Gambling Addiction as a Public Health Crisis: Harms, Stigma, and Paths Forward

The global gambling industry is expanding due to increased legislation and an influx of online gambling opportunities accessible through mobile phones. Horrifyingly, it is predicted that net losses by consumers could reach up to $700 billion by 2028 [1]. While gambling is often framed as a form of entertainment, a substantial minority of individuals develop problematic or disordered patterns of behavior. Similar to disordered thinking surrounding alcoholic substances and drugs in which the user feels the need to overuse in order to maintain the emotional effect they feel from the substance, a gambling addict will persuade themselves to continue the self-destructive activity to achieve an acute, emotional high [5]. Thus, gambling addiction is increasingly recognized as a significant public health issue – extending well beyond financial loss – and global estimates suggest that around 80 million people experience gambling disorder [2]. According to the National Council on Problem Gambling, 2.5 million people in the US have a “severe gambling problem” and another 5 million to 8 million have “mild or moderate” problems [3]. The way in which the compelling gambling industry is structured only promotes the increase of gambling disorders, so the question is: how do we mitigate widespread harm to population wellbeing while addressing the stigma that prevents those from seeking treatment against this clinical addiction?

Financial harm is typically the most visible consequence of gambling addiction, which is one, more surface level incentive to treat it. Individuals frequently accumulate substantial debt, depleted savings, experiencing bankruptcy or housing insecurity. A study found that 22.8% of pathological gamblers had declared bankruptcy with an average debt of $53,103, with debts ranging from $5,000 to $250,000 [4]. These financial pressures in turn enforce a cyclical pattern of individuals continuing to gamble in an attempt to recover losses, thereby exacerbating their situation. On a broader scale, the annual social cost of gambling addiction in the U.S. has been estimated at $14 billion, expenses adding up in healthcare, lost productivity, and criminal justice expenses [5].

Yet, beyond financial consequences, gambling addiction is strongly correlated and interrelated with a range of other mental health issues. A large meta-analysis found that 30.9% of individuals with gambling disorder have mood disorders (such as depression) and 29.9% have anxiety disorders, while 34.2% experience substance abuse disorders [6]. In clinical populations and in treatment services for problem gambling, between 22 and 81 percent of individuals have been found to have suicidal ideations, while between 7 and 30 percent of individuals have had suicide attempts [7]. These findings underscore that gambling addiction is a life-threatening condition, highlighting the need for effective intervention not only to improve their financial condition but to augment the physical safety and wellbeing of the individual. Despite the evident severity of these harms, stigma remains a major barrier to recognition and treatment. Individuals experiencing gambling harms are often perceived as irresponsible or lacking in self-control, which reinforces shame and discourages help-seeking. As many as 90% or more of people with gambling problems never seek help [8]. Fear of judgment, wishing to conceal the extent of their indebtedness from others, and internalized shame all contribute to underdiagnosis and undertreatment.

Addressing gambling addiction requires intervention on clinical, social, and policy levels. Evidence-based treatments such as cognitive behavioral therapy (CBT) and peer-support programs have shown effectiveness in helping individuals reduce or stop gambling behaviors [9]. Peer-support programs, including mutual aid groups, can also provide important social support and reduce isolation. If we can work to decrease isolating sentiments, more people will gradually seek help, and it will become more of a social norm. Additionally, policies such as self-exclusion programs, which allow individuals to voluntarily ban themselves from gambling venues or platforms, spending limits, and digital monitoring tools should be implemented to help individuals manage their gambling behavior. Critically, these resources should be done in a manner that enhances the gamblers autonomy in aiding their own situation, rather than invoking

a sentiment of taking over their lives unwillingly.

Furthermore, preventative public health measures are essential. Efforts to reduce stigma through education and awareness can encourage help-seeking and improve early detection, and regulating online gambling environments may help reduce exposure to high-risk products. Addressing gambling addiction requires both support on an individual basis but also on a public basis, modifying and being aware of environments that can contribute to harmful behaviors. We must reconstruct the narrative that gambling addiction is not a personal failing and showing the world how it is in fact a complex public health issue associated with a wide spectrum of harms, including financial strain, mental illness, and significantly elevated suicide risk. These harms affect more than directly to individual subjects, affecting families, communities, and healthcare systems – both directly and indirectly – involved with the individual. Persistent stigma continues to hinder recognition and treatment, so comprehensive solutions such as combining clinical care, public health interventions, and structural reforms are necessary to effectively address the problem.

Reviewed By: Sydney Berger

Designed By: Devin Mulcrone

References

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[3] National Council on Problem Gambling. (2024). FAQs: What is Problem Gambling? National Council on Problem Gambling. https://www.ncpgambling.org/help-treatment/faqs-what-is-problem-gambling/.

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[5] National Council on Problem Gambling. (2024). FAQs: What is Problem Gambling? National

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[6] Galeazzi, G. M., Marchi, M., & Castagnini, A. C. (2025). Psychiatric morbidity and gambling disorder: A systematic review and meta-analysis of population-based surveys. European Psychiatry, 68(1), e161–e161. https://doi.org/10.1192/j.eurpsy.2025.10122.

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