By Igor Studenkov
The number of people grappling with gambling addiction is rising. While more traditional gambling options such as the State lottery still dominate, problem gamblers are far more likely to take part in newer forms of gambling such as online betting.
These facts form the major takeaway from the 2021 Statewide Assessment of Gambling and Problem Gambling in Illinois report, which the Illinois Department of Human Services (IDHS), Division of Substance Use Prevention and Recovery, commissioned and released in 2022. Experts on problem gambling told Gazette Chicago, however, that correlation revealed by the study does not necessarily imply causation. Many agencies have worked to raise awareness about problem gambling; the study’s numbers account only for people who sought treatment, which simply could mean awareness campaigns brought more people to treatment centers.

A strong correlation exists between problem gambling and substance abuse, the report shows.
The study comes as Illinois residents have more gambling options than ever. In June 2019, the Illinois General Assembly legalized sports betting; authorized up to six new casinos, including one in Chicago; allowed casino-like gaming at horse racetracks; and allowed gambling video game terminals in restaurants, taverns, fraternal organizations, and truck stops outside Chicago. According to the IDHS study, these actions resulted in the State’s current ten casinos and more than 36,000 video gaming terminals, with further expansion planned.
Sportsbook operations are coming to the United Center, home of the Chicago Bulls and Chicago Blackhawks; Wrigley Field, home of the Chicago Cubs; and Guaranteed Rate Field, home of the Chicago White Sox. Legislation passed by the State in 2019 and the Chicago City Council in 2021 allows them.
IDHS already operated a gambling addiction help line, and this fiscal year saw the State give the department $10 million to invest in addiction awareness and treatment. The Chicago Department of Public Health (CDPH) has been working with IDHS and intends to monitor adverse health effects of gambling, as officials expect Chicago’s casino to open its temporary location in spring 2023.
Shane Cook directs the gambling disorder program at Gateway Foundation, an addiction treatment provider with facilities locally at 55 E. Jackson Blvd. and 3828 W. Taylor St. Cook said spending significant time gambling does not necessarily mean addiction.
“The vast majority of people can enjoy gambling as a recreational activity, as entertainment,” Cook said. “Perhaps they set the budget and just consider it as form of entertainment.”
Struggle to set limits
It becomes an addiction when people struggle to set limits, however.
“They become restless, they become irritable when they try to cut down on gambling,” Cook said. “They may be asking people for money to deal with financial problems” stemming from gambling, “and they may be hiding and lying about their gambling. It’s when you get to the point where you find it difficult to walk way, there might be an issue at hand and it’s time to speak to somebody, a professional counselor and any number of hotlines.”
The Statewide Assessment of Gambling and Problem Gambling in Illinois represents IDHS’s first attempt to get a statewide perspective on this issue. The study’s executive summary cautioned IDHS conducted the study from 2020 to 2021, during the COVID-19 pandemic, “a unique and ever-changing time period in which to conduct a statewide assessment,” according to the study.
The study found “41.9% of adult Illinoisans reported participating in any form of gambling in the past month, 68.4% had gambled in the past year, and 90.3% had gambled ever in their life.” Lottery accounted for 54.2% of gambling in the past year, followed by betting with friends (33%) and organized betting on sports or fights (15.3%). The number of people using video gaming terminals nearly quadrupled between 2013 and 2020, going from 7,920 to 36,145 and accounting for 14% of all gambling. Online gambling accounted for 12.9% of all gambling.

Gambling remains prevalent in Illinois, according to the report.
The study also found 3.8% of Illinois adults, approximately 383,000 people, have a gambling problem. Another 7.7%, or 761,000 people, are at risk for developing one. It also noted the types of gambling reported by those looking for help skewed to specific forms of gambling, in percentages greatly exceeding participation by those in the general population: 72.3% of gambling addicts reported gambling online, 71.4% reported betting at racetracks, and 69.9% reported playing the lottery.
Gambling and substance abuse
The study also showed gamblers who struggled with addiction were more likely to drink alcohol and/or use cannabis than gamblers in general.
For example, 70.4% of people struggling with problem gambling “had ever used alcohol while gambling, compared to only 48.1% of frequent recreational gamblers,” the study indicated. “44.5% had ever used marijuana while gambling, compared to only 10.4% of frequent recreational gamblers. Over 30% had ever used illicit drugs or prescription drugs not as prescribed while gambling, compared to less than 3% of frequent recreational gamblers.”
Cook said the spread of video gaming terminals and online betting made gambling more easily accessible. Online betting in particular offers an activity one can do any time using a phone, he said.
Cook cautioned against assuming higher rates of addiction stem from gambling’s greater availability. He believes much of the rise comes from increased awareness that gambling addiction even exists as well as the treatment available. Without such awareness, gamblers and their loved ones may not realize the gambler’s behavior might be a problem.
“I’m not sure that you can tie that back to availability, because gambling has [already] been ubiquitous—the lottery, bingo, the side door betting around sports that’s been happening for years,” he said.
Treating gambling addiction involves cognitive behavioral therapy, antidepressants, and anti-narcotic medication. Several nonprofits, including Gateway, also offer support groups.
Cook said gambling’s greater accessibility makes outreach more important than ever. On April 19, 2022, the Illinois General Assembly passed House Bill 4700, which requires IDHS to “promote public awareness” of “the impact of gambling disorders on individuals, families, and communities and the stigma that surrounds gambling disorder” and use treatment to help people struggling with gambling addiction. It also requires every casino, betting website and app, and other gambling license holders to post statements detailing available addiction treatment resources. The law took effect July 1.
Under the bill, IDHS issues grants to organizations such as Gateway to provide treatment and provide outreach.
Cook said gauging the bill’s impact will take some time, but he sees plenty of potential.
“I expect that they will grow and improve over time and get more granular in terms of being able to pinpoint specific communities and offer services,” he said.

Are you really winning?
IDHS recently launched the “Are You Really Winning?” gambling addiction awareness campaign. The campaign website (areyoureallywinning.com) includes information about the signs Cook mentioned, testimonies of people struggling with addiction, and information on how to reach the help lines via phone, text, and online chat. The department also set up a help hotline at 1-800-GAMBLER. Cook said this effort provides another piece of the puzzle to help get the word out.
Gazette Chicago contacted CDPH regarding local municipal responses to address gambling addiction. Besides working with IDHS on gambling addiction awareness and running its existing network of addiction service providers, “CDPH anticipates adding gaming/gambling addiction to the list of conditions that it monitors through its Healthy Chicago survey in 2023,” the agency stated. “CDPH will utilize this survey data to monitor the prevalence of gaming/gambling addiction among Chicago residents and to inform evidence-based strategies to address these conditions.”
There has been no slowdown in gambling so far this year. The American Gaming Association estimated that a record 50.4 million Americans wagered $16 billion on the 2023 Super Bowl.
IDHS Secretary Grace B. Hou stressed the need for her department’s report.
“It is so important that we have data on the patters and depth of gambling across the State,” she said. “I hope this report will be used to advance and expand effective treatment and recovery options for people experiencing problem gambling disorder throughout Illinois. For those who do struggle with gambling disorder, they seldom seek help and often hide their behavior from family members.”
“We hope that the findings of this assessment will provide much needed information for people working on prevention and treatment of problem gabling in Illinois, which will help them make data-informed decisions on how best to assist individuals on their road to recovery,” said Hannah Carliner, lead author of the study.
For the Chicago Department of Public Health, log on to www.chicago.gov/city/en/depts/cdph.html. For Gateway Foundation, log on to www.gatewayfoundation.org/ or call (844) 492-0887. .For IDHS, log on to www.dhs.state.il.us/page.aspx or call 1 (800) 843-6145; the gambling report can be found at https://e.helplineil.org/areyoureallywinning/statewide-gambling-assessment/. For help, call 1 (800) GAMBLER or text GAMB to 833234.