casinos, wagering on sports at physical sports betting locations, and from placing bets with any online sports betting company licensed to operate in Massachusetts.
• Mobile apps to block online betting. Similar to time management or screen time limiting apps, you can download apps that block all online betting sites and apps.

Dr. Faust notes that you don’t need a diagnosis of gambling disorder to benefit from any of these resources. “Reach out to the Problem Gambling Helpline even if you’re not sure whether your gambling has become a major problem,” he says. “Those resources can be really helpful, especially before a gambler begins to experience more significant problems from their gambling use.”

How to prevent gambling addiction or gambling disorder relapse

For anyone in gambling disorder recovery or anyone with risk factors worried about problem gambling behavior, there are tactics to help avoid a relapse or a step towards gambling addiction.

Dr. Faust recommends abstaining from gambling entirely. While some people may want to only limit their time or money spent gambling, that’s often unrealistic.

“It’s often a safer plan to avoid gambling entirely rather than trying to set strict limits on use,” he says. “Trying to set limits on gambling does tend to be more challenging, even if someone is just starting to experience gambling problems. If you want to increase the likelihood of success, avoiding gambling entirely is usually the safest approach.”

He also recommends using the resources of the MA Problem Gambling Helpline, gambling blocking apps, and groups like Gambler’s Anonymous or SMART Recovery to help strengthen recovery and support you.

“The individual therapy we provide through the Digital Addiction and Gambling Treatment Program tends to be quite effective,” says Dr. Faust. “The best chance of successful recovery is to abstain from gambling entirely. CBT treatment tailored for gambling disorder and medication management together increases the likelihood of successful recovery. Ongoing support groups and ongoing therapy, even after someone’s already abstained from gambling for a while, still increases the likelihood of long-term success.”

Surprise sources of gambling behavior

While most people think of casino slot machines or sports betting when you think of gambling, there are surprising hobbies that contain elements of gambling and may be a problem for those inclined towards gambling disorder or those in recovery.

These include:

• Videogames, particularly those with microtransactions or loot boxes. Microtransactions are small purchases to help advance or enhance your gameplay. Loot boxes are randomized rewards that can mimic gambling behavior. “A number of patients I work with, that’s how they got started gambling,” notes Dr. Faust.
• Scratch tickets and lottery tickets. They may seem like low stakes, but they can often be an entryway into gambling habits. “They’re required to have the statistics of odds on the back of the cards, but it doesn’t seem to matter,” Dr. Faust says. “People still get addicted to it.”
• Prediction market apps. These apps advertise as investment apps but let you “invest” in anything from political races to awards shows to the weather. “It’s pretty much anything you can imagine, you can bet on,” says Dr. Faust. “Especially if you’re carrying that around in your pocket, it’s extremely dangerous.”
• Bingo. While a familiar game for the senior center, it’s also a casino game that can draw people in by seeming harmless.
• Day trading. “Most people wouldn’t put this in the gambling category, but the risk is often so high and the likelihood of someone actually making money off of it so low, that I would personally put it in the gambling category,” says Dr. Faust.
• Arcade games. Any machine where you’re inserting money or credits in order to win more credits or tickets to exchange for prizes could be a trigger for someone in recovery.

If you or a loved one is struggling with problem gambling, gambling addiction, or recovery, there are resources and treatments available. “While recovery from gambling can be quite difficult, it is possible,” Dr. Faust says. “Especially if someone is willing to seek help and work hard to practice and use the various tools and techniques that are out there to avoid gambling.”