Sportsbooks Spread Rapidly as Gambling-Addiction Help-Seeking Searches Rise
The expansion of legalized sports betting in the United States has been fast, visible, and measurable. In this longitudinal analysis, operational sportsbooks grew from a single state in 2017 to 38 states in 2024, while total sports wagers climbed from $4.9 billion in 2017 to $121.1 billion in 2023. By 2023, 94% of those wagers were placed online, a shift that matters because digital betting lowers friction, shortens the time between impulse and wager, and keeps gambling available on the same devices people use for work, news, and social contact.
Alongside that commercial growth, internet searches for gambling addiction help-seeking rose. Nationally, queries involving gambling and addiction, addict, anonymous, or hotline increased by 23% (95% CI, 15%-30%) after Murphy v National Collegiate Athletic Association. In practical terms, public appetite for wagering rose in lockstep with digital access, and search behavior suggests that some users were also reaching for help or at least information about help.
Online Access Coincided With Larger Search Surges Than Retail Sites
The analysis examined Google search trends from January 1, 2016, through June 30, 2024, and compared periods before and after the legal and market changes that enabled sportsbooks. The outcome measure was searches per 10 million queries that referenced gambling and addiction-related terms. This is not a clinical diagnosis, and it cannot prove individual causation, but it functions as a population-level signal of concern: when gambling-related distress grows, people often search before they present to care.
State-level patterns were especially striking after sportsbooks opened. Massachusetts showed a 47% increase in search activity above expectation (95% CI, 21%-79%), New Jersey 34% (95% CI, 21%-45%), New York 37% (95% CI, 26%-50%), and Pennsylvania 50% (95% CI, 35%-66%). Those are not trivial deviations. They suggest that the introduction of legalized betting platforms may be associated with an immediate and localized rise in help-seeking behavior, particularly in states where access became newly available or more convenient.
Online sportsbooks appeared to drive a larger increase than retail sportsbooks. The mechanism is easy to understand at the bedside and at the public-health level: online platforms remove geographic barriers, operate continuously, and support rapid, repeated betting. The same features that make sports wagering convenient also make it harder to pause. For patients vulnerable to compulsive gambling, the distinction between a game, an app, and a financial transaction can collapse in seconds.
Betting Volume Rose as the Market Shifted Into Phones and Browsers
A second pressure point in the data is the sheer scale of wagering. Total sports wagers expanded more than twentyfold from 2017 to 2023, and nearly all of that activity in 2023 occurred online. Such growth changes the exposure environment for millions of adults at once. It also makes the health implications more difficult to ignore, because gambling harm rarely remains confined to the individual bettor. Family conflict, debt, sleep disruption, workplace impairment, anxiety, depression, and crisis-level financial strain often travel with it.
The rapid increase in sportsbooks mirrors a familiar public-health pattern: when access broadens, use tends to broaden too, and high-frequency products generate the most concern. Sports betting is not a passive form of entertainment. It is structured around repeated decisions, variable rewards, near misses, and constant cues—features that can reinforce compulsive behavior through well-established behavioral conditioning pathways. With mobile access, those cues are no longer restricted to casinos or betting shops; they arrive during games, in notifications, and in real time.
The study’s design cannot isolate every confounder, and Google searches are an imperfect proxy for clinical need. Some people search out of curiosity, not distress. Yet the signal is still clinically relevant because help-seeking often begins outside the clinic, especially for stigmatized conditions such as gambling disorder. A rise in addiction-related searches may therefore represent the earliest visible trace of a larger problem.
Public Health Systems Will Need Earlier Detection and Easier Entry to Care
The findings point to a simple but demanding public-health reality: sportsbook access is expanding faster than many treatment systems are prepared to respond. Gambling disorder is often underrecognized in primary care, psychiatry, emergency medicine, and substance use services. Patients may present with insomnia, anxiety, irritability, relationship conflict, or financial crisis before anyone asks about betting behavior. If sports wagering is becoming more common and more continuous, routine screening needs to move earlier in the clinical encounter.
Treatment access also matters. Effective care requires more than telling patients to stop. It involves recognition, motivational interviewing, referral pathways, and sustained support, including treatment for co-occurring depression, anxiety, substance use, or suicidal thinking when present. The search-data signal in this analysis suggests that demand for those services may be rising in parallel with the sportsbook market.
This is especially important because online platforms are not merely a new storefront for an old behavior. They alter the exposure itself. Mobile betting can intensify cue-reactivity, encourage repeated in-game wagers, and enable rapid loss chasing. In that setting, gambling harm can escalate quickly, and families may notice the consequences before the bettor does.
The Remaining Question Is Scale, Not Direction
What this analysis establishes is direction: as sportsbooks expanded after Murphy v National Collegiate Athletic Association, sports wagering grew and gambling-addiction help-seeking searches increased. What it does not establish is the precise number of people harmed, the clinical severity of those harms, or how many searchers ultimately entered treatment. Search trends are a population-level barometer, not a diagnostic instrument.
Even so, the pattern is hard to dismiss. Sportsbooks have become a mainstream, digitally distributed product in a very short period of time, and the public-health system is now seeing a corresponding rise in interest in gambling-addiction help. The practical challenge is no longer whether betting access changed. It did. The challenge is how quickly clinicians, regulators, and treatment systems can respond to the harms that appear to be growing alongside it.