Gambling Disorder Diagnoses Rise 61% In Betting States

Diagnoses of gambling disorder have risen more than 60% since 2018 in US states that have legalised sports betting, according to a new study of electronic health records published by Epic Research.

Among adult patients in states with legal 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, an increase of around 61%.

The Opposite Trend In Non-Legal States

In states that have not legalised sports betting, the rate moved in the opposite direction, falling from 3.1 per 100,000 patients in the first quarter of 2018 to 2.2 per 100,000 in the first quarter of 2026. 

The researchers said the divergence between the two groups of states points to a measurable association between legal sports betting access and diagnosed gambling disorder rates, though the study does not establish the specific causal mechanism.

Young Men Show The Largest Increase

The study found the increase was most pronounced among young men.

That is a group researchers and treatment providers have repeatedly flagged as the demographic most exposed to mobile sports betting advertising and product design since legalisation expanded across the US following the 2018 repeal of the federal sports betting ban.

Ever-Growing Market 

The US Supreme Court struck down the Professional and Amateur Sports Protection Act in May 2018, clearing the way for states to legalise sports betting on their own terms. As of 2026, 39 states plus Washington, D.C. have legalised sports betting in some form, with roughly 30 of them offering regulated online or mobile betting through licensed sportsbooks. 

The expansion from zero legal state markets in 2017 to nationwide availability across most of the country in under a decade is the backdrop against which Epic Research's diagnosis-rate findings are being read.

What The Data Shows

Epic Research's study is based on electronic health records and tracks diagnosed gambling disorder rates rather than self-reported gambling behaviour, giving it a clinical rather than survey-based basis. 

The researchers describe the finding as an association between legal sports betting access and rising diagnosed disorder rates, not a confirmed single cause, since other factors that vary by state, including broader gambling availability and demographic differences, could also contribute to the gap between legal and non-legal states.