When lawmakers passed a wide-ranging bill legalizing casinos in 2011, they promised strong addiction protections and generous support for tracking problem gambling in Massachusetts, which already had the highest per-capita lottery spending in the United States.
Then-state Senator Stephen Brewer said that “this bill provides more money for gambling addiction services than any state in the union.”
But there hasn’t been a statewide study published on the prevalence of problem gambling since 2015, when the state released a baseline study. And the efficacy of some of the state’s vaunted problem-gambling mitigation measures is unclear, since studying that, too, is still ongoing.
As Massachusetts welcomed a slots parlor and two resort casinos, researchers don’t know if or how many more people fell into addiction.
“As an addiction psychiatrist, I can tell you it’s really important to track [problem gambling] like it’s COVID or monkeypox,” said Dr. Timothy Fong, who co-directs UCLA’s gambling studies program. “If we don’t know what the trends are, how can we stay in front of prevention and treatment?”
Now with sports betting legalized and on its way to casinos and residents’ phones, some experts say Massachusetts may see an increase in the number of people struggling with problem gambling, a term encompassing gambling addictions and other forms of harmful, repetitive gambling.
When asked if the Massachusetts Gaming Commission is tracking the prevalence of problem gambling over time, its top official offered a non-answer.
“We may not have the precise number of problem gamblers, and I can’t say that we don’t have that,” said commission chairwoman Cathy Judd-Stein. “I know we have a general percentage based on all of that research, and it’s a small percentage.”
Among other measures, the 2011 law mandated an unprecedented “baseline” research program and regular follow-ups to take stock of problem gambling in Massachusetts. The commission partnered with GameSense, an on-site help center designed to encourage responsible play and act as a safe haven for problem gamblers on the casino floor.
“The statute made a big commitment to research, and we pulled that out and blew it up into its biggest possible dimensions,” said Steve Crosby, who led the commission during the initial casino buildup.
That baseline study, which began in 2013 with full results made public in 2015, was run out of UMass Amherst, and described itself as the “largest problem gambling survey ever conducted in the United States.” It found that about 2 percent of Massachusetts adults had a gambling problem, in line with national averages.
But Plainridge Park Casino, a Plainville racing track, set up a slot machine parlor in 2015; MGM Springfield, a resort casino, opened in 2018; and Encore Boston Harbor, a resort casino in Everett, opened in 2019.
A statewide follow-up to the baseline study has yet to be published, so lawmakers and regulators don’t have a full understanding of whether the population of problem gamblers has increased, decreased, or stayed the same.
Mark Vander Linden, who heads up the responsible gaming research arm of the gaming commission, said that in the intervening time the commission has conducted site-specific “follow-up studies” at the Plainridge Park Casino and MGM Springfield. In the surrounding communities, there wasn’t a significant increase in the prevalence of problem gambling, Vander Linden said.
Currently, the commission is analyzing the survey data of its baseline follow-up study to parse out the state of problem gambling in Massachusetts. Data was collected last year and the commission will publish its report next year, about a full decade after the original benchmark research launched, but potentially after sports betting becomes legally available across the state.
Clyde W. Barrow, a former UMass Dartmouth professor who studied the Massachusetts gambling industry, said that given how much gambling goes on in the state, surveying how many problem gamblers there are should be a regular task on the research agenda.
“It should be done every two years, every five years,” Barrow said. “It’s just basic survey research. It’s not terribly expensive to do a basic analysis at all. It’s something they should be doing on a regular basis.”
That said, Barrow notes that most jurisdictions don’t study problem gambling at all, let alone on some sort of regular interval, even if that interval is 10 years.
In 2015, Massachusetts was the first state in the country to adopt the Canada-based GameSense program, which runs information booths at each of the gambling sites available in the state. The state’s GameSense program, facilitated by the gaming commission, is run by the nonprofit Massachusetts Council on Gaming and Health.
Keith Whyte, of the National Council on Problem Gambling, said that most public health issues — like smoking and alcoholism — have extensive research behind the campaigns to help stanch them.
But that’s not always the case with gambling. Marlene Warner, executive director of the Massachusetts Council on Gaming and Health, said the current data collection and analysis amounts to “bean counting,” but the nonprofit is bringing in a third-party evaluator to make a more conclusive report in the coming months.
The state has released some reports on GameSense’s ability to reach struggling gamblers and encourage responsible play. The most comprehensive report, published four years ago, focused on the GameSense booth at Plainridge Park Casino. Survey respondents said they were satisfied with interactions with GameSense advisers, but mostly didn’t report changes in gambling behavior.
And legal sports betting will begin in a sports-crazed state, now that Governor Charlie Baker signed sports betting into law. Legislators have promised safeguards for the new way to wager money.
“If you look objectively at the more than 30 states that have legalized sports betting,” said state Senator Eric P. Lesser, who coauthored the sports betting compromise, “we are by far the strictest and will have the most significant consumer protections surrounding it.”
The bill includes a list of measures to preempt problem gambling, including a requirement that casinos present a plan to the commission on how they will responsibly bring sports betting into the fold.
Vander Linden, the commission’s gambling researcher, couldn’t say based off of the baseline data if Massachusetts might see a hike in problem gamblers under sports betting, but said it could be a factor in increasing risk.
“The more types of games [patrons] view or interact with, the higher risk of developing a gambling problem,” Vander Linden said. “Understanding sports wagering behavior is something that we’re very invested in.”
The commission survey following up on the original baseline included questions about sports wagering. The commission’s annual report last year included a study co-led by UMass Amherst professor Rachel Volberg that tracked problem gamblers’ health over time. It concluded that betting on sports is “considered one of the strongest predictive variables” of problem gambling. But more research is needed.
Ultimately though, Volberg said to temper expectations for what sports betting will bring.
“With any new form of gambling,” Volberg said, “it’s not going to be as bad as you think it is, but it’s not going to be as good as you hope it will be.”
Researchers like Barrow say they just hope that the state will have the numbers to back it up.
Material from the State House News Service was used in this report.
Simon J. Levien was a Globe intern in 2022. Follow him on Twiitter @simonjlevien.