Illinois Moves to Classify Gambling Disorder as Public Health Issue Under Substance Abuse Act

Illinois lawmakers are redefining how the state treats gambling disorder, advancing legislation that would formally recognize compulsive gambling as a public health crisis deserving the same infrastructure and resources currently dedicated to drug and alcohol addiction.

Senate Bill 2749, introduced by Senator Julie Morrison in January, passed the Senate Executive Committee last week with an 8-0 vote and now heads to a second reading. If enacted, the measure would fold gambling disorders into Illinois' Substance Abuse Disorder Act, fundamentally changing how the state approaches prevention, treatment, and recovery support for problem gambling.

The Scale of the Problem

The legislation responds to data showing gambling disorders affect a significant portion of Illinois residents. According to the Department of Human Services, approximately 3.8% of Illinois adults—roughly 370,000 people—currently experience problem gambling. Another 7.7% are at risk of developing gambling disorders, a figure that translates to more than 700,000 additional residents.

Those numbers have grown alongside the state's gambling infrastructure. Illinois now operates 17 casinos, nearly 9,000 licensed video gaming terminals, and 14 approved sportsbooks. These regulated operations generated over $2.2 billion in combined tax revenue for state and local governments in 2025, creating a complicated dynamic where economic benefits coexist with public health consequences.

Senator Morrison framed the issue in direct terms: "Gambling disorders have long affected people and families across Illinois, leading to devastation and a lower quality of life. By providing support and resources to those affected, we are ensuring that our neighbors can continue to thrive in our communities and do not have to endure their battle alone."

What the Bill Would Change

SB 2749's primary impact lies in its formal recognition of gambling disorder as a substance use disorder under state law. The bill's text establishes that both substance use and gambling disorders "constitute a serious public health problem" with wide-ranging effects on public safety, the criminal justice system, and social and economic wellbeing.

By bringing gambling disorders under the Substance Abuse Disorder Act, the legislation would:

Authorize coordinated state response. The Department of Human Services' Division of Substance Abuse Prevention and Recovery (SAPR) would assume responsibility for coordinating gambling disorder prevention, treatment, recovery, and support services across the state. This centralization aims to create a more coherent system than the current patchwork of programs.

Establish prevention requirements. The department would be required to develop and promote awareness initiatives targeting the stigma surrounding gambling disorders, early recognition of warning signs, and prevention strategies. Critically, the bill mandates specific attention to preventing minors from accessing gambling and gaming activities.

Create treatment infrastructure. State-funded addiction treatment programs would expand to include gambling disorder services, backed by the same recovery support framework currently available for substance use disorders. This includes counseling, peer support, family services, and aftercare planning.

Develop public messaging. The legislation directs the department to prepare standardized statements about gambling risks, which operators would be required to display on their premises and integrate into online platforms, websites, and mobile applications.

Launch a dedicated hotline. A new toll-free crisis line would provide immediate access to counseling, referrals, and support services specifically for gambling-related issues, giving families a clear point of entry when problems emerge.

Expanding the Definition of Gambling

One of the bill's more significant technical changes involves broadening the legal definition of "gambling" itself. Current Illinois law defines gambling narrowly, limiting it to activities regulated by the Illinois Gaming Board. SB 2749 would replace that restriction with an expansive definition covering "any activity of betting or wagering on uncertain outcomes, including, but not limited to, betting or wagering activity regulated by the Illinois Gaming Board."

This change matters because it would bring unregulated or illegal gambling activities—such as offshore online betting, informal sports pools, or unregulated gaming machines—within the scope of the state's treatment and prevention efforts. It acknowledges that problem gambling extends beyond regulated casinos and sportsbooks.

Video Gaming and Suicide Prevention

The legislation includes two provisions that extend beyond traditional gambling disorder treatment:

Problematic video game use. The bill explicitly incorporates education about excessive video gaming into prevention programs. While the text stops short of classifying video game overuse as a gambling disorder, it recognizes the behavioral overlaps and aims to address emerging concerns about gaming addiction among young people.

Gambling-related suicide prevention. SB 2749 mandates that the state's prevention and education efforts address the documented connection between gambling disorders and suicide risk. Research has consistently shown elevated suicide rates among people with severe gambling problems, particularly when financial losses lead to desperation.

Support for High-Risk Populations

The bill directs specific attention to individuals leaving correctional facilities, a population research has identified as particularly vulnerable to gambling disorders. By requiring engagement with this group during reentry planning, the legislation attempts to prevent gambling problems from becoming a barrier to successful community reintegration.

This focus aligns with broader criminal justice reform efforts that recognize untreated behavioral health conditions—including addiction—as significant contributors to recidivism.

Political and Industry Context

The bill's unanimous committee passage suggests strong bipartisan support, though that consensus may face testing as the measure moves through the full legislative process. Illinois' gambling industry represents a substantial economic interest, with operators, suppliers, and associated businesses employing thousands of residents and generating significant tax revenue.

Industry stakeholders have generally supported responsible gambling initiatives, but the specifics of how regulations are implemented—including operator posting requirements, funding mechanisms for new programs, and potential future restrictions—could generate pushback during debate.

Consumer advocacy groups and treatment providers have largely endorsed the approach, arguing that formalizing gambling disorder as a public health issue brings much-needed resources and legitimacy to an often-overlooked problem.

National Trend Toward Recognition

Illinois joins a growing number of states reconsidering how they address gambling disorders in an era of expanded legal gambling. Following the 2018 federal deregulation of sports betting, numerous states launched legal wagering operations while simultaneously grappling with the public health implications.

Some states have dedicated portions of gambling tax revenue specifically to problem gambling programs, creating sustainable funding streams for treatment and prevention. Others have established regulatory requirements for operators, including mandatory self-exclusion programs, betting limits, and responsible gaming messaging.

The Illinois approach stands out for its integration of gambling disorders directly into the existing substance use disorder framework rather than creating a parallel system. Proponents argue this approach reduces stigma, leverages existing treatment infrastructure, and ensures gambling disorders receive comparable attention and resources.

Implementation Questions

If SB 2749 becomes law, significant work remains to translate legislative language into operational programs. The Department of Human Services would need to:

• Develop clinical standards for gambling disorder treatment
• Train existing addiction counselors on gambling-specific interventions
• Create screening tools for identifying gambling problems in treatment settings
• Design prevention curricula for schools and community organizations
• Establish referral networks connecting people to appropriate care
• Set requirements for operator postings and disclosures

These implementation steps would likely unfold over months or years, requiring coordination among state agencies, treatment providers, gambling operators, and community organizations.

What's Next

The Senate has scheduled SB 2749 for a second reading on February 24. Following that procedural step, the bill would proceed to a floor vote in the full Senate. If it passes, the legislation moves to the House for consideration.

Senator Morrison emphasized the urgency: "Recognizing gambling disorders as a public health issue ensures that all residents have access to the support and resources they need, when they need it—our residents can't wait."

The timeline for final passage remains uncertain, but the unanimous committee vote and lack of vocal opposition suggest the bill has momentum. Whether that translates to enactment will depend on negotiations over implementation details, funding allocations, and potential amendments during floor debate.

For the hundreds of thousands of Illinois residents affected by gambling disorders, the legislation represents a potential turning point—formal recognition that their struggles deserve the same systemic response the state provides for other forms of addiction.

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If you or someone you know is struggling with problem gambling, the National Council on Problem Gambling operates a confidential helpline at 1-800-522-4700, available 24/7.