Epic Research Uncovers Sharp Rise in Gambling Disorder Diagnoses After Sports Betting Legalization

Researchers at Epic Research examined nearly 200 million patient records and documented a 61 percent increase in the quarterly rate of diagnosed gambling disorder in states that legalized sports betting, while rates in states where such betting stayed illegal showed a slight decline over the same period. The analysis tracked diagnoses from the first quarter of 2018 through the first quarter of 2026 and revealed that the rate climbed from 3.0 per 100,000 patients to 4.8 per 100,000 patients during those eight years.

Study Scope and Data Collection

The Epic Research team pulled data from a massive electronic health record database that covers patients across multiple states and insurance types, which allowed observers to compare trends before and after legalization occurred in various jurisdictions. Because the dataset spans nearly 200 million records, analysts could isolate the impact of state-level policy changes without relying on smaller survey samples that often miss rare diagnoses. Figures reveal the quarterly diagnosis rate rose steadily in states that permitted sports betting, whereas states that maintained prohibitions recorded a modest drop in the same metric.

Legalization timelines varied by state, yet the pattern held across the board once sports betting became available through retail and mobile platforms. The study period captured the wave of expansions that followed the 2018 Supreme Court decision striking down the federal ban on sports betting, and it extended into early 2026 when most active markets had been operating for several years.

Demographic Patterns in the Data

Young adults between the ages of 18 and 29 experienced the largest increases, followed closely by men across all adult age groups. The data indicates that diagnosis rates among this younger cohort grew faster than those recorded for older adults, while male patients accounted for a disproportionate share of the overall rise. Researchers noted that female patients also showed elevated rates in legalized states, although the absolute numbers remained lower than those observed among men.

These demographic shifts appeared consistently across multiple states that introduced sports betting at different times, which suggests the pattern is tied more to policy changes than to regional cultural factors alone. Observers note that the concentration among younger adults aligns with the heavy marketing of mobile betting apps that target smartphone users in this age bracket.

Comparison Between Legal and Illegal States

In states where sports betting remained illegal, the quarterly diagnosis rate declined slightly over the eight-year window. That contrast stands out because the same national database captured both sets of jurisdictions, which reduces the chance that broader societal changes drove the divergence. The report highlights that the difference emerged after legalization took effect in the comparison group and persisted through the first quarter of 2026.

States without legal sports betting still recorded some diagnoses, yet the downward trend there differed markedly from the upward trajectory seen elsewhere. Analysts pointed out that the absence of regulated markets did not eliminate gambling disorder but coincided with stable or falling identification rates in clinical settings.

Timing and Policy Context Through Mid-2026

By July 2026 many states had operated legal sports betting markets for three to seven years, giving researchers enough post-legalization data to detect sustained changes rather than short-term spikes. The study captured the cumulative effect across multiple legislative cycles and regulatory adjustments that occurred between 2018 and the middle of 2026. Because the analysis stopped at the end of the first quarter, any further developments in the second quarter of 2026 fell outside its scope.

Policy variations such as age restrictions, advertising rules, and responsible gambling requirements differed among states, yet the overall increase in diagnoses appeared regardless of those specific measures. The uniformity of the rise across diverse regulatory environments points to the availability of sports betting itself as the common factor tracked in the records.

Clinical Identification and Record Keeping

Diagnoses in the dataset came from ICD codes entered by physicians and mental health providers during routine care, which means the numbers reflect cases that reached clinical attention rather than all instances of problematic gambling behavior. The study therefore measures changes in diagnosed disorder rather than changes in underlying prevalence that might go undetected. Still, the sharp divergence between legalized and non-legalized states suggests that increased access corresponded with more individuals seeking or receiving formal diagnoses.

Electronic health records allowed Epic Research to follow the same patient population over time and to control for changes in screening practices that might otherwise inflate numbers. The large sample size also helped smooth out random variation that can affect smaller studies.

Conclusion

The Epic Research analysis provides one of the largest-scale examinations to date of how state sports betting legalization correlates with clinical records of gambling disorder. Data collected through the first quarter of 2026 shows a 61 percent rise in diagnosis rates in states that legalized betting, with the steepest increases concentrated among young adults and men, while rates edged downward in states that kept sports betting illegal. The findings rest on nearly 200 million patient records and offer a clear before-and-after comparison tied directly to policy changes that unfolded between 2018 and early 2026. The full report supplies additional breakdowns by state and by quarter for those seeking more granular figures.