Jonathan D. Cohen

When someone engages in a pleasurable activity like gambling, their brain releases dopamine, a neurotransmitter that processes rewards. Dopamine is what makes these activities feel pleasurable. Psychiatrist Anna Lembke explains that pleasure and pain act on an equilibrium, encouraging limits on the activity in question, no matter how enjoyable. Over time, repeated exposure to pleasure means the brain requires more of that activity—gambling with more money, for example—to receive the same amount of dopamine. Once someone has built up a tolerance, they are susceptible to addiction and, with their equilibrium imbalanced in favor of pain, they will need ever-increasing amounts to experience even a modicum of pleasure—or simply a break from pain.

Winning money felt different, providing a hit of dopamine no biweekly direct deposit ever could. Unlike a salary, winning said something about the gambler as a person. It marked them as a winner. The lottery lets bettors feel they are lucky or blessed. Sports betting lets gamblers feel smart. Of course, luck plays an important role in sports, and by extension in sports betting. However, because gamblers make their own picks, they can imagine sports betting as an exercise in intelligence.

Problem gambling has a higher suicide rate than any other type of addiction. According to a 2023 Rutgers study of New Jersey bettors, almost 30 percent of individuals with a gambling disorder reported thoughts of suicide, 25 percent had engaged in self-harm, and 20 percent had attempted suicide. An important factor is gender. Men are already much more likely to die by suicide than women, and heavy gamblers, especially sports bettors, are predominantly male. Gambling studies scholarship offers two additional reasons for the high prevalence of suicide among problem gamblers. First is indebtedness, the understanding that the gambler’s debts would disappear with them. The second is shame. Gambling addiction has not been destigmatized nearly as much as other substance addictions.

Young men across the globe have a documented appetite for risky behavior that might predispose them to gambling, especially for large stakes. In the United States, this appetite for risk is augmented by a relative decline in income for all but the top-earning men and by lower rates of enrollment in higher education compared to women. For many, gambling presents a seemingly rational alternative way to try and get rich. The sportsbooks know all this.

People who have lost their savings or have developed an addiction need to know that they are not solely at fault and that support is available. Given the high suicide rate among problem gamblers, American families and educational institutions need to do everything they can so that if someone runs into trouble with gambling, they know to come forward before their life is in danger.

Seven states have legalized iGaming — online casino games like slot machines and blackjack. From personal experience, these games are terrifying in how addictive they are. They offer much better margins than sports betting, so major gambling companies will leverage their sportsbooks to dominate this market, just as they leveraged DFS to dominate sports betting. While sports betting can be tweaked to be made safer, iGaming needs to be stopped in its tracks until it can be proven that the games are designed with player safety in mind. And even these games are just the beginning, as young people are caught up in a range of online gambling-adjacent activities, from stock trading and cryptocurrency to video-game skin gambling and loot boxes.

By the time someone recognizes the need for a deposit limit, their dopamine pathways may already be rewired in a way that makes it difficult to slow their gambling -- and therefore makes them unwilling to opt into a program to do so.