In just a few short years, legalized gambling in Virginia has exploded, most notably with the opening of casinos across the state and booming online sports betting. 

However, are Virginians — and the state itself — truly prepared for the fallout that can follow when people slip from casual fun into problem gambling, with far more at stake?

“As a state, we went from zero to 60 very fast,” said Carolyn Hawley, Ph.D., professor in VCU’s Department of Rehabilitation Counseling. “And yet, our safety net for people developing gambling problems is playing catch-up.”

Hawley and her team, through the Virginia Partnership for Gaming and Health (VPGH), housed in the department, are working to change that through a robust system of outreach, screening, treatment and – most importantly – peer support where people in recovery guide others toward help. The goal of every initiative is to meet people where they are, whether they’re calling a helpline, sitting in prison or even visiting a primary care clinic. 

“Gambling addiction is still so misunderstood,” said Hawley, who also heads the nonprofit Virginia Council on Problem Gambling. “It activates the same pathways in the brain as other diseases of addiction, and it can be just as devastating.”

Gambling is everywhere

Part of what makes the issue so urgent is how accessible gambling has become and how few people recognize when it crosses a line.

“We hear it all the time: ‘Oh, sports betting isn’t gambling,’ or ‘The lottery doesn’t count,’” Hawley said. “But it’s all gambling. And people don’t always realize how easily it can become a problem.”

Compared to other states, Virginia’s gambling laws are relatively young. Historical horse racing became legal in 2018, with sports wagering and casinos following in 2020. Today, three casinos operate across the state (with more in the pipeline), and mobile apps make it possible to bet 24/7.

Over the past half-decade, VCPG has seen a 200% increase in people seeking help for gambling problems. Internet-based gambling (including illegal forms) is now one of the top gambling types reported by Virginians, which is often indistinguishable from legal apps in appearance and marketing. “Some of them even have celebrity endorsements,” she noted. “People, including youth, don’t realize they’re playing on unregulated sites.”

That’s why the VCU-based group is strongly advocating for prevention and educational outreach. “We’re trying to get into primary care systems, schools, prisons – any place where someone might already be showing signs of a problem,” she said. “We want to screen early, raise awareness and intervene before things spiral.”

‘You’re not alone.’

Peer recovery specialists, first hired by VCU in 2023, are at the heart of Hawley’s work. These specialists have lived experience with addiction and are trained to support others just beginning their recovery journey.

“They’re the ones who can say, ‘I’ve been there,’” said Hawley, who started studying problem gambling early in her career at the request of a mentor. “They know the shame. They know the fear. And they provide hope.”

According to the VPGH, 93% of individuals who respond to a referral from Virginia’s gambling helpline and others are connected with a provider within one week. She calls that notable in a mental health system often marked by long wait times and overwhelmed providers.

She credits the university’s hybrid public-private model for that efficiency. “Any licensed provider or certified peer specialist in Virginia can be part of our network, and we train them for free,” she said. “That’s allowed us to grow fast and connect people to care quickly.”

The impact has been powerful. “Before, only about 15% of people who called the helpline would follow through with treatment,” she said. “Once we added peers, that jumped to 45%, and it’s gone even higher since.”

Gambling is a mental health condition

Many people still view gambling addiction as a weakness, not a diagnosable mental health condition. Hawley says that stigma is one of the biggest barriers to seeking help.

“ With gambling, people think it’s a character flaw,” she said. “That prevents people from reaching out, and, sometimes, by the time they do, they’ve lost everything.”

Signs of addiction include increasing time and money spent gambling, cravings, lying about gambling habits, withdrawing from other interests, and borrowing money to cover losses. Even physical withdrawal symptoms, such as sleeplessness and irritability, can present as with substance use disorders.

“We’ve had people come to us in extreme debt, isolated from family, even with thoughts of self harm,” Hawley said. “It’s critical that they know there’s help, and that recovery is possible.”

Recovery may look different for each person. While abstinence is often the goal, some begin by trying to reduce their gambling. “Most eventually realize it’s all or nothing,” Hawley said. “But we work with people where they are, using motivational interviewing and cognitive behavioral therapy to help them regain control.”

Growing a system with limited resources

Despite surging demand and impressive outcomes, funding remains a major challenge. Virginia currently allocates just a sliver of its gambling tax revenue to problem gambling services, far less than peer states such as Maryland and Massachusetts. The state’s three casinos generated $732 million in revenue in 2024, a jump of 32% over the previous year.

“In February alone, tens of millions of dollars in casino revenue were generated in Virginia,” Hawley said. “You know how much went to the treatment fund? A sliver of that. It’s outrageous.”

Even worse, the state’s problem gambling hotline – a key entry point for support – has received no direct funding.

But Hawley continues to push for new opportunities. She’s also hopeful the state will take steps to consolidate gambling regulation – currently spread across disparate agencies – and create consistent messaging and safety practices.

“People love to gamble. The state makes money from it. We’re not saying get rid of gambling,” she said. “We’re saying: Let’s do it responsibly. Let’s make sure people have the support they need when it stops being fun.”

If you or someone you know is struggling with gambling, help is available.
Call the Virginia Problem Gambling Helpline at 1-888-532-3500 or visit vcugamblinghelp.org.