By Lydia Homovich
The $210 Million Question
June 25, 2025: Three years after Russia invaded Ukraine, President Volodymyr Zelensky attended the NATO Hague summit. For foreign policy and military analysts, top-of-mind questions included whether the United States would continue its support of Ukraine’s defense, what arms it would supply, and how its leaders would navigate hopes of reforming the alliance. For a certain subset of the internet, however, a more pressing question was top of mind: “Will Zelensky wear a suit before July?”
On the line was not foreign policy, but rather over $210 million in wagers on Polymarket. The platform decided that he had not worn a suit at the event, despite multiple outlets describing the President’s outfit as a suit. Whether Zelensky’s outfit counted as a suit ultimately mattered less than what the controversy revealed: Millions of dollars can now be wagered on events far removed from the traditional sportsbook or casino floor, highlighting the growing ubiquity of modern gambling.
Gambling Is Easier Than Ever
Watching any sports broadcast makes readily apparent how much interest there is in betting on every aspect of the game. News shows now highlight what the sponsored prediction markets think the outcome of upcoming elections will be. The internet has made gambling more accessible than ever, and companies have been hard at work developing ways to integrate it deeper into daily life and harder to step away from.
Since the Supreme Court struck down a federal ban on sports betting in 2018, sportsbooks have aggressively pushed for state-level legalization and to expand their influence in athletics. Sportsbooks use a variety of tactics to bring in users and make gambling as frictionless as possible: free first bets, gambling on granular outcomes beyond just wins/losses, and the ability to automatically approve payments. At the same time, the transition to app-based gambling has removed previous barriers like physical travel, cash, and facility operating hours. The result is a closer integration of gambling into the sports watching experience; wagering on the game is just as easy as checking the score.
Recent years have also seen the growth of prediction markets – platforms that allow users to wager on the outcome of events far beyond sports in areas like politics, business, and pop culture. Rather than traditional wagers in casinos or sportsbooks, prediction markets offer shares of “contracts” on the binary outcome of an event. Because they operate through this shares/contracts model, they are not regulated as gambling but rather as financial futures markets that don’t rely on a state’s legalization of gambling. Just as sports gambling platforms aim to integrate themselves with the sports-watching experience, prediction markets are working to integrate themselves as part of the news cycle. Pollsters and political analysts regularly cite prediction markets in their election forecasts, and prediction market platform Kalshi inked an official partnership with CNN in 2025.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9105963/https://ideas.repec.org/p/osf/socarx/4s6ck_v2.html
What Is Gambling Disorder?
Gambling triggers the release of feel-good chemical dopamine in the brain, creating the excitement and thrill that many feel when engaging in such activities as sex and exercise. Casinos and betting platforms are designed in ways that maximize the excitement of gambling, prompting the activation of the body’s reward system. The repeated activation of the body’s reward system can create patterns of addiction that make it harder to stop gambling, ultimately impacting a person’s health and wellness. https://pmc.ncbi.nlm.nih.gov/articles/PMC3803105/https://pubmed.ncbi.nlm.nih.gov/24077065/What makes gambling particularly addictive is that the wins are intermittent and random – individuals don’t know when the next win will be, prompting further engagement.
Gambling disorder was first recognized in DSM-III as an impulse-control disorder alongside others like kleptomania. The DSM-5 reclassified it to more closely align with substance use disorders due to significant overlap in symptoms and physiologic influences.
Gambling disorder can have serious consequences including sleep deprivation; loss of interest in hobbies or relationships; emotional stress; feelings of shame, guilt, or worthlessness; exacerbation of mental health issues; suicidal thoughts and attempts; financial and emotional harm to family; and criminal activity. Individuals with gambling disorder face a fifteen times higher risk of suicide attempts and a three times higher rate of depression. One in five individuals ultimately file for bankruptcy. In states with legalized sports gambling, credit scores declined an average of 12 points. Meanwhile, 82 percent of affected families experience harm including divorce, social isolation, and increased mental health risks for children.
In a 2024 survey, 8 percent of American adults (20 million) reported experiencing at least one indicator of gambling disorder within the past year. Certain demographics are at a higher risk for developing gambling disorder, including:
- Low-income individuals who stand to gain most from a win
- Young adults
- Men
- Individuals living in states with legalized sports betting
- Children of parents with addiction problems
- Gamblers who play more than one game and have longer sessions.
Gambling disorder is also heavily stigmatized, making recognition and ultimately treatment more difficult. Individuals are often categorized as “greedy” and “irresponsible,” messages that can be internalized as a moral failure. As a result, individuals with gambling disorder often conceal and avoid treatment. https://www.abi.org/feed-item/law-review-economics-hollenbeck-brett-and-larsen-poet-and-proserpio-davide-the-financial
Policy Implications
As the availability and accessibility of gambling continues to grow, so do the costs of gambling disorder. A 2023 estimate by the NCPG puts the annual national social cost at $14 billion, including health care, judicial, job loss, and bankruptcy costs. Challenges in addressing gambling disorder include stigma, limited awareness, lack of federal funding, gaps in research, and a shortage of clinicians qualified to treat it. Despite the existence of federal research and treatment programs for other addictive disorders such as alcohol, tobacco, and SUDs, none exist for gambling disorder.
Congress should support additional research to better understand the scope of the problem and identify effective prevention, treatment, and recovery strategies. Examples of bills that have been introduced to address this include:
- Gambling Addiction, Recovery, Investment, and Treatment (GRIT) Act (S. 454/H.R. 1141) allocates one-half of the federal excise tax towards formula and competitive research grants for states and requires the Secretary of HHS to provide a report on their efficacy within three years.
- Providing Opportunities for Individuals in Need of Treatment and Support (POINTS) Act (H.R. 7875) allocates one-third of the federal excise tax towards competitive grants for states to establish or expand programs for the prevention and treatment of gambling disorder. It amends the Public Health Service Act to include gambling addiction alongside other substance use and mental health disorders. The Assistant Secretary of HHS is required to submit an annual report on their effectiveness.
- The Gambling Disorder Health Study Act (H.R. 8970) requires the Secretary of HHS to produce a report within two years examining the causes, long-term consequences, treatments, and best policy approaches to the issue of gambling disorder.
At the state level, many states have implemented requirements that proceeds from sports wagering be set aside for gambling disorder prevention and treatment funds; others establish dedicated funds for research and treatment. Colorado’s Sports Betting Protections Act limits deposits on gambling platforms to six in a 24-hour period, bans push notifications soliciting bets, and prohibits the use of credit cards to fund accounts. Since its passage, Pennsylvania lawmakers have introduced similar legislation.
The rapid growth and increased ease of gambling opportunities have created additional opportunities for individuals to develop gambling disorder. Combined with efforts to destigmatize the disorder and raise awareness of the health effects, opportunities to provide evidence-informed care for these individuals are also growing. Policymakers, health plans, and the clinical community should work together to ensure that all individuals with gambling disorder have access to high-quality, evidence-based, and compassionate care.
