New research from UC San Diego provides the most comprehensive look yet at how the rapid expansion of sports betting venues, particularly online, is driving record increases in gambling addiction across the United States. Photo by Areli Alvarez of Qualcomm Institute at UC San Diego
A recent study published in JAMA Internal Medicine highlights a significant rise in sports betting and gambling addiction help-seeking following the 2018 Murphy v. NCAA Supreme Court decision, which allowed states to legalize sports betting.
Led by researchers from the University of California San Diego’s Qualcomm Institute and School of Medicine, the study points to a dramatic increase in individuals seeking support for gambling-related issues. The findings underscore the impact of expanded sports betting access on public health and the growing need for resources to address gambling addiction.
“When the Supreme Court legalized sportsbooks — a venue where people can wager on various sports competitions — in Murphy v. NCAA, public health experts paid little attention,” said the study’s senior author John W. Ayers, Ph.D., who is vice chief of innovation in the Division of Infectious Disease and Global Public Health, deputy director of informatics at UC San Diego Altman Clinical and Translational Research Institute (ACTRI), and Qualcomm Institute scientist. “Now, sportsbooks have expanded from a single state to 38 states, with hundreds of billions of wagers, mostly online, coinciding with record-breaking demand for help with gambling addiction as millions seek help.”
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Since the 2018 Supreme Court ruling, the study documents staggering growth in the sportsbook industry:
The number of states with operational sportsbooks grew from 1 in 2017 to 38 in 2024.
Total sports wagers skyrocketed from $4.9 billion in 2017 to $121.1 billion in 2023, with 94% of wagers during 2023 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.”
A troubling trend has emerged alongside the surge in sportsbooks: a dramatic increase in searches for gambling addiction help. Since the Murphy v. NCAA ruling, national searches have climbed 23%, with millions seeking assistance. State-by-state, the pattern is clear – sportsbook launches correlate directly with sharp rises in addiction-related searches, highlighting a growing public health concern.
The study also found that online sportsbooks had a substantially greater impact on gambling addiction help-seeking than traditional brick-and-mortar sportsbooks.
“Sportsbook regulations are lacking because the Supreme Court, not legislators, legalized them,” concluded Ayers. “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.”
