Study Links Legal Sports Betting To More Anti-Anxiety Drug Use
A Johns Hopkins study links state-sanctioned sports betting to higher population-level risks of depression and anxiety, as well as medication use for those conditions.
Legalization was associated with higher probabilities of an outpatient depression diagnosis: 6.7% for men and 5.5% for women, relative to the study’s sample averages. The probabilities of using antidepressant medications were also higher, at 5.4% for men and 5% for women.
The findings were similar for anxiety, with 7.2% and 6.5% increases in the probability of an anxiety disorder outpatient diagnosis, and 5% and 5.2% increases in the probability of using anti-anxiety drugs, for men and women, respectively.
The study comes from researchers at the Johns Hopkins Bloomberg School of Public Health.
Benjamin Westermeyer, Matthew Eisenberg, and Mark Meiselbach co-authored the paper, published online Oct. 14 in JAMA Psychiatry.
Methodology
The researchers used a large national dataset of employer-sponsored health insurance claims from January 2016 to December 2023. Many states began legalizing sports betting in 2018.
They compared insurance claims of individuals in the 22 states that legalized online sports betting between 2018 and 2022 and those in 13 “control” states that had not legalized online sports betting by the end of 2023.
The researchers excluded states that legalized online sports betting in 2023 or before 2018.
The study found that, after legalizing online sports betting, states saw significant increases in filled prescriptions for antidepressants and anti-anxiety medications, as well as outpatient diagnoses of depression and anxiety.
What They’re Saying
“Overall, these findings support the concern that there are broad mental health effects of online gambling legalization, though those who are experiencing those effects, and their clinicians, don’t necessarily attribute it to gambling,” Westermeyer said in a statement.
The authors note that the study does not fully capture legalization’s devastating mental health impact.
The study was limited to people with employer-sponsored health insurance and does not measure the effects of legalization on other groups.
The researchers also could not link individual sports betting to changes in healthcare use.
Zooming Out
The study didn’t include the impact of so-called prediction markets, which have grown rapidly since early 2025. Those platforms claim federal regulation to offer sports betting nearly nationwide.
State-legalized sports betting has also been linked to increases in household food insecurity, intimate partner violence, binge drinking, debt-related delinquency, among other harms.
Americans are losing faith in states’ ability to regulate these platforms, as adults oppose legalization (47%) more than they support it (31%), according to a recent Overton Insights survey. Support for prediction markets is even lower. A Reuters/Ipsos poll showed just 29% of American adults support sports betting via prediction markets.
Former U.S. Surgeon General Jerome Adams described legal sports betting as the “new opioid crisis.” Americans lost more than $16 billion on state-sanctioned sports betting platforms in 2025, a figure that represents just a portion of Americans’ total sports betting losses.
Some advocacy groups have asked the U.S. Supreme Court to reverse its ruling that allowed for state-sponsored sports betting. Meanwhile, others prefer regulation through the SAFE Bet Act.
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