Gambling is no longer confined to neon casino strips or smoky betting shops, it now lives in our phones, on our couches and in the middle of televised sports. As this new wave of gambling addiction spreads through sports betting apps, online casinos and digital slot machines, one scientist’s early work on compulsive betting looks less like a historical footnote and more like a warning we failed to fully heed.
By tracing how Psychiatrist Dr Robert L. Custer reframed gambling as a medical disorder and how later researchers dissected the design of modern machines, I can show how today’s crisis was not only predictable, it was practically scripted in advance by the very systems built to keep people playing.
The quiet surge in a newly legal pastime
Legal sports betting and online wagering have turned what used to be a niche habit into a mainstream pastime, and the fallout is starting to show up in clinics and hotlines. A new study described in Article Content found a surge in gambling addiction following the legalization of sports betting, with researchers from the University of Califo tying rising problem gambling to the rapid expansion of states that chose to legalize sports betting. The pattern is straightforward but alarming, when access and advertising explode, so do the number of people who discover they cannot stop.
Substance use specialists are now watching gambling creep into their caseloads, even among patients who never set foot in a casino. Schreier, an addiction-treatment provider, described how his patients increasingly talk about sports betting apps and online slots, a shift that reflects a growing unease among clinicians that gambling is becoming a parallel epidemic to drugs and alcohol, as detailed in his presentation on the harmful rise of gambling addiction linked to the American Gaming Association in a report on Schreier. When therapists who once focused on opioids and alcohol now routinely ask about parlay bets and in-game wagers, it is a sign that gambling has slipped into the everyday fabric of risk.
The psychiatrist who said gambling was not a sin
Long before betting apps and digital slots, Psychiatrist Dr Robert L. Custer was arguing that compulsive gambling should be treated as a medical problem rather than a moral failing. In his clinical work, Psychiatrist Dr Robert, Custer developed six categories of gambling types and insisted that what he was seeing in his patients was a “behaviour disorder” that required structured treatment, not sermons, a shift captured in guidance on different types of gambling addictions that credits him as a pioneer who argued gambling should be treated as a “behaviour disorder” in the first place, as outlined in the description of Psychiatrist Dr Robert. By naming and classifying the problem, he gave families and patients a language that did not revolve around shame.
That reframe eventually reached the broader public, and Robert Custer helped shift the reputation of gambling addiction from moral failing to treatable medical condition, a transformation that is now widely recognized in addiction medicine and public health circles and highlighted in a summary noting how Robert Custer changed the conversation. When I look at today’s surge in gambling problems, I see the direct legacy of that work, without his insistence that compulsive betting was an illness, the current spike in cases might still be dismissed as a lack of willpower instead of a predictable response to an environment engineered to keep people wagering.
Dec, Despite and the birth of a modern diagnosis
The current wave of gambling harm did not catch researchers entirely off guard, because Dec, Despite the relative obscurity of early gambling science, one scientist’s work on impulse control and betting laid out a framework that looks eerily suited to the digital era. Reporting on how gambling addiction spreads has emphasized that as gambling addiction spreads, one scientist’s work reveals timely insights into how impulsive drives interact with games of chance, a connection that has become more urgent as betting opportunities multiply, as described in an analysis of how Dec research anticipated today’s crisis. The core idea was simple but profound, gambling could hijack the same neural and psychological circuits that drive other compulsive behaviors, which meant it needed to be studied with the same seriousness as substance use.
Around the time Freud was still shaping psychoanalysis, this scientist’s interest in gambling as an impulse problem was unusual, yet it eventually led to a formal role at a Veterans Administration hospital and then to a position at a university in Cleveland in 1953, a trajectory that shows how fringe curiosity became institutional research, as recounted in a historical note that explains how this work grew around the time Freud was influential and culminated in a post at a University in Cleveland in 1953. When I connect that timeline to today’s app-based betting, it is clear that the conceptual tools to understand gambling as an impulse disorder have existed for decades, what changed was the scale and sophistication of the games themselves.
How early research missed who was really at risk
Even as clinicians like Custer and his contemporaries were building a medical model of gambling addiction, the research base had blind spots that still echo in today’s treatment gaps. Many early studies that did include women were based on small numbers of women or relied on anecdotal reports of women in Gamblers Anonymous, which meant that the lived experience of female gamblers was often filtered through secondhand stories rather than systematic data, as documented in a review that notes how Many early studies sidelined women in Gamblers research. When I talk to clinicians now, they describe a wave of women losing money on online slots and mobile bingo, a pattern that early male-focused studies were never designed to anticipate.
Those gaps matter because they shaped which warning signs were considered typical and which were dismissed as outliers. If the foundational research leaned heavily on Gamblers Anonymous case histories and small male samples, it is no surprise that women, younger players and people using new technologies often struggle to see themselves in the classic portrait of a problem gambler, a portrait that still influences screening tools and public messaging built on those early Gamblers studies. As gambling shifts from smoky back rooms to smartphone screens, the old research canon looks increasingly incomplete, and that incompleteness can delay recognition and help for those who do not fit the original mold.
Natasha Dow Sch and the science of the “zone”
If Custer helped define gambling addiction as a disorder, Natasha Dow Schüll has helped explain why modern machines are so good at pulling people in and keeping them there. Natasha Dow Sch is a cultural anthropologist and associate professor at MIT, working in the Program in Science, Technology, Society, where she studies how technologies like slot machines shape the way we understand and govern ourselves, a role described in her profile that introduces Natasha Dow Sch at MIT’s Program in Science, Technology, Society. Her fieldwork in Las Vegas did not just catalog machines, it listened to gamblers describe a trance-like state they called “the zone,” where the goal was no longer to win but to keep playing.
In her book Addiction By Design, she shows how machine gambling is engineered to create and sustain that zone, turning play into a continuous flow with as few interruptions as possible. An academic discussion of her work notes that Abstract, Natasha Sch’s Addiction By Design is concerned with machine gambling in the zone and connects those patterns to other technologically mediated behavioral disorders, highlighting how the same design tricks that keep people at slot machines can also keep them scrolling or tapping on other platforms, as summarized in an analysis of Abstract on Natasha Sch and Addiction By Design. When I look at sports betting apps that offer endless in-game wagers and instant cash-out buttons, I see the same logic at work, a design that blurs the line between game and compulsion.
Las Vegas lessons for a digital casino
Schüll’s research in Las Vegas shows that the addictive pull of gambling is not just about odds or jackpots, it is about how the entire environment is tuned to keep people moving in one direction, toward more play. Addiction by Design explores the intricacies of machine gambling in Las Vegas, examining how machine attributes, feedback loops and casino layouts influence consumer behavior, and it demonstrates that machine gambling is shaped by design and technology in ways that showcase advanced psychological insights, as detailed in a study of Addiction and Design in Las Vegas. Local gamblers in her work often described playing not for the thrill of a big win but for the steady, numbing rhythm of small, frequent outcomes that kept them in the chair.
That same logic now appears in digital form, where apps mimic the sensory cues and rapid feedback of casino floors. Many casinos try to avoid making you ever have to turn at a 90 degree angle so you keep drifting past more machines, a detail that illustrates how even the geometry of a gambling space is optimized for continuous play, as explained in a discussion of how Many casinos design their floors. When I open a betting app that automatically suggests the next wager or slides me into a new game with a single tap, I see a digital version of that 90 degree avoidance, a user interface that quietly steers me away from exits and toward the next spin.
From casino carpets to smartphone screens
The migration of gambling from physical casinos to digital platforms has not softened its impact, it has intensified it by removing friction and adding secrecy. Participants in qualitative research on harmful gambling reported that technologies increased the spiral to addiction, because technologies facilitated secretive behaviors, allowed people to hide transactions from bank accounts and accelerated the speed of play, a pattern described in a study where Participants linked digital tools to a faster descent into harm. When gambling happens on a personal smartphone instead of a public casino floor, it becomes easier to hide mounting losses from partners, employers and even therapists.
That secrecy dovetails with the design insights from Las Vegas, creating a perfect storm of accessibility and compulsion. A person can now move from watching a game on television to placing a live bet on the next play, then to spinning a virtual slot machine during commercial breaks, all without leaving the couch or logging off a single app, a seamless flow that mirrors the continuous play Schüll documented in physical casinos and that the study on technologies shows can accelerate harm. When I connect those dots, it is hard to see today’s spike in gambling addiction as anything other than the logical outcome of systems built to maximize engagement and minimize pause.
Why the old warnings matter more than ever
Looking back at Custer’s insistence that gambling was a behaviour disorder and at the early scientist whose work in Dec, Despite limited attention, framed gambling as an impulse problem, it is clear that the core warning has been on the table for decades. As gambling addiction spreads, one scientist’s work reveals timely insights into how impulsive drives and environmental cues interact, and that insight now feels like a blueprint for understanding why legal sports betting and online casinos have produced such a sharp rise in harm, as highlighted in the analysis of how Despite early research, the problem has grown. The science did not just predict that some people would struggle, it explained that when games are designed to exploit human psychology, the line between entertainment and addiction will always be thin.
What has changed is not the human brain but the reach and sophistication of the gambling industry, from Las Vegas carpets to smartphone screens and live sports broadcasts. The research on machine gambling in Las Vegas, the accounts from Participants who describe technology-fueled spirals, the surge documented by Article Content after sports betting legalization and the clinical warnings from Schreier all point in the same direction, a world where gambling is woven into everyday life without a matching investment in safeguards or treatment. When I put those threads together, the story that emerges is not of a sudden, mysterious epidemic, but of a long-anticipated crisis that unfolded exactly as the science said it would, once we built systems that turned every idle moment into a chance to place a bet.
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