Only Utah and Hawaii continue to outlaw gambling altogether. lose about $125 billion on gambling every year. Forty-five states now host casinos, and 38 states have legalized sports betting. The National Council on Problem Gambling estimates that people in the U.S. Most other states are less attentive to the potential harms of gambling, even as experts worry about the rapid expansion of gambling across the country, through legalized sports betting, online gambling, and mobile betting apps. The law requires regulators to develop a comprehensive framework to address problem gambling and to fund research. A 2011 state gambling law requires casinos to funnel a portion of their revenue into the Public Health Trust Fund, now reported at $24 million, which is distributed by the gaming commission and the state’s public health department. Massachusetts is the only state that requires gambling intervention in its casinos, paid for by the casinos themselves. Related Book Review: The Root of What Ails Us He says the program’s mantra is harm reduction - not judging or even necessarily discouraging gambling, but meeting people “where they’re at, and where they’re gambling.” Mark Vander Linden, the director of Responsible Gaming and Research at the Massachusetts Gaming Commission, launched GameSense in 2015, when the first slots parlor opened.

“We know how they think we know their misconceptions we know their jargon.” The advisors are trained to offer information and teach basic gambling literacy, including the slim odds of winning. “We understand these guys,” she says. Now, as a GameSense advisor, Gabrila’s job is to watch for people who have been in their seats too long, and possibly lost too much money. Gabrila, 47, who has short spiky hair and a no-nonsense demeanor, works for the state-funded GameSense program, now operating at all three casinos in Massachusetts and meant to promote responsible gambling. She used to be part of the casino industry as a table dealer, she says, “my job was to keep butts in the seats.” This article originally appeared in Harvard Public Health magazine.

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