Online Gambling's Rising Toll on Public Health and Finances

16 September 2026

The surge in online gambling since the 2018 Supreme Court ruling in Murphy v. NCAA has corresponded with a troubling rise in gambling addiction and related harms, with experts warning of a growing public-health crisis.

Between the 2018 court decision and June 2024, internet searches for help with gambling addiction spiked 23%, according to a study from the University of California, San Diego. This rise corresponds to an estimated 6.5 to 7.3 million help-seeking searches nationwide.

The trend lines suggest online sports betting, which has expanded rapidly in the wake of the court's decision, is a key driver of growing gambling-related harms. Online sportsbooks in particular appear to be more tightly linked to gambling addiction than traditional brick-and-mortar venues.

With round-the-clock access on phones and computers, online betting is increasing the reach of gambling in ways that pose greater risks, especially to younger demographics. Online sports betting in particular is linked to increased rates of problem gambling. Perhaps even more worrisome is the rising popularity of parlay betting, a riskier gambling style where bettors combine multiple individual wagers into a single bet, with odds of winning just a fraction of one percent among recreational bettors who lose on average.

The latest evidence shows online gambling participation in the US rose to 22% in 2024 from just 15% in 2018, with sports betting the vehicle propelling the shift to digital. Aided by incentives like free bets and loyalty programs, states that legalized sports wagering between 2018 and 2024 saw a 27% surge in problem gambling rates, outpacing the national average.

The stakes are high. A 2024 report from the Lancet public health commission estimated that roughly 450 million people globally show harmful symptoms from gambling, some 9% of the adult population in countries, including the US. Including those with recognized disorders, the total reaches nearly 10% of adults.

With lives on the line, what are the impacts of online gambling's expansion, and how can we frame it in years of awareness and advocacy for responsible gambling?

Impact on Finances

For many, the endgame with online gambling is not fun and games, but financial ruin. The uncapped convenience of gambling from a smartphone, coupled with sportsbook incentives to keep bettors engaged, is fueling a disparate rise in financial harms, including a marked uptick in personal bankruptcy.

A 2024 report from Kindbridge Research Institute and UCLA linked online gambling legalization to a 28% spike in personal bankruptcy filings in the states that liberalized sports betting between 2018 and 2024. This difference is statistically significant, the report said, noting that the gap is widening. At its core, this is about the aggression with which consumer-friendly online gambling is marketed and the ease of on-demand gambling that pushes addicts deeper into debt.

Saundra Olson, 37, lost her house in Omaha in what she says was a downward spiral as a result of gambling. "It's easy to gamble so whenever I do lose, I just want to get into my phone and win my losses back. But that's not how the odds work and it don't work that way," she told ABC News in a 2025 interview. "Now I'm starting to think that there could be something wrong with me."

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It's more than just broken debts for Olson. She is married, has a small child, and a history of depression and mood swings that in her view make her particularly susceptible to gambling addiction. "I've gotten counseling every once in a while, but I think I need professional help," she said.

Physical and Mental Harm

With casino gambling experimenting to court mainstream audiences, those at risk have grown beyond a small market, including White men 45-65, college grads, and urban and suburban high-income earners. This is no longer about isolated individuals. It's about the knock-on effects as young adults spiral out of control, people missing appointments, and arguments and unmanageable debt. At stake is harm at the household and neighborhood level, including partner abuse, partner violence, and child neglect, according to a 2024 report on the consequences of online gambling published in the Lancet.

A review of the literature, spearheaded by a Harvard addiction specialist and published in the American Journal of Psychiatry, warned of increased rates of suicide attempts among gamblers, with the risk rising as participation grows. An Australian study in the 2024 journal BMC Psychiatry said 10% of men between 20 and 24 who had gambled online said they had considered suicide. The review noted a gap in understanding the medical risks associated with online gambling.

The research also warned of "increased coercion" in risky online betting, implying compulsive bettors subject to online incentives to continue gambling may be obliged to engage in illegal or harmful activities to acquire more money.

Calling for Action

What can be done? A coalition of reform groups, consumer advocates and gambling addiction experts is calling on states to overhaul their regulatory approach to online gambling, which is largely modeled on legacy land-based regulations. They say states should focus more on the consumer, including warning signs, and put a check on aggressive incentives to keep online bettors in the fold as long as possible.

Instead of giving sportsbooks free rein to target at-risk users with tailored incentives, states in this view should cap the volume of incentives, including "free" bets and loyalty points, to prevent sportsbooks from enticing at-risk bettors into more frequent gambling that is then reinforced with those incentives.

Regulators should also take a more aggressive approach to threshold warnings, to ensure bettors at a high risk of problem gambling, including younger demographics, see the signs immediately.

Finally, supporting a system of registration and ID verification and stronger reporting by operators on consumer activity could be an overdue step to intervene with at-risk users, say consumer advocates, along with more aggressive steps on behalf of state consumer protection officials to investigate practices that pose disproportionate risks of harm.

Ultimately, the stakes are high. If bettors go belly up, that's one thing, but when gambling exacerbates existing mental health conditions or propels younger demographics to self-harm, many see a growing public-health crisis that demands urgent action.