Panel Discussion 3 - Addressing Gambling Behaviors and Problems in the Wake of Rapidly Expanding Access: Perspectives from Public and Behavioral Health

Gambling access in the U.S. has increased exponentially in the 21st century, with even greater increases since the U.S. Supreme Court paved the way for sports betting legalization in 2018. As of March, 2025, 49 states have some form of legal gambling, 39 states have legal sports wagering, and 33 states have some form of legal online gambling. Not surprisingly, this rapid expansion in gambling access has coincided with evidence of clear increases in gambling-related behaviors and harms in various jurisdictions. In short, consistent with the convention's theme of research at the interplay of public health and behavioral treatment, gambling has garnered increased attention as a challenge to both public and individual health.
Even so, research related to the proper assessment, prevention, and treatment of gambling-related problems has failed to keep pace with increased access and harm. Recent research suggests that gambling problems are especially related to comorbid substance use issues, greater suicidality, and a wide range of other psychiatric comorbidities. Yet, treatment research is sorely underdeveloped in this domain.
Panelists for this discussion were chosen based on extensive experience working with gambling-related research, policy, and treatment in a variety of settings and with diverse populations. Initial discussions will focus on the evolution of gambling access and research over the past 15 years, including the rise of both legal and illegal online gambling. Next, consistent with the convention's themes around affirmative therapies, gambling-related problems in special populations (e.g., veterans, emerging adults, minoritized communities) will be considered. This will be followed by discussions of how sports gambling legalization has changed the landscape of gambling behavior and problems since 2018. Finally, we will discuss where cognitive and behavioral treatments have shown the most promise in treating gambling-related problems and how these therapies have been translated to diverse groups. Collectively, this panel will aim to broaden awareness of the intersection of gambling-related problems in various mental health treatment settings, while providing clear insights regarding current and future needs for research.