New research reveals that gambling addiction is rising in areas that have legalized sports betting. A study of electronic health records across the U.S. found that gambling disorder diagnoses have increased by more than 60% in states that have legalized sports betting since 2018.
Epic Research analyzed electronic health records from more than 197 million U.S. adults between January 2018 and March 2026. Among adults living in states that legalized sports betting, the quarterly rate of diagnosed gambling disorder rose from 3.0 per 100,000 patients in the first quarter of 2018 to 4.8 per 100,000 in the first quarter of 2026, a 61% increase.
In the 11 states that have not legalized sports betting, the rate moved in the opposite direction, dropping by 30% during the same period.
New research out of Ontario also found a dramatic increase in emergency department visits from gambling in just the past few years, following the rapid growth of online gambling in that province and the legalization of betting on single sports events.
“The introduction of a competitive online gambling market in Ontario was associated with a doubling of ED visits for gambling disorders,” researchers wrote.
Both studies found that the biggest increases have been among boys and men, with males being 72 percent of the total hospital visits for gambling in Ontario.
Gambling disorder is a recognized behavioral health condition in which a person continues to gamble despite financial, emotional, or social harm.
Researchers say the findings likely represent only a small portion of gambling-related harm because many people with gambling problems never seek treatment or receive a formal diagnosis. They also caution that the trends cannot be attributed to any single event, including a state’s decision to legalize sports betting.
The study comes as sports betting has expanded rapidly across the United States. In 2018 the U.S. Supreme Court struck down the federal law that had largely prohibited states from legalizing sports betting, clearing the way for states to establish their own laws. By early 2026, sports betting was legal in 39 states and the District of Columbia.
The researchers also point to the growing popularity of online prediction markets as another factor that could be influencing gambling behavior.
