Sports Betting: Risks & Ripple Effects Teach-Out

Bringing clinical and research perspectives together, Chris Frank and Erin Bonar explain how online sports betting can affect young adults’ mental health and the people around them.

Takeaways: Technology and the 4 Cs

We have prepared a list of key points from the Technology and the 4 Cs of Addiction interview for your reference:

1. Emerging adults face elevated risk due to development, access, and design. Young adults are in a developmental stage marked by ongoing brain maturation related to impulse control and risk evaluation. When combined with 24/7 access to private, mobile betting platforms, this creates a uniquely high-risk environment where harmful patterns can develop quickly and remain hidden.

2. Online sports betting products are intentionally engineered to reinforce repeated use. Betting platforms are designed using psychological principles common to addictive technologies, including intermittent rewards, in-play betting, bonuses, and rapid feedback. These features encourage frequent engagement and can pull users away from enjoying sports toward compulsive monitoring of bets.

3. Certain populations face disproportionate addiction risk. Research shows that people who engage in sports betting have roughly double the risk of gambling addiction compared to those who participate in other forms of gambling. Contributing risk factors include being male, being younger, peer normalization of betting, substance use, and overconfidence in one’s sports knowledge.

4. Gambling-related harms are often underdetected, extensive, and undertreated. Gambling disorder mirrors other addictions and can be recognized through the “4 Cs”: cravings, loss of control, compulsive behavior, and negative consequences. Harms often emerge through anxiety, depression, academic or financial strain, and relationship conflict. The impact extends beyond the individual, affecting an estimated 6–9 other people, including family members and, in sports settings, athletes and officials who may face harassment. Problem gambling and gambling disorder are treatable, recovery is possible, and seeking help is not a personal failure.

5. Prevention, technology, and treatment must work together. A public health approach emphasizes early education, screening, and environmental protections rather than waiting for crisis-level harm. Technology has amplified risk, but it could also support solutions through guardrails, warnings, and responsible design. Currently, these solutions are largely self-governed by sportsbooks, with little regulation or requirements for transparency and collaboration.

Reflection Questions

In your daily life, you may have one or more than one of the following roles. Think about the questions that we have posed here. How can you use the Technology and the 4 Cs of Addiction interview to respond to these questions?

• Public health professionals:
  • What public health frameworks could be applied to create harm-prevention programs specifically designed for emerging adults ages 18–24?
• Young adult casual bettors:
  • How might your current life stage, stress levels, or coping habits influence the way you engage with sports betting or other risky behaviors?
  • Thinking about the “4 Cs,” have you noticed any of these patterns in yourself or friends who bet regularly?
  • How might the aggressive marketing and sign-up bonuses described in this interview be influencing your friends’ betting behaviors?
• High school or college athletics professional:
  • How well do your current programs, policies, or screening practices address gambling risk alongside mental health and substance use?
  • How can you use the information about harm to student-athletes to develop conversations or policies that protect your students from gambling-related harassment?
• Parent or guardian:
  • What changes in behavior, mood, or finances would prompt you to start a conversation about gambling or online betting with someone you care about?
  • What specific behaviors or changes might signal that a young person’s casual sports betting has shifted into something more concerning?

Additional Resources

1. The Paradox of Pleasure, featuring Dr. Anna Lembke.
2. Dopamine Nation: Finding Balance in the Age of Indulgence, by Anna Lembke (2021).
3. Comprehensive Review of Sports Wagering and Gambling Addiction