Finding and funding ways to combat problem gambling on the table for lawmakers, advocates as easy access raises the stakes

The Foxboro resident tried to convince himself that if he stayed clear of betting on the home teams –- the Red Sox, for example — it would remove the “emotion.” Because if he bet on the Sox or Celtics, he would be rooting for the home team to win, which would figure into his wagering.

“I’d gamble on sports every day,” says Kenny, noting he started at age 13 and was entrenched for several decades. He would also “go to the casino two or three times a month or two or three times a week.”

“It’s a disease, an insidious disease,” says the real estate agent, now 58, who is known as “Kenny O.” in his role speaking to people in the Morton Comprehensive Addiction Program, or MORCAP, at Morton Hospital in Taunton. The Sun Chronicle is withholding his last name in this story.

That program brings him into contact with people of all ages who have multiple addictions, including problem gambling. It recently included an 18-year-old who Kenny says “blew through all his savings” gambling. “He thought his parents would bail him out; they kicked him out.

“Giving money to a compulsive gambler is like giving alcohol to an alcoholic,” he says. “It enables them.”

And now, with the institution of online sports betting, “it’s in your face,” making it all the more accessible to people who can become addicted, Kenny says.

It’s one of the reasons he testified a couple of months ago before the state House Ways and Means Committee against a budget cut in the coming fiscal year proposed by Gov. Maura Healey. It would reduce a public health fund that provides treatment, resources and services for problem gamblers.

“There is a need for awareness and education,” says Kenny, adding that while he does not denounce gambling, problem gambling is a growing health concern.

“It’s really about the access,” he said.

Under Healey’s $56 billion budget plan, the percentage of casino gambling funds that since 2018 have been earmarked for programs to reduce the harm associated with gambling and to research its effects, would be cut in half, or roughly $6 million. Healey’s administration has stated it would be a one-time reduction.

But it comes just a year after Massachusetts legalized online sports betting with an inundation of gambling advertisements from online sports betting operators like DraftKings and FanDuel. Healey’s budget proposal also includes extending the Massachusetts Lottery online, an authorization that could generate around $75 million for the state in its first year alone.

Researchers, who conducted the state’s first study of gambling behavior about a decade ago have not yet had time to study the full public health effects of the latest wave in legalized betting.

At a meeting of the Massachusetts Gaming Commission in early April, UMass researcher Rachel Volberg of the School of Public Health and Health Sciences at UMass/Amherst, said the prevalence of problem and at-risk gambling has not significantly changed since casinos, including Plainridge Park in Plainville, were introduced in the state beginning in 2015.

Volberg’s findings were based on the comparison of data from the baseline pre-casino survey in 2013-2014 and the follow-up survey in 2021-2022. The statewide population survey compares gambling behavior and attitudes before and after the opening of three casinos in the state.

Volberg notes the pre-casino survey found a high level of overall participation (73.1%) in different types of gambling among Massachusetts residents, including 21.5% who traveled to resorts in Connecticut and other states with a casino industry. In 2021, 60.2% of residents surveyed said they had participated in gambling in the past year; the researchers’ analysis suggests the decline was in part due to the lingering effects of COVID-19 restrictions, according to her summary.

“We hypothesized that because of the clear exposure to casinos in Connecticut, we might not see the increase in problem gambling that often happens in the wake of the introduction of a new form of gambling,” she said in her summary. “And it was nice to see our hypothesis confirmed.”

According to the latest survey of 3,000 people, about 10% of the population either has — or is at risk for — a severe gambling problem. That rate of problem gambling has stayed pretty constant since the casinos opened, she said.

One area of concern was revealed by the latest survey, according to an online summary published on the school’s research site. The proportion of gambling expenditures that came from at-risk gamblers increased from 51% in 2013 to 68% in 2021. “These aren’t problem gamblers,” Volberg said, “but the financial losses are still an impact on them and their families and their communities.”

The 2021 survey also showed considerably more people believed that gambling is too widely available — increasing from 15.6% to 67.5% since 2013.

That increase suggests that the target for minimizing and mitigating gambling harm needs to shift to identify potential gamblers in need earlier, Volberg said.

But the number of people aware of where to get help has gone down by half, she told the commission.

“There is quite a lot of stigma around gambling problems,” Volberg told the gaming commission, according to an article by New England Public Media. “People have great shame about not being able to manage their money. But there’s also quite a lack of awareness about where to find help. People (incorrectly) think that they need to have insurance coverage to get that help. Those are all messages that can be pushed out there — and I think should be pushed out there.”

The study did not look at how easy it is to get gambling treatment, which advocates say is a problem in Massachusetts.

Rates of problem gambling are significantly higher among sports bettors, primarily because they are engaged in a wider range of gambling activities, according to a 2022 analysis by Volberg and other UMass Amherst researchers.

The state Department of Public Health, which controls the state fund that oversees treatment options, does not track the number of people who get treatment.

Volberg said researchers asked how many people sought treatment, but so few responded that they couldn’t include those results.

She said it’s hard to know what causes someone to go from recreational to problem gambling — or back again — without researchers following the same people over time. That’s called a cohort study and it’s one that state researchers used to conduct until the gaming commission stopped funding it.

The new study also found that problem gamblers spend much more money on gambling than other types of gamblers compared with 10 years ago. And it found high gambling participation among sports bettors, though sports betting was not yet legal when the original baseline study was conducted.

And some critics of Healey’s proposal say that with increased accessibility, comes the risk of more problem gambling. Further raising concern is that adolescents and teens are circumventing regulatory safeguards and gaining access to the new digital betting platforms.

Since the advent of mobile sports betting in the state, gamblers have wagered about $4.8 billion on those platforms, according to statistics from the state Gaming Commission. More than 1 million wagering accounts were opened and 135 million transactions with online sports betting platforms were recorded in the last fiscal year.

Volberg attributed the steady rate, rather than a rise of problem gamblers (2% in 2013 and 1.4% in 2021) and at-risk gamblers (8.4% in 2013 and 8.5% in 2021) to the state’s problem gambling prevention programs — GameSense, PlayMyWay and voluntary self-exclusion.

Problem gamblers are defined as those who experience significant impaired control over their gambling and negative consequences as a result, according to the researchers’ information. At-risk gamblers are those whose behaviors place them at greater risk of experiencing a gambling problem, such as persistently betting more than planned, spending more time gambling than intended and borrowing money to gamble.

Marlene Warner, CEO of the Massachusetts Council on Gaming and Health (MACGH), a statewide non-profit agency established in 1983 and charged with promoting public health by mitigating the negative personal and community impacts of gambling and gaming, agreed with Volberg’s assessment in regards to ensuring accessibility to resources for problem gamblers.

“There’s certainly a lot more we could be doing outside casinos, in communities and in more languages,” she said, noting the Voluntary Self-Exclusion programs offered through MACGH have been successful. In those programs, players can remove themselves from casino floors, marketing lists, and with Sports Wagering Self-Exclusion, sportsbooks, and mobile apps.

“We’ve seen a pretty steady increase since sports betting has gone live,” Warner said, adding the increase was expected based on the experience of other states where mobile sports betting was already in place.

Services include 24/7 help lines as well as live chats: GamLine: 1-800-GAM-1234; National Helpline: 1-800-GAMBLER; LiveChat: MACGH.org

GameSense, which facilitates a player health and education program on site at the state’s three casinos, staffs the 24/7 LiveChat for people to ask gambling-related questions and to enroll in Voluntary Self-Exclusion. It has fielded 459 LiveChats from January through April this year. This is on pace to be an increase from 2023, which had 1,229 LiveChats for the full year, according to statistics provided by MACGH. There is a 17.6% uptick in calls from the previous January through April. There was an increase in LiveChats in March 2023 following the rollout of sportsbooks apps.

GamLine intake calls increased 49 percent from FY22 to FY23; 88 percent from FY22 to FY24, according to MACGH.

While the contact numbers are advertised, “We need to expand efforts to spread the word,” Warner said. And that includes “figuring how to reach out to kids,” which while there are currently no numbers to indicate how many youths are gambling, she says there are anecdotal stories from parents, coaches and others who have concerns.

“We don’t know how big a problem it is or how big a problem it will become,” she said, adding more research is needed.

If funding is reduced, she said, it would limit furthering the goals of increasing awareness of programs and services as well as expanding those services.

Legislators boost prospects for funding

“We don’t want to see any reduction to that fund,” state Rep. Adam Scanlon, D-North Attleboro, says of the public health fund overseen by the state Deptartment of Public Health, which in turn allots funds to MACGH.

The budget passed by the House would restore the percentage of casino revenues going into the public health fund to 5 percent, up from Healey’s proposed 2.5 percent. It’s the level which the fund has received since its inception, Scanlon said.

The Senate followed in May, but by boosting it to 5.5 percent.

The issue will now go to a conference committee.

Scanlon says the funding is necessary because with legalized betting, and especially access to online sports betting, problem gambling will increase.

“I think it’s beyond online gambling,” Scanlon said. “We need to be concerned about the rise in problem gambling online and on casino floors.

“We need to be cognizant that when we make these activities available, we need to provide funding for treatment,” he said.

Scanlon points to information from the National Association of Addiction Professionals that shows “gambling, compared to overall addiction, has the highest rate of suicides” and is also tied to other addictions.

“It’s a dangerous problem that’s likely to rise,” he said.

Scanlon says he’s glad that gambling is legalized because then it can be regulated.

“If it wasn’t, I think it would be even worse,” Scanlon says. But since it is, “we need to provide services and treatment for those adversely impacted by it.”

Concerns about youth access to digital gaming platforms is indicative with the creation of The Youth Sports Betting Safety Coalition by state Attorney General Andrea Joy Campbell, to which Scanlon has been appointed to serve.

The coalition is billed as “a unique public-private collaboration to educate young people on the laws, risks, and public health harms associated with sports betting, as it increasingly permeates our sports culture.”

One of Scanlon’s priorities as a member of the coalition is to work with the state Gaming Commission “to strengthen consumer protections against the risks inherent in gambling, particularly our recently legalized sports betting, which is now just a swipe away on millions of phones throughout the Commonwealth.”

“In this new world, major sporting events are now also major betting events,” he said. “We need to make sure that the attention paid to these events, the avalanche of advertising, and the possibility of wagering on them, does not ensnare the young people of the Commonwealth in a cycle of law-breaking and addiction.”

Scanlon said like so many of the critical policy challenges facing the state, it’s not just up to government. “To reach young people and to influence their conduct for the better, we need to collaborate with both the nonprofit and private sectors.”

Building on a proposal by MACGH, the attorney general’s office, the state Gaming Commission, and the Civic Action Project, are working together to develop a sports betting education, training, and safety curriculum for middle school, high school, and college-aged young people, ages 12-20, Scanlon said, adding the expectation is eventually to also “shape how responsible actors in this space — professional sports teams, sports media and licensed sports books — communicate about the risks of gambling, both internally and externally.”

Campbell publicly announced the move in late March at TD Garden, a host to this year’s NCAA’s March Madness games, and along with the NCAA was joined by the Red Sox, Boston Celtics, Boston Bruins, New England Patriots, and New England Revolution who have all agreed to become founding members of the coalition.

In a related move, an amendment by Scanlon to create an advisory committee to advise the Lottery Commission was recently adopted by the House. The committee would advise the Lottery Commission on the operation of the lottery, including the new online lottery ticket sales, similar to the Gaming Policy Advisory which advises the state Gaming Commission.

“Crucial to this new body, the Stakeholder Lottery Modernization Committee, is a seat for a representative of the Massachusetts Council on Gaming and Health as well as seats for representatives of the retail industry and of licensed lottery sales agents,” Scanlon said. “Together, they will ensure that stakeholder perspectives, whether on responsible gambling principles or the interests of small businesses, will be heard by Lottery Commission decision-makers.”

He pointed to a move by the state Gaming Commission in May, following a letter he and state Rep. Marcus Vaughn, R-Wrentham, penned in February to the commission encouraging a study of AI and problem gambling. The commission voted to seek two requests for bid proposals on research into the potential impacts of iGaming and the use of artificial intelligence in the gaming industry. iGaming is a separate issue from online sports betting, according to the proposals. It includes digital variations of popular casino-style games or poker available through websites and mobile apps.

Research on the subject is somewhat limited so far, the commission notes, with Rhode Island becoming the latest state to legalize iGaming as of 2023.

One of the RFPs seeks a study including potential for rises in problem gambling and impacts on those 25 and younger. The other is proposed to look at the current and future possible uses of AI in the gaming industry, especially as it pertains to marketing, player acquisition and responsible gaming and player health.

The combined studies are budgeted for $75,000.

In a separate letter to the gaming commission in February, the two state lawmakers noted: “The Massachusetts Youth Risk Behavior Survey, developed by the Centers for Disease Control and Prevention and conducted along with the Department of Elementary and Secondary Education and the state Department of Public Health every two years, has shown that 40 to 50 percent of Massachusetts students have engaged in some form of gambling, such as playing the lottery or participating in fantasy sports, consistently over the past decade.”

Online sports betting operators like DraftKings and FanDuel are required to post services and resources for problem gambling.

Both provide resources including a national toll-free helpline number on their websites, apps and retail sportsbooks.

DraftKings include specific state information online as well as national resources, including 1-800-327-5050; Text: GAMB to 800327 and a chatline, gamblinghelplinema.org.

FanDuel doesn’t list contacts specific to Massachusetts online, but has a national hot number, 1-800-BETSOFF.

In March, seven of the nation’s largest gaming companies announced that they were creating a trade group to promote responsible gaming, and for the first time, share information about problem gamblers.

The seven operators — FanDuel, DraftKings, BetMGM, Penn Entertainment — which oversees Plainridge Park — Fanatics Betting & Gaming, Hard Rock Digital and bet365 — will form the Responsible Online Gaming Association, or ROGA.

The members account for more than 85% of the legal online betting market in the United States. Collectively, they have pledged more than $20 million to fund ROGA.

“I’m incredibly excited to move this forward and to really do some impactful things and to really expand the knowledge through the research and to create these evidence-based best practices and to really empower players with information,” Jennifer Shatley, executive director of ROGA, said in a published report of the announcement.

ROGA members commit to work together on issues ranging from education, responsible gaming best practices, conscientious advertising and marketing across the industry, according to the announcement.

The new group will also create an independent database, that will allow them to share key information related to protection of consumers, though the details on how it would work aren’t yet clear.

Two weeks ago, the Massachusetts Gaming Commission held a public meeting to discuss the issue of betting limits being placed on winning players, however, BetMGM, PENN/ESPN BET, DraftKings, FanDuel, Caesars, and Fanatics all informed the MGC that they would not attend. Representatives of the state’s three casinos also did not show.

Commission members were not pleased about the no-shows.

The operators voiced concerns about some of the information to be discussed in a public forum.

PENN Entertainment, the parent company of Plainridge Park Casino and the operator of the ESPN BET sportsbooks, told the MGC that “it is unable to participate in a public meeting regarding this topic due to the competitively sensitive and proprietary nature of PENN’s risk and trading information.”

PENN, however, did offer answers to five questions the MGC had asked operators.

There are no rules or regulations that prohibit customer limits for any reason.

“A law or regulation prohibiting or limiting operators’ ability to allow limits would lead to a large reduction in the amount of wager opportunities offered, reduced limits for all patrons (rather than just individual patrons who are manipulating or abusing the system), less sports and leagues available to wager on, and potentially, a reduction in available operators entirely. The typical, recreational bettor would experience a vast reduction in betting options if such a law or regulation were put into place. The result would be a less competitive product offering for the customer and reduced revenues for the Commonwealth,” Samantha Haggerty, Deputy Chief Compliance Officer, Regulatory Affairs Counsel for PENN, wrote.

An email to PENN’s corporate offices by The Sun Chronicle seeking additional information about player protections and the possibility of a future meeting with the state Gaming Commission went unanswered.

Scanlon, who watched the session via YouTube, said, “It’s extremely frustrating and unfortunate that operators refused to meet in good faith with the Gaming Commission to discuss very fair and common-sense questions on their ‘methods’ to curb problem gambling.

“We need to hold these operators accountable for their actions, I am glad that the Gaming Commission views this issue as a priority. Problem gambling is a public health crisis, therefore it should be discussed in public. We as residents deserve better transparency from entities that generate tax revenue for our Commonwealth, they need to hold up their end of the deal in taking this crisis seriously.”

Kenny said he started attending Gamblers Anonymous meetings when he was in his late teens, early 20s, “but it was exploratory. I didn’t take it seriously.”

“I was there with a bunch of 40- and 50-year-olds. I figured I had time,” Kenny said. He said his compulsive gambling lasted until age 33.

“You’re not doing the same damage at 13 as you are when you’re 23 or 33,” when you perhaps have equity in a home, credit cards, among other financial obligations, he said.

“The common denominator is that I lost more than I could afford to lose,” Kenny said. “Compulsive gambling is an emotional illness.”

For him the stakes were too high. “It was a financial pig mess,” Kenny said.

He attended daily meetings and stopped watching sports.

And unlike many others, he was lucky. He kept his job, his home and his marriage.

“And I have two kids who didn’t know their father when he was an active compulsive gambler,” Kenny said. “The joy of living is having your day be your day and not have gambling controlling it.”