March Madness this week features a collection of 67 single-elimination basketball games that will not only win championships over 2½ weeks, but also billions of dollars in sports betting.
Experts say young people are especially at risk of developing gambling problems.
According to a 2024 survey conducted by Fairleigh Dickinson University, 24% of men reported at least one problem behavior when it comes to gambling. That number rises to 45% for men 30 and younger.
With more games comes more opportunities to bet, including live, in-game bets on multiple sports betting apps at your fingertips.
Perhaps it’s no surprise that the American Gaming Association estimates that about $3.3 billion in legal bets will be placed on tournament games this year — a 54% increase over the past three years.
Fairleigh Dickinson professor of government and politics Dan Cassino, director of the survey, said the men who reported problems didn’t just attribute it to sports books, but online sports betting made gambling more addictive, he said.
Events like March Madness make it worse, he said.
“You can’t be in the United States in March and not hear about what’s going on in the basketball tournament within the NCAA, and because of that, people are simply thinking about it more.”
Josh Ercole, executive director of the Pennsylvania Gambling Council, said online betting has changed the game. Ercole said the center is monitoring a nationwide gambling hotline that has grown over the years since online sports betting was legalized in 2018.
In 2025 the center received nearly 3,000 calls, 403 of which mentioned online sports betting, according to its annual data report.
“It’s really a blurred line where sports betting and gambling don’t live in separate worlds,” he said.
‘My identity is more than just a gambler’
Don Trallaro knows firsthand the pitfalls of sports gambling.
He started betting as a coping mechanism after the 9/11 terrorist attacks. His friends who worked in New York were killed in the attacks.
“I saw things I wish I hadn’t seen, and it affected me. It kind of locked me in a mental prison, so to speak,” he said. “I started gambling as a way to cope and escape. And for me, gambling went from being fun to something I had to do to feel better.”
He began extorting money from people giving financial advice to his gambling habit and spent 4 and a half years in state prison after turning himself in.
While in prison, Trullaro reflected, tried to repair broken relationships and regained faith.
He decided that he wanted to help people who were struggling like him. He completed a master’s degree in psychology while in an intensive supervision program, a prisoner reintegration program.
Since 2016, he has worked in various gambling rehabilitation roles. He now works as the Manager of Education and Responsible Play Management at IC360, a technology consulting firm specializing in integrity and compliance in sports betting.
Today, Trallaro runs educational workshops for college athletic departments in Pennsylvania and trains professional and amateur athletes about the risks.
He said that understanding a person’s relationship with gambling is essential to reducing harm.
“We want to equip them with the knowledge, and we want to equip them with the knowledge, how to enjoy gambling as entertainment in a safe, responsible way, if they choose to,” he said.
He also shows where to go for help.
Social expectations may encourage young people to take up sports betting, he said.
“It’s culture. I think it’s normal. I think it’s social. It’s pervasive. It’s all over culture,” Trullaro said. “You start out in high school with your parents or your friends, and in college, you have a group of friends and that’s something.”
Casino examines social perceptions of men and how they influence men’s actions.
He said sports betting attracts men because it allows them to prove their expertise in social settings.
A modern problem
A 2026 American Gaming Association study found that sports betting advertising has actually declined by 27% on television and social media platforms since 2021.
Still, a 2025 study by Burches Health found that some form of sports betting ad was seen every 13 seconds during the 2025 Stanley Cup Finals — including player jersey patches, broadcast studio integrations and logo placements.
A sports association study said the NHL has the highest ad saturation and that NBA broadcasts typically have about 100 betting references.
Despite the ads, the casino said it was unlikely to attribute gambling problems to it. But ease of access and mid-game bets can be blamed.
Before the advent of online betting, people had to bet with a bookie, unless they were at a sports book venue such as a casino. The casino said that this form of gambling is much less addictive than online betting.
“If I make a bet on the outcome of a game, well, I only have one bet there, and I don’t get immediate feedback, and we know that there is an element of immediate feedback in gambling addiction,” Casino said. “Online sportsbooks have realized this. And that’s why we don’t just bet on the outcome of the game, we bet on what the player will do during the game.”
What used to be minor hassles — traveling to the casino, withdrawing money and sitting at a table or kiosk — is now negligible, Trullaro said.
“When you’re playing online, they’re also very interested. They keep you very busy,” Trolaro said. “Having it in your pocket and accessible can certainly lead someone down the path of problematic use a little faster.”
Aging and warning signs
Judy Bechtold, founder of the Better Institute of Pittsburgh, a consulting center, said Pennsylvania allows interactive gambling and online sports betting. Interactive gambling can include sites that provide a live casino setting or real-time sports betting while games are in progress.
The annual Pennsylvania Interactive Gaming Assessment to 2025 study found that up to 30% of Pennsylvania adults reported gambling online and 78% of people who only gambled online were men.
According to the PIGA study, more than 50% of calls to the National Problem Gambling Helpline cited online gambling as a primary concern.
Legal age restrictions also don’t always prevent certain bets, Bechtold said. And, in some cases, she said, some go back to bookies in person.
“We’re seeing a lot of college-age students have a significant problem with sports betting because they’re betting with what they call a bookie on campus,” she said. “So, they’re going past the traditional Draft Kings, FanDevil, Beat MGM because they don’t age.”
Young people struggle more than ever with self-regulation, coping with anxiety, controlling emotions and understanding money, she said.
“This current cohort that’s in college right now is struggling more than we’ve seen since Covid,” Bechtold said.
She said more government regulation and advocacy is needed to protect consumers.
Trullaro said people should address their personal relationship with gambling.
“If it’s causing harm, if you have a family history of gambling addiction, we have to talk about it so people are aware, because there’s not enough education,” he said.
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