Thread

ER visits for gambling disorders doubled after expanded online gambling market

164 points · 157 comments · geox

whatever1 · 1789584798 · focus · HN ↗
All gambling should be state owned. It is a strict societal loss anyway, we can at least soften the overall blow.
Losses can be redistributed and cover for the externalities of gambling. And we will be able to control the knob on how addictive we make them.
For profit companies have the target to maximize their profit, so of course they will ramp up any method that can bring in more revenue.
1. pstuart · 1789585485 · focus · HN ↗
  Pretty much agree. But even then, the state should not be incentivizing its use (looking you, CA lottery and friends).
  Gambling is a drug, and should be recognized as such.
  1. ffsm8 · 1789587463 · focus · HN ↗
    Adrenaline is the drug, ain't it ... And gambling is just one way to leverage it.
    However once you realize that gambling is not the drug, and merely something that triggers your body to create a rush... Then can you really call it a drug? At least any more then any other of those activities?
    Eg Skydiving and basically any other extreme sports.
    And once you're there, you should really realize that it's not worth the sacrifice.
    This is a societal issue and should not be addressed with legislation.
    The only thing that can be safely regulated are things like disallowing marketing.
    nrb · 1789588583 · focus · HN ↗
    Dopamine, and many drugs trigger it in the same way as gambling.
    toomuchtodo · 1789588952 · focus · HN ↗
    We should try GLP-1s. It patches the brain's reward center.
    GLP-1 drugs may fight addiction across every major substance - <a href="https://news.ycombinator.com/item?id=47280797">https://news.ycombinator.com/item?id=47280797 - March 2026
    GLP-1 medications get at the heart of addiction: study - <a href="https://medicine.washu.edu/news/glp-1-medications-get-at-the-heart-of-addiction-study/" rel="nofollow">https://medicine.washu.edu/news/glp-1-medications-get-at-the... - March 4th, 2026
    <a href="https://news.ycombinator.com/item?id=45907422">https://news.ycombinator.com/item?id=45907422 (citations)
    There is a fentanyl vaccine approaching human trials, but I don't believe its mechanism works close enough to the reward center. Maybe gene therapy is a long term fix as it relates to the reward center dysfunction, to be determined.
    HN Search: fentanyl vaccine - <a href="https://hn.algolia.com/?dateRange=all&page=0&prefix=true&query=fentanyl%20vaccine&sort=byDate&type=story" rel="nofollow">https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...
    Resetting the Brain’s Reward Pathway: Gene Therapy’s Breakthrough in Alcohol Addiction - <a href="https://scitechdaily.com/resetting-the-brains-reward-pathway-gene-therapys-breakthrough-in-alcohol-addiction/" rel="nofollow">https://scitechdaily.com/resetting-the-brains-reward-pathway... - August 20th, 2023
    mrguyorama · 1789591953 · focus · HN ↗
    I have recently found the following article interesting:
    <a href="https://en.wikipedia.org/wiki/FOSB" rel="nofollow">https://en.wikipedia.org/wiki/FOSB
    Specifically the part where a variant of this protein seems directly implicated in the specific self upregulation that leads to changes in the brains reward pathways that seem to directly cause the sort of "Drug seeking" and other addiction seeking behaviors that are so harmful in addiction.
    I especially love the part where we tried inhibiting this protein expression with simple chemicals administered orally in rats and it significantly improved their addictions, and we did that in 2015, and we have not touched it since
    Gosh, wouldn't it just be the best if we had spent $4 trillion on bioscience instead of GPUs? I feel like we understand circuits pretty well by comparison.
    mitxela · 1789603923 · focus · HN ↗
    That's crazy that the whole reward system might just come down to one protein and how long you crave another reward is literally just the time until that protein decays.
    [deleted] · 1789589168 · focus · HN ↗
    [deleted]
    elil17 · 1789590298 · focus · HN ↗
    Why wouldn't it be addressed with legislation? What is legislation for if not to solve societal issues?
    Also, gambling is empirically much more addictive and leads to worse outcomes than extreme sports - hence why many feel it needs to be limited.
    cortesoft · 1789591094 · focus · HN ↗
    How do we determine at what point something is “too addictive” to be allowed?
    There are many people who can gamble responsibly and enjoy it. I love playing poker, and play in a tournament every few years. Lots of people are compulsive gamblers, though, and lose it all.
    Do I have to give up my hobby because some people can’t handle it?
    What about drinking? I enjoy a happy hour once a month or so, and have a couple of drinks when I do. Others drink 10+ drinks a month. Do we ban it because of the people who can’t stop? (We know how well that works)
    I am not saying we do nothing, but I don’t think it is as easy as “just pass legislation”
    fragmede · 1789591608 · focus · HN ↗
    We know how full 100% alcohol prohibition in 1920's worked in the USA, but what's missing is that it doesn't have to be a full 100% for it to benefit society. Laws restricting sales, like no selling alcohol past a certain hour, or on Sundays, still exist on the books in many places, and while I can't speak to how well they actually work, given that we'd just stock up on Saturdays anyway, there's also no Al Capone levels of violence in places with those restrictions. So let's not say "we know how that goes" hinting at 1920's prohibition, which was over a century ago now, and just leave it at that.
    For a counter example, I like driving fast. Really fast. Should I be banned from doing that because other people can't handle that responsibly? Society has looked at that and decided that, yes, no one should be allowed to do that on public streets. So I keep that behavior to the race track and sign an extra liability waiver in order to do so.
    Why should gambling or alcohol be treated different from that?
    tonyarkles · 1789592667 · focus · HN ↗
    > Society has looked at that and decided that, yes, no one should be allowed to do that on public streets. So I keep that behavior to the race track and sign an extra liability waiver in order to do so.
    So can I still drink and gamble in private if I sign a waiver?
    pstuart · 1789594245 · focus · HN ↗
    Sorry, but alcohol prohibition did not work and was instrumental in fueling the rise of organized crime (does that ring any bells?).
    I happen to believe the War on Drugs (prohibition v2) is an even bigger mistake than the first one, which also ignores why it came to be: v1 prohibition enforcers needed something to do and there was a growing problems with an "uppity" segment of society that needed to be put in its place. The history of it is horrifying; and the current implementation of it is horrifying as well.
    So legalize it all. Regulate the advertisement/promotion/access/purity, etc. It's going to happen one way or another and pushing it into the shadows only makes it worse.
    So let the gambling happen but keep it on a short leash.
    triceratops · 1789598354 · focus · HN ↗
    > Sorry, but alcohol prohibition did not work
    That's what GP said too, albeit poorly.
    ikr678 · 1789622714 · focus · HN ↗
    What would a gambling liability waiver cover? Your losses/damages are not in a confined circuit or ringfenced from your general finances. Are you just agreeing not to sue if you lose your house/wife/job?
    elil17 · 1789713768 · focus · HN ↗
    If all you're saying is that it needs the right legislation/thoughtful legislation and not just a blanket ban, then I guess I agree. The base of this thread was someone saying that all gambling should be state owned, which seems like a reasonable thing to me.
    thenayr · 1789590395 · focus · HN ↗
    [dead]
    pstuart · 1789593963 · focus · HN ↗
    I was playing fast and loose with the word, but you know what I meant.
    I'm all for individuals to choose their own paths and mistakes and don't want a true nanny state, so I'd be ok with banning advertising of those services, as well as independent audits to ensure that they are not letting minors in.
    bothers · 1789601321 · focus · HN ↗
    [dead]
  2. mitxela · 1789603512 · focus · HN ↗
    Social media is also a drug. So is television.
    cindyllm · 1789614001 · focus · HN ↗
    [dead]
2. pfisch · 1789587508 · focus · HN ↗
  It should either be illegal or not. This idea that the state has a monopoly on getting money from doing a thing that you are saying is bad doesn't make sense.
  If it is bad and yet the government is allowed to use it to make money then is the government evil? Why does the government get to do it if we can't? It just makes the whole thing seem ridiculous and makes underground betting seem like I guess it isn't really that bad since the government is allowed to do it. The operators are just people fighting for their freedom to operate the same business the government operates.
  1. Zigurd · 1789587943 · focus · HN ↗
    Harm reduction. In the US, state lotteries have reduced illegal gambling. Illegal gambling would increase under a total ban.
    Some markets fail. If the government can step in and provide a service that doesn't end in a failed market, that's not an imposition on anyone's freedom.
  2. chunky1994 · 1789588181 · focus · HN ↗
    Because any addictive thing is on a spectrum and you don't want the people with incentives to go all the way up the spectrum to be the operator of the harmful thing, a là the dose makes the poison. (See alcohol, cigarettes, any class of drugs etc.)
    Some things are just wholly harmful where no small amount provides any benefits, some are harmful in large doses, but not so harmful in small doses that they cannot provide other uses.
    Governments (ideally) don't exist to maximize profit so they are (generally) not incentivized to increase the addictions of their populace.
    fragmede · 1789588419 · focus · HN ↗
    Which is to say, total prohibition doesn't work, so they need to provide a some release, just not a total free for all.
  3. CDRdude · 1789588327 · focus · HN ↗
    It reminds me of state-run liquor stores in some US states.
  4. NikolaNovak · 1789588439 · focus · HN ↗
    I think of it is the level of regulation I'd require / desire in an endeavour.
    On one side there's things with very little regulation required, private companies go crazy (and they will!:).
    On the other hand, there's things I want high regulation on - use of violence (army / pokice / security), medicine, key infra utilities, alcohol/drugs/gambling, etc.
    We can discuss whether we agree those things need regulation, and if so, what form that regulation takes.
    (To me, some things I want so highly regulated there's no benefit in private ownership, just risk of runaway loop exploitation)
  5. well_ackshually · 1789588504 · focus · HN ↗
    Some things are better left in control of the government _because_ they are dangerous. You either:
    * Outlaw gambling, and gamblers will just go towards shadier options, putting their own lives in even more risk.
    * Allow private operators whose goal is to extract as much money from possible from gamblers as possible and ensure that you will inevitably have people abusing the system up to the limits to which it can go and testing out if they can go further, over and over again
    * Government ran gambling organisations that can ensure they also offer proper systems to wean yourself off, offer healthcare, and make use of the money "made" from operating it to improve your health care systems.
    Only one of those options is sensible.
    >The operators are just people fighting for their freedom to operate the same business the government operates.
    HAHAHAHAHA. No. Absolutely not. Some people are truly as caricatural as movies and books make them appear, and casino owners truly live up to it. I worked for them, for "betting rooms", anything you want: they are thieves, mafias, manipulators and bring nothing but misery on the world. They're not "fighting for their freedom", they have found a legal way to abuse human misery and addictions.
    SoftTalker · 1789591409 · focus · HN ↗
    > Government ran gambling organisations that can ensure they also offer proper systems to wean yourself off, offer healthcare, and make use of the money "made" from operating it to improve your health care systems.
    Please list any state lotteries that offer any of these things. All I've seen is an 800 number to call, listed in the fine print at the bottom of the advertising. And they advertise everywhere, and though many were established with promises to "fund education" or something that sounds noble, money is fungible so it just gets sloshed around in the state budgets.
    well_ackshually · 1789592296 · focus · HN ↗
    "My country that is hostile to public healthcare doesn't offer public healthcare" no shit sherlock, the US's healthcare system is a shitshow. Look at anywhere in Europe where those lotteries are publicly ran. The entire post is about changing the law, that doesn't include closing your eyes on how it's currently shit.
  6. [deleted] · 1789589058 · focus · HN ↗
    [deleted]
  7. bliteben · 1789589285 · focus · HN ↗
    >It should either be illegal or not. This idea that the state has a monopoly on getting money from doing a thing that you are saying is bad doesn't make sense.
    So no nation in history should have been allowed to have a military to defend its loot or to acquire more loot.
    Dracophoenix · 1789668642 · focus · HN ↗
    Or conversely, individuals should possess the right to form a militia or employ a private force to defend oneself and one's property from the encroachment of the state and other trespassers. They should be able to exercise this right for so long as each nation retains its respective armed forces.
  8. cogman10 · 1789591689 · focus · HN ↗
    > This idea that the state has a monopoly on getting money from doing a thing that you are saying is bad doesn't make sense.
    It makes a lot of sense. Here in Idaho, hard alcohol can only be sold in state run liquor stores. The stores aren't advertised and the staff is all well trained. People that want booze can still get it, but at the same time it's not being ran like a business (It still turns a profit). That is to say, there's no advertising or marketing for it.
    > If it is bad and yet the government is allowed to use it to make money then is the government evil?
    People are going to gamble if they want to. Making it illegal just pushes them to underground gambling. Making it state ran allows the state to better control the gambling, including doing things like having the ability to provide recovery options and interventions.
    > Why does the government get to do it if we can't?
    The government isn't motivated by (just) money. They don't have to advertise for gambling and they don't have shareholders to make happy. They could even operate the gambling at a loss if they wanted to.
    > It just makes the whole thing seem ridiculous and makes underground betting seem like I guess it isn't really that bad since the government is allowed to do it.
    Completely the opposite. The government doing it happens to stop underground gambling from happening. You can sue the government and expect them to treat you fairly. Underground gambling, on the other hand, has no reason or motivation to treat it's participants fairly.
3. micromacrofoot · 1789590212 · focus · HN ↗
  State owned, no advertising, and your last year's tax return to prove income.
  As they are now, even state level gambling is used as a tax on the poor, because they're the people desperate enough to do it.
4. [deleted] · 1789590293 · focus · HN ↗
  [deleted]
5. ramesh31 · 1789590803 · focus · HN ↗
  An advertising ban would solve 80% of the problem. This stuff has always been around for those who want it, and (arguably) in a free society should be. But shoving it down people's throats in every channel imaginable has to end.
  1. cm2012 · 1789591240 · focus · HN ↗
    As a professional advertiser: yes. Gambling ads should be illegal. Big issue is supreme court said states cant ban gambling ads due to first amendment.
    tayo42 · 1789592616 · focus · HN ↗
    Cigarette ads have a ton of restrictions despite that first amendment existing
    cm2012 · 1789598698 · focus · HN ↗
    Funnily enough cigarette ads were banned in 1970 before the Supreme Court regime that says you can't ban ads for a given legal product. If someone were to take the case to the Supreme Court, they could probably get cigarette ads un-banned.
    queenkjuul · 1789615002 · focus · HN ↗
    With a sufficient endowment to the Trump family, one can get anything they want from this supreme court
    mitxela · 1789603484 · focus · HN ↗
    Certain porn is illegal despite the first amendment existing - the court merely invented a "nuh uh" exception, called "obscenity".
    cm2012 · 1789603774 · focus · HN ↗
    Current precedent is that states can ban almost anything they want, but if something is legal, you cant ban ads for it.
    beAbU · 1789620647 · focus · HN ↗
    Is it legal to advertise cigarettes in the US?
    mitxela · 1789624754 · focus · HN ↗
    Point is the supreme court can just "nuh uh" anything they want to
  2. paconbork · 1789592110 · focus · HN ↗
    It's still shocking to me that there are so many California Lottery advertisements (I'm sure other states have these too). They're spending taxpayer money to make poor people poorer...
    bguebert · 1789745290 · focus · HN ↗
    Illinois has a bunch of these too. They would always sell expanding what gambling is allowed by saying that the proceeds were going to go to pay for public schools, but its hard to say if that is true or not. Even if the gambling money goes to schools seems like it just frees up other tax money for whatever else. Now here its like a town of 4000 will have over a dozen places offering electronic slot machines. It's like every gas station and bar has them now. And then you can also have stuff like draft kings and fan duel on your phone. It seems like it would be inescapable once you fell into the habit of gambling.
  3. nozzlegear · 1789612842 · focus · HN ↗
    Watching some new shows on Amazon this past month, Kevin Hart can fuck right off with those draft kings commercials. I swear there are at least 10 gambling ads per 1 hour show. It's disgusting.
6. [deleted] · 1789592073 · focus · HN ↗
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