Addiction Data Bulletin 6

This bulletin provides an overview of the continuum of services and treatment provided and overseen by the New York State (NYS) Office of Addiction Services and Supports (OASAS) for those affected by gambling harms and gambling disorder. We highlight several specific services and treatment in this bulletin, including workforce training, a 24/7 helpline, inpatient and outpatient treatment, and a voluntary self-exclusion (VSE) program. 

• Service and treatment utilization in NYS for gambling harms, including gambling disorder, has increased since at least 2020.
• The helpline, VSE program, and inpatient and outpatient treatment had the largest single year increase from 2021-22, following the implementation of legalized mobile sports betting in January 2022.
• As of 2022, mobile sports betting surpassed casino gambling as the primary reason for gambling-related helpline calls made by New Yorkers.
   

Gambling risk environment includes the range of policies, gambling establishments and operators, services and supports, and individual family and social supports, that influence the likelihood and the severity of gambling harms. 

Legal gambling activities in NYS include lottery (e.g., Mega Millions, Lotto, scratch-offs), mobile sports betting, commercial casinos, tribal casinos, video lottery, horse racing, charitable activities (e.g., bingo, raffles).

Gambling Disorder (DSM-5-TR)⁴ is a persistent and recurring pattern of problematic gambling behavior leading to significant distress or impairment. At least 4 of 9 criteria must be met in a 12-month period for a diagnosis. Gambling disorder is diagnosed as mild (4-5 criteria met), moderate (6-7 criteria met), or severe (8-9 criteria met). 

Criteria include the following (in brief): 

• preoccupation with gambling
• need to gamble with increasing amounts of money to achieve desired excitement
• unsuccessful attempts to stop or control gambling
• restlessness or irritability when attempting to stop gambling
• gambling when feeling distressed
• chasing losses
• lying to conceal the extent of gambling involvement
• jeopardizing or losing important relationships, jobs, or educational/career opportunities
• relying on others to provide money to relieve desperate financial situations caused by gambling. 

Gambling Harms refers to negative consequences associated with gambling disorder.

At Risk for Gambling Disorder includes those who experience gambling harms such as financial problems and interpersonal difficulties. The Problem Gambling Severity Index is an instrument used to assess risk for gambling disorder.⁵  

NYS OASAS provides and oversees a continuum of services to reduce gambling harms that span prevention, treatment, harm reduction, and recovery. (Table 1)

OASAS operates a multi-lingual 24/7 confidential helpline which provides on-demand crisis support and referrals for those experiencing gambling harms and/or substance use harms. Calls are answered by bachelor’s- and master’s-level clinicians who have training in crisis response and who have extensive knowledge of gambling and substance use harms. Callers receive referrals as needed including to community-based supports as well as warm transfers to one of seven Problem Gambling Resource Centers throughout the state. Further, all callers have the option to talk to a peer with lived experience.   

In January 2022, mobile sports betting was implemented in NYS. Prior to 2022, the top reason for calls made by those experiencing gambling harms were harms related to casino-based gambling. Since 2022, the top reason has been online betting (e.g., mobile sports betting). (Figure 2)
 

NYS has a robust voluntary self-exclusion (VSE) program operated by the NYS Gaming Commission. Individuals can voluntarily choose to ban themselves from engaging in gambling at specific establishments or with mobile operators for time periods of 1-year, 3-years, or 5-years or lifetime. The VSE program includes the option of receiving a follow-up call from the helpline to receive further gambling services and/or treatment if needed.

From 2017-23, the annual volume of VSE applications ranged from 980 in 2017 to 1,646 in 2023, with peak application volume in 2023. VSE applications during this timeframe significantly increased. (Figure 3)

From 2017-23, the volume of VSE applications increased 68.0% from 2017 (n=980) to 2024 (n=1,646). Similar to the helpline annual call trends described above, the largest single year increase of 36.0% was from 2021 (n=957) to 2022 (n=1,333). (Figure 3)

Further, the annual volume of VSE applications for a 1-year ban significantly increased more than any other duration (3-year, 5-year and lifetime). This pattern could suggest an increase in those who may be newly experiencing gambling harms and/or who may be using VSE as a time-limited harm reduction strategy.

Of note, the VSE application processing was stopped then reduced during 2020 due to the COVID-19 pandemic, with processing fully reinstated by December 2020. Direct comparisons between 2020-21 were therefore excluded.

DATA ELEMENTS AND DEFINITIONS

Gambling disorder treatment data include unique individuals engaged in inpatient and outpatient treatment. Gambling disorder was identified by either identifying individuals through gambling disorder screening or by having had gambling disorder treatment goals in their treatment plan.

Unique individuals If individuals were receiving both inpatient and outpatient treatment in a single year, they were counted only once in analyses.

OASAS provides a continuum of care for those affected by gambling harms across the state.  All services are available to anyone affected by gambling harms, including individuals, family members, significant others and community members. Services are available regardless of ability to pay.

Psychosocial Interventions

Cognitive-behavioral therapy (CBT) is an effective evidence-based treatment that focuses on developing coping skills to manage high-risk situations that can lead to gambling harms. While CBT usually involves a therapist to guide treatment, self-directing formats such as CBT workbooks and online programs are also available.¹

Motivational interviewing, a brief counseling intervention that can enhance motivation to change, delivered alone or in combination with CBT, is also an effective treatment for gambling disorder.² Further, Gamblers Anonymous (GA) is modeled after 12-step programs such as Alcoholics Anonymous, but little is known about its effectiveness because the anonymous nature of this intervention limits research opportunities. Currently, there are no effective medications for the treatment of gambling disorder, despite numerous research trials.³  

FINANCIAL COUNSELING: GamFin is a new initiative which offers free online financial counseling to individuals and families in financial distress related to gambling. Counseling is aimed at relieving the pressure and stresses of financial harms due to gambling. All financial counselors have experience of gambling harms and are credentialed/certified in financial counseling.

Treatment Service Utilization

From 2020-23, the annual number of New Yorkers engaged in inpatient or outpatient treatment with gambling disorder ranged from 3,535 in 2020 to 5,173 in 2023. (Figure 4)

The annual number of New Yorkers engaged in inpatient or outpatient treatment with gambling disorder increased 46.3% from 2020 (n=3,535) to 2023 (n=5,173).

Similar to the helpline annual call trends described above, the largest single year increase of 22.4% was from 2021 (n=3,983) to 2022 (n=4,876). 
 

NYS OASAS uses service and treatment utilization data to inform resource allocation and expansion of services as part of our data-driven approach to meet the needs of New Yorkers experiencing gambling harm. Data demonstrate increases in the number of New Yorkers engaging in the following services and treatment: the helpline, the VSE program, and treatment. Service and treatment utilization in NYS for gambling harms, including gambling disorder, has increased since at least 2020. The largest single year increases for all presented service and treatment utilization data were observed between 2021-22, following the implementation of legalized mobile sports betting in January 2022. As of 2022, mobile sports betting surpassed casino gambling as the primary reason for gambling-related helpline calls made by New Yorkers

Please see Addiction Data Bulletin No. 2025-05 The Gambling Risk Environment and Public Perceptions of Gambling Harms in New York State.

Suggested Citation

Rebecca Cooper, Grace Hennessy, Shawna Black, Tracy Stickle, Jennifer Farrell, Sean Locke, Shuo Chen, Nina Gargon, Andrew Heck, Chinazo O Cunningham, Ashly E Jordan. Gambling Harms and Gambling Disorder Healthcare and Service Utilization in New York State. Addiction Data Bulletin (No. 2025-06). Apr 2025. 

References

1. Potenza MN, Balodis IM, Derevensky J, et al. Gambling disorder. Nature Reviews Disease Primers. 2019/07/25 2019;5(1):51. doi:10.1038/s41572-019-0099-7
2. Cowlishaw S, Merkouris S, Dowling N, Anderson C, Jackson A, Thomas S. Psychological therapies for pathological and problem gambling. The Cochrane database of systematic reviews. Nov 14 2012;11:Cd008937. doi:10.1002/14651858.CD008937.
3. Mestre-Bach G, Potenza MN. Pharmacological management of gambling disorder: an update of the literature. Expert Rev Neurother. Apr 2024;24(4):391-407. doi:10.1080/14737175.2024.2316833
4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. American Psychiatric Association; 2013.
5. Ferris JA, Wynne HJ. The Canadian Problem Gambling Index. Canadian Centre on Substance Abuse; 2001.