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Parlays and Point Spreads: Gambling Addiction in Athletes

Psychiatry
03.09.2025

Dr. Pam Weatherbee, Sports Psychiatrist

In less than two minutes, anyone with a smart phone or a laptop can set up an online account and gamble. Whether it’s blackjack, roulette or betting the over/under on a football game, it’s easier than ever to gamble with unlimited access at our fingertips. In the general population in Canada, almost two-thirds of the population over the age of 15 have gambled in the last year. Problematic gambling in Canada ranges from 0.7-6.5%, more common in 15-24 year olds and males1.

Combine easy access this with the ultra-competitive, risk-taking nature of an elite athlete and it’s not hard to imagine athletes developing a gambling addiction. Data is limited when it comes to athletes and gambling disorder, but a survey of National team level athletes in 2018 indicated a 7% prevalence; 14% in males and 1% in females2.

Gambling Addiction was added to the DSM5 in 2013 recognizing the problematic behavioral condition leading to intense reward activity in the brain3. Similarly to substances, shopping and sex problematic versus responsible gaming is certainly not dichotomous and exists on a spectrum where the difficulties arise from functional impairment of significant distress. On a spectrum, individuals with a Gambling Disorder have difficulties stopping or cutting back, tolerance and withdrawal, and significant social and relational conflicts. Athletes may start to isolate from the team, demonstrate mood changes and dysregulation, performance can drop. Individual sport athletes have been demonstrated a similar prevalence of problematic gambling when compared to team sports in a study looking at university level athletes2. Evidence from studies in the general population report Gambling Disorder increasing psychiatric co-morbidity and suicide deaths and we can certainly expect to be able to extrapolate this to the athlete population.

Gambling can exist as a subculture within a team environment and can be a way to pass the time during the off-season, during recovery or traveling. The reward of a win at the casino can mirror the win on the field in terms of a rush and some athletes have extra money to burn at a young age. The characteristics that drive an athlete to success in their sport can also predispose to risk taking behaviors off the field, and it has been demonstrated that athletes in particular are prone to risky drinking behaviors when compared to the general population4. We might recall when some of our favorite hockey players promoted sports gambling via commercials airing during the game, marketing gambling culture to the general population. However, in 2021, Canada banned athletes from appearing in ads or commercials that involve sports betting via Bill C-218, the Safe and Regulated Sports Betting Act.

Unfortunately, there is also an element of dehumanization of an athlete when there are numbers tied to their play, for example in fantasy leagues where the individual performance of a single athlete becomes the focus as opposed to the team. Sport gambling has led prominent athletes to engage in unprofessional play including point-shaving or manipulation of the game to shape the outcome in favor of a specific outcome. Several famous athletes have had lifetime bans imposed from their professional sport organizations following gambling related offenses including Calvin Ridley, Jontay Porter, and Shawn Lemon.5,6,7

So how do we protect our athletes from the potential consequences of gambling? Education is paramount, specifically around risks leading to problematic gambling behaviors, where to seek help, and approaching all conversations with curiosity, empathy and non-judgement. Promoting a team culture where gambling is not a focus can be the responsibility of the administration, coaching staff and leaders on and within the team. Team contracts and organizational policies can outline consequences related to gambling on the team. Screening during pre-season medicals and checking in throughout the season can provide touchpoints for identification of problematic behaviors. Screening tools include the “Lie/Bet” two-question screening tool or the Brief Biosocial Gambling Screen (BBGS).8,9 Identification of problematic gambling may benefit from referral to a sports psychiatrist to screen for additional psychiatric co-morbidities.

Treatment for problematic gambling exists and is accessible for athletes and is based on evidence-based principals and generally a multidisciplinary approach that would be warranted for other problematic use disorders.10 Identification of co-morbid conditions such as ADHD, depression or anxiety should be managed concurrently, given that gambling behaviors can be a means of mitigating untreated symptoms. While no specific recommendations exist for treatment of Gambling Disorder in the athlete population, a biopsychosocial approach, ruling out iatrogenic causes (I.e. dopamine-agonists) and treatment of co-morbid conditions can all yield potential benefit to the athlete. Consideration of behavioral therapies such as Motivational Interviewing, Cognitive Behavioral Therapy, contingency management and environmental/social interventions (I.e. smart phone application blockers, self-exclusion bans) can all provide benefit to the athlete depending on their preference and motivation level.10 Involvement in Gambling Anonymous can be useful though confidentiality can be a limiting factor in willingness to engage. Low-dose naltrexone has demonstrated some evidence in reducing problematic gambling, though this is limited and the pros and cons of pharmacological management in athletes needs to be considered due to the potential side effects of medications11.

As physicians, acknowledgement and identification of problematic gambling and Gambling Disorder in the athlete population is critical. We all play a role in education, assessment and early intervention in a multidisciplinary setting to help our athletes avoid the financial pitfalls, damage to social and occupational roles and development or exacerbation of mental health co-morbidities.

References

  1. Statistics Canada. (2022, August 9). Who gambles and who experiences gambling problems in Canada, 2022. https://www150.statcan.gc.ca/n1/pub/75-006-x/2022001/article/00006-eng.htm?utm
  2. Håkansson A, Kenttä G, Åkesdotter C. Problem gambling and gaming in elite athletes. Addict Behav Rep. 2018 Aug 14;8:79-84. doi: 10.1016/j.abrep.2018.08.003. PMID: 30140727; PMCID: PMC6104348.
  3. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders(5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
  4. Mastroleo, N. R., Scaglione, N., Mallett, K. A., & Turrisi, R. (2013). Can personality account for differences in drinking between college athletes and non-athletes? Explaining the role of sensation seeking, risk-taking, and impulsivity. Journal of Drug Education, 43, 81–95
  5. Falcons WR Calvin Ridley suspended indefinitely through at least 2022 season for betting on NFL games, National Football League, available at https://www.nfl.com/news/falcons-wr-calvin-ridley-suspended-indefinitely-through- 2022-season-for-betting- (Mar. 8, 2022)
  6. Zhou, Li (April 18, 2024). “Jontay Porter’s lifetime NBA ban highlights the risks of sports gambling”. Vox. Retrieved April 23, 2024
  7. Campbell, Morgan. 2024 Shawn Lemon’s indefinite CFL ban reveals hidden cost of pro leagues going all in on legalized betting. August 29, 2024. CBC. https://www.cbc.ca/sports/football/cfl/cfl-morgan-campbell-shawn-lemon-betting-1.7307749
  8. Johnson, E.E., Hamer, R., Nora, R.M., Tan, B., Eistenstein, N., & Englehart, C. (1988). The lie/bet questionnaire for screening pathological gamblers. Psychological Reports, 80, 83-88
  9. Gebauer L, LaBrie R, Shaffer HJ. Optimizing DSM-IV-TR Classification Accuracy: A Brief Biosocial Screen for Detecting Current Gambling Disorders among Gamblers in the General Household Population.The Canadian Journal of Psychiatry. 2010;55(2):82-90.
  10. Burger JW, Goncalves R, Stull T. Managing Substance-Related and Addictive Disorders in Athletes. Psychiatric Annals. 2024;54(11): e301-e307. doi:10.3928/00485713-20241121-01
  11. Ward S, Smith N, Bowden-Jones H. The use of naltrexone in pathological and problem gambling: A UK case series. J Behav Addict. 2018 Sep 1;7(3):827-833. doi: 10.1556/2006.7.2018.89. Epub 2018 Sep 21. PMID: 30238780; PMCID: PMC6426388.