Between 2018 and 2021, three major events transformed gambling in the United States: the expansion of legal sports betting, increased internet gambling, and the COVID-19 pandemic. These changes led to a rise in problematic gambling behavior, with the pandemic showing the most significant impact.

Prohibition has proven ineffective at reducing gambling disorders, especially with widespread internet access. While legal gambling facilities need regulation, simply moving players from offshore sites to legal venues doesn't reduce problem gambling without proper support programs.

Key risk factors for problematic gambling include:

• Young age
• Participation in multiple gambling activities
• Sports and fantasy sports betting
• Poor gambling literacy
• Misconceptions about gambling as a money-making method

Young adults show the highest rates of problematic play and gambling misconceptions, highlighting the need for targeted education and prevention efforts.

Investment trading frequency correlates with problem gambling, suggesting the need for:

• Further research into this connection
• Collaboration between gambling and investment professionals
• Including investment behavior in gambling treatment assessments

The lottery remains crucial for problem gambling awareness, reaching 90% of gamblers. However, gambling disorders continue to be misunderstood and stigmatized, leading to:

• Reluctance to seek treatment
• Low awareness of available resources
• Need for better public education

Problem gambling affects all demographics, although risk levels vary. It requires a comprehensive public health approach involving:

• Government agencies
• Gambling industry
• Healthcare providers
• Legal professionals
• Educational institutions
• Financial sector
• Non-profit organizations
• Recovery community

Continued research and policy updates are essential to address evolving gambling landscapes and ensure effective prevention and treatment strategies.

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