Super Bowl gambling: Does America have a problem?

Gambling disorders expert and UCLA psychiatrist says every state has seen increased demand for treatment services related to gambling problems since 2018
A man looks at a sports betting website on his smartphone.
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6 min read

In addition to very likely being one of the most-viewed sporting events in the world, Super Bowl LVIII is expected to be one of the largest sports betting events in U.S. history, with tens of millions of Americans expected to wager billions of dollars on Sunday’s matchup. But experts say the advent and rapid expansion of legalized, online sports betting has led to an unprecedented accessibility to gambling and the problems that can arise from it.

The American Gaming Association, a gambling industry organization, estimated this week that a record 67.8 million American adults will bet on the matchup between the Kansas City Chiefs and San Francisco 49ers – a 35% increase from last year’s Super Bowl. About $23.1 billion in wagers – including traditional wagers and casual bets among friends and family -- are expected to be placed, up from the estimated $16 billion last year, according to the association.

So far, 38 states and Washington, D.C., have adopted a legalized sports betting market since 2018, though some are limited to in-person betting only. For the remaining states, including California, sports gambling of any kind, whether online or in-person, remains illegal, though that could soon change in some states. The Georgia Legislature is currently debating a bill to legalize sports betting, which could take effect as soon as 2025. 

Timothy Fong, MD, a UCLA Health psychiatrist and co-director of the UCLA Gambling Studies Program, was asked to explain how the paradigm shift in sports betting has impacted gambling disorders in the U.S. and why so many people place wagers during the Super Bowl. 

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Dr. Timothy Fong (Photo by Joshua Suddock/UCLA Health)

 

Q: Big sporting events such as the Super Bowl have always attracted gambling, but how has the rise of sports betting apps and services changed the prevalence and accessibility of sports betting, especially in recent years?

Dr. Fong: Since 2018, access to sports betting has exploded exponentially. There are regulated and unregulated applications and websites opening up constantly, making it nearly impossible to keep up with the different gambling options. The end result is access 24/7 to sports betting, in every state in America. Having unprecedented and nearly unlimited access to sports betting transforms gambling into a commonplace and embedded activity that is part of daily American life. It is no longer in the shadows or hidden away – it’s ubiquitous.   

Q: How does sports gambling differ from other types of gambling such as online poker or a traditional casino? 

Dr. Fong: There are many, many more different types of wagers and bets that can be placed on sports than traditional casino games. They don’t require any human interaction or dealers to be placed. Now, with the advent of artificial intelligence and big gambling data, there are different types of bets that can be offered every few seconds while watching games in real time. Sports betting offers up a wider variety of bets that can appeal to any personality and gambling preferences. 

Q: What makes the Super Bowl stand out from other sporting events in the sports betting world?

Dr. Fong: Every year, the Super Bowl is the most watched sporting event in the world. It has become a global phenomenon, highlighting many aspects of the leading edge of popular culture. Its growth in popularity is also tied to gambling as it is the single most wagered-on sporting event every year and growing. The Super Bowl has become more than just a sporting event, it’s become a national tradition that’s more about connecting with family and friends, eating, gambling, entertainment and being part of a communal event.

Q: How has the popularity of sports betting changed since the U.S. Supreme Court opened the door to legalized sports betting in 2018? Has this resulted in an increase in gambling addiction cases?

Dr. Fong: Since 2018, sports betting has grown into a massive industry, even though it is not yet legally available in all 50 states. Much of the growth has been in the online betting platforms that offer a dizzying number of wagers that change minute-to-minute. Fueled by new partnerships (professional sport leagues, online influencers, traditional media outlets), fast regulations put out by state legislatures and aggressive advertising and marketing campaigns, sports betting has become so commonplace that it is now considered a part of the American entertainment menu. This rise in acceptability and the promotion of sports betting has naturally led to increased participation by the general public. Nearly every state in the United States has seen increased demand for treatment services related to problems cause by gambling and several statewide surveys have shown increased numbers in the incidence and prevalence of gambling disorder.

Q: What are some of the early warning signs that someone is starting to develop an unhealthy gambling habit?

Dr. Fong: Gambling disorder is an addictive disorder that is characterized by continued gambling despite harmful consequences. Not every case presents the same way but, typically, early signs of an unhealthy or problematic relationship with gambling include preoccupation with gambling, not being able to cut down or stop gambling, gambling repeatedly beyond one’s means or budgets, borrowing money to finance gambling or chasing after losses by gambling more. 

Like any other addictive disorder, gambling disorder can also impact sleep, worsen physical conditions through emotional stress and exacerbate mental health conditions like depression or anxiety disorders.

Q: Can sports betting be a “gateway drug” into developing other gambling addictions?

Dr. Fong: There is no current evidence to suggest that sports betting will lead to other types of betting or increase a person’s risk of developing gambling disorder. In many cases of individuals who enter treatment for gambling disorder, they report engaging in multiple types of gambling, not just sports betting but oftentimes three to four types of gambling at the same time.

Q: What are the clinical reasons why people gamble and form gambling addictions? How does brain activity change when a person is gambling?

Dr. Fong: There are clear risk factors to developing gambling disorder including family history of gambling disorder, starting to gamble at a young age, gambling with high frequency, access to gambling along with access to money to gamble with, and the presence of active mental health conditions like depression, ADHD or substance use disorder. Gambling disorder has biopsychosocial risk factors just like substance use disorders. 

Gambling has been shown to activate the same brain regions that are activated during the process of using substances that are highly rewarding. When gambling (or even before gambling), the brain activates the natural reward system and all of the accompanying brain systems that are responsible for positive and negative emotions, excitement, anxiety, reward, hope, attention and more. Men and women with gambling disorder have been shown to have differences in brain activity as compared to those without the disorder.

Q: Is there a “healthy” way to gamble?

Dr. Fong: Gambling is part of the human condition and taking risks and learning to deal with losses is a normative part of life. Recreational gambling does not create harmful consequences to the individual, the family or to the community. Gambling, when viewed as another form of entertainment to which money spent is considered part of the experience, can lead to social connection and enjoyment. A generally accepted guideline to keep gambling in the social and recreational category is to ask: “Is gambling making my quality of life better or worse?”

Take the Next Step

If you are concerned or want to know more about your gambling behavior or the gambling behavior of a family member, call 1-800-GAMBLER or visit the UCLA Gambling Studies Program