How Gambling Affects the Brain and Who Is Most Vulnerable

Once limited to the neon-lit casinos of Las Vegas and Atlantic City, gambling has now infiltrated every corner of daily life. With the rise of online platforms, mobile betting apps, lotteries, and video games with gambling elements, it has never been easier or more tempting to place a wager. Sports betting is now legal in 37 U.S. states plus Washington, D.C., with several more considering legislation. The result: gambling is no longer just an adult pastime it’s increasingly accessible to teenagers, and even children. Psychologists warn that with greater access comes greater risk. And evidence shows that certain groups particularly young men are especially vulnerable to addiction. Who’s Most at Risk? Research suggests people in their early 20s are the fastest-growing group of gamblers, with many starting even earlier. A 2018 Canadian survey of over 38,000 youth found that nearly two-thirds of adolescents aged 12 to 18 had gambled or played gambling-like games in the previous year. Early exposure carries heavy consequences, including a higher likelihood of psychological distress and long-term addiction. Other risk factors include: Low income – The potential for a life-changing win can be more enticing for those with fewer resources. Co-occurring mental health issues – An estimated 96% of people with gambling problems also have another psychiatric condition, such as depression, anxiety, or substance use disorder. Gender – Men outnumber women 2 to 1 in gambling addiction rates, though female addiction rates are rising. Inside the Addicted Brain For decades, gambling addiction was seen as a matter of poor self-control. Now, brain research is painting a more complex picture. Neuroimaging studies show that problem gamblers often have differences in brain areas like: The Striatum – Involved in reward anticipation, showing reduced activity that may drive risk-taking. The Amygdala & Hippocampus – Linked to emotional learning and stress regulation, often smaller in volume in addicted individuals. The Prefrontal Cortex – Responsible for decision-making and impulse control, which develops late in adolescence—particularly in males—making teenagers more prone to risky gambling behaviors. Genetics also play a significant role, accounting for roughly half of the risk of developing gambling problems. The Video Game Connection Not all gambling takes place in casinos or on betting apps. “Loot boxes” in video games—digital grab bags offering random rewards—mimic the mechanics of slot machines. These virtual rewards tap into variable ratio reinforcement, a psychological principle where unpredictable rewards keep players hooked. Studies show: Many young adults cite loot boxes as their introduction to gambling. Spending on loot boxes is linked to higher gambling risk, especially in adolescence. The relationship is bidirectional, gamblers spend more on loot boxes, and loot box spenders are more likely to gamble later. Early Exposure, Long-Term Consequences Children as young as six have been observed playing free casino-style games, which often have higher win rates than real gambling. This creates a false sense of success, potentially priming them for future riskier play. Seeing family members gamble also normalizes the behavior, making it more likely they’ll gamble themselves. The earlier the exposure, the greater the risk—and the more severe the potential addiction. Sports Betting: The New Frontier With smartphones and tablets, sports betting has become one of the most impulsive and dangerous forms of gambling. The ability to place wagers mid-game—on anything from the coin toss to individual plays—feeds into high-emotion, high-impulsivity environments. Young adults aged 21–24 are the fastest-growing demographic of sports bettors. Alarmingly, research in New Jersey found that sports bettors had higher rates of mental health problems, substance use, and suicidal thoughts than other gamblers. Treatment and Prevention Gambling addiction is difficult to treat—partly because it’s easy to hide, and up to 90% of sufferers never seek help. Currently, cognitive behavioral therapy (CBT) is the most common treatment, tailored to three main pathways to addiction: Habitual chasing of wins until gambling becomes compulsive. Escape from trauma or mental distress through gambling. High impulsivity and thrill-seeking behaviors. Promising new treatments include neuromodulation, where brain stimulation is used to regulate cravings and emotional control. On the prevention side, experts stress the need for education. While schools regularly cover alcohol, drugs, and safe sex, gambling is rarely part of the curriculum. Parents are encouraged to talk openly with children about the risks of gambling including loot boxes and to set limits on spending and screen time. Gambling is no longer confined to casinos it’s in our pockets, our games, and our social feeds. While most people can gamble without developing problems, the risks for young people, those with mental health challenges, and individuals with lower incomes are real and growing. As technology continues to blur the lines between gaming and gambling, society faces a critical choice: treat problem gambling with the same urgency as other addictions or wait until a generation raised on in-game betting faces the full weight of its consequences.