A study from the Johns Hopkins Bloomberg School of Public Health indicates that U.S. states that legalized online sports betting experienced rises in the use of medications for depression and anxiety, as well as an increase in outpatient diagnoses for these conditions. The researchers analyzed a large dataset of employer-sponsored health insurance claims from January 2016 to December 2023, focusing on the years after the legalization of online sports betting in many states.
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The study compared insurance claims from 22 states that legalized online sports betting between 2018 and 2022 with data from 13 control states that had not legalized it by the end of 2023. States that had legalized online sports betting prior to 2018 were also excluded from the study. Findings revealed significant increases in filled prescriptions for antidepressants and anti-anxiety medications in states post-legalization. Outpatient diagnoses for depression and anxiety also rose.
Mark Meiselbach, PhD, a senior author of the study, emphasized the importance of these results for psychiatrists, primary care doctors, and online sports bettors, noting the potential harms beyond financial risks associated with online betting. The first author, Ben Westermeyer, a PhD candidate in Meiselbach's research group, contributed to highlighting these serious implications.
Since the 2018 U.S. Supreme Court ruling, online sports betting has become legal in most states, primarily through popular apps like DraftKings and FanDuel, with millions of Americans now participating. Researchers have increasingly framed gambling as a public health concern due to its association with mental health issues, including anxiety, depression, and substance use disorders.
The analysis demonstrated that legalization correlated with a 6.73% increase in outpatient diagnoses of depression for men and a 5.47% increase for women. Additionally, it found a 5.44% rise in antidepressant use among men and a 5.00% increase among women. Similar increases were noted for anxiety disorders, with probabilities rising by 7.20% for men and 6.50% for women, along with a 4.99% and 5.17% increase in anti-anxiety medication use respectively.
However, the researchers did not find significant increases in substance use disorder diagnoses or medication use related to the legalization of online sports betting. They also observed no rise in emergency department or inpatient visits for depression or anxiety diagnoses.
Westermeyer stated that these findings reflect broad mental health effects from online gambling legalization, although individuals experiencing these effects and their clinicians may not directly associate them with gambling. The study, while substantial, is limited to individuals with employer-sponsored health insurance and does not account for other groups. Future research aims to gather more targeted data linking sports betting directly to mental health outcomes. The study was co-authored by Benjamin Westermeyer, Matthew Eisenberg, and Mark Meiselbach.