States Spend $75 Per Problem Gambler, vs. $919 for Substance Use

State governments budgeted $188 million for problem gambling services in fiscal year 2025, roughly double the $94 million they set aside four years earlier — and then spent only about $145 million of it, leaving $43 million unspent. The finding comes from the annual budget update published by the National Association of Administrators for Disordered Gambling Services, the only organization that surveys publicly funded problem gambling programs across all fifty states.

The headline comparison the survey produces is stark. Spread across an estimated 2.5 million people with a gambling disorder, the $188 million works out to about $75 per person. States spent roughly $44.5 billion on substance use disorders in the same year, or $919 for each of the estimated 48.5 million people affected — more than twelve times as much per person.

An unspent balance that is not a surplus

The $43 million gap is the detail that drew the strongest reaction. In a statement accompanying the report, National Council on Problem Gambling board president Derek Longmeier described the underspending as evidence of a capacity problem rather than an absence of need.

"The states that are underspending their problem gambling budgets aren't telling us they have too much money," Longmeier said. "They're telling us they don't yet have the system to use it. It's on all of us — states, providers, and the federal government — to build that system before more allocations are eliminated on the theory that the need wasn't real."

The report attributes the unspent balances to procurement delays, contracting timelines, workforce shortages and program start-up time. Longmeier's formulation — "That is not a funding success story. That is a capacity crisis hiding behind a budget line" — has become the framing the council is using in its advocacy.

The underlying complaint is structural. Problem gambling money in most states comes from gambling revenue set-asides, which have grown quickly as sports betting and online casino play expanded. The clinical workforce to absorb it has not.

Funding is concentrated in a handful of states

Forty-three states fund problem gambling programs. Eight states plus the District of Columbia do not: Alaska, Alabama, Hawaii, Idaho, Montana, Texas, Utah and D.C.

Among those that do, spending is heavily skewed. Massachusetts spends more than three times as much on problem gambling services as any other state, and the five highest-funded states account for roughly half of all problem gambling funding nationwide. That concentration helps explain why the average state allocation and the median diverge so widely.

The report does not attempt to measure whether higher spending produces better outcomes, and the field lacks the kind of standardized national outcome data that substance use disorder treatment has accumulated over decades through federal reporting requirements.

What NCPG wants states to do with the money

The council's recommendations are largely about building infrastructure rather than adding dollars. It wants problem gambling folded into public education campaigns, routine screening questions added to primary care and behavioral health visits, and a credentialing pathway created for providers who treat gambling disorder.

Longmeier argued that the condition should not be managed as a stand-alone budget line. "NCPG believes it is time to stop treating problem gambling as a stand-alone line item and start treating it as what it is: a behavioral health condition that deserves the same integrated response we've built, however imperfectly, for substance use disorders," he said.

That integration argument has picked up support outside the advocacy world. Nora Volkow, director of the National Institute on Drug Abuse, told a House committee in May that the gambling crisis is deepening, particularly among teenagers. In August, former Surgeon General Jerome Adams described sports betting as "the new opioid crisis."

The federal gap

Problem gambling remains unfunded at the federal level for research and treatment, even as gambling's annual social impact is estimated at roughly $14 billion, according to NAADGS. About 20 million American adults — around eight percent of the adult population — report frequent indicators of disordered gambling in a given year.

That leaves the field dependent on state set-asides and on a treatment workforce that is thin in much of the country. The practical results are visible in state-level demand data: Virginia's publicly funded gambling treatment network, for instance, reported a 36 percent jump in demand in early 2026 as casinos and sportsbooks expanded there. Medication-based treatment exists for opioid and alcohol addiction, but there is no approved pharmacological treatment for gambling disorder — only behavioral therapy, which places a heavier burden on a workforce the survey says states have not yet built.