Rising toll: Are NC sports betting protections enough?

By Anne Blythe and Michelle Crouch

When Jessica Auslander set up her counseling practice in the Charlotte/Weddington area almost a decade ago, she was a true pioneer in her field.

As the only gambling addiction specialist in the state holding the premier certification from the International Gambling Counselor Certification Board, her practice quickly became a bustling, vital resource. “That was great, let me tell you,” Auslander said.

And that was before sports betting in North Carolina had become legal. Now that it is, she rarely has an open spot for the significant surge in demand for problem gambling services.

The gambling landscape in this state has undergone a seismic shift over the past two years. Sports fans who like to wager on game outcomes, player statistics and a host of other events no longer have to rely on offshore websites or local bookies, or to travel to gambling meccas like Las Vegas.

Instead, anyone 21 and older can pull out a phone and legally wager on game winners, point spreads and prop bets such as a player’s total points or rebounds.

The nearly $13 billion in wagers placed from North Carolina in 2024 and 2025 not only has generated more than $262 million in new tax revenue for state coffers. It has also exacerbated a swelling public health threat characterized by more people in need of help for gambling problems in a counseling and treatment infrastructure that’s ill-equipped to handle the flood. Calls to the problem gambling hotline are up more than 300 percent since 2021, according to state data. 

“We need more education so people understand exactly what problem gambling is and isn’t,” Auslander said. “And then we need to increase prevention and treatment resources when people are affected.”

Is $2 million enough?

The law that the General Assembly approved to legalize sports betting requires that $2 million of the tax proceeds go annually to the state Department of Health and Human Services for gambling addiction education and treatment programs. Unlike in other states, that amount does not increase as betting revenue grows. In North Carolina, the flat rate has been less than 2 percent of the taxes collected from sports betting operators each year. The money is divvied up among treatment services, counselor training, support for the NC Problem Gambling Helpline and research.

Counselors, gambling researchers and public health advocates say that set dollar amount falls woefully short of what’s needed.

“It’s a penny compared to what these companies are making off North Carolinians,” Kelly Crosbie, director of the DHHS Division of Mental Health, Developmental Disabilities and Substance Use Services, told NC Health News.

In its budget last year, the state Senate proposed doubling the sports-betting tax to 36 percent, but the House kept the rate at 18 percent. Lawmakers never reached agreement on a final budget.

Several other states have bumped up their tax rates since legalization, with at least three now collecting about half of sports book revenue.

Other states ban prop bets

North Carolina’s sports betting law includes more than 40 regulations designed to encourage responsible gambling, including requirements for “time out” tools, allowing customers to set voluntary spending limits and a ban on advertising that targets minors.

Crosbie said more enforcement is needed to ensure that companies are complying, particularly when it comes to age verification, marketing practices that target minors and other safeguards.

“We don’t really have robust oversight of gambling companies here in North Carolina,” she said.

Another step North Carolina could take, Crosbie said,  is to ban so-called “prop bets” on individual college athletes, as some states have done. Critics contend that this type of bet can fuel anger toward players, increasing the risk of harassment or manipulation. North Carolina NCAA athletes have reported being targeted on social media by bettors upset over their performance.

At least 17 states have banned prop bets on college athletes. Other states allow prop betting on out-of-state teams but strictly ban them on schools within their borders.

NCAA president Charlie Baker has been actively lobbying gaming commissions to ban prop betting on college athletes amid reports of harassment by bettors, and his message has resonated with some. 

In North Carolina, lawmakers from both sides of the aisle in the state House of Representatives filed a bill last April to prohibit prop bets on college and amateur sports. They also proposed banning in-person sports wagers at facilities before, during and after college games there. 

Although the bill never gained enough momentum to get a vote, it could come up again when lawmakers reconvene in April.

Proposed limits on ads, live betting

Lawmakers in several states are considering other avenues to help rein in problems they’ve seen emerge after they legalized sports betting. 

In Massachusetts, for example, a proposed bill would limit gambling ads during live sports broadcasts and cap wagers at $1,000 per day. 

New York lawmakers are considering a slate of proposals to restrict betting, including measures to require operators to provide bettors with monthly statements detailing their gambling activity and to eliminate live betting during a game.

Shane Kraus, a psychologist and addiction researcher at the University of Nevada-Las Vegas, said live betting is one of the most problematic aspects of sports betting because it allows wagers to be placed continuously, with little time to think, which makes it easier for gamblers to chase losses.

People also make riskier bets during games when their emotions are high and when they’re more likely to be drinking, he said.

“If live betting is banned, it doesn’t mean people with problem gambling won’t set 40 parlays before they start,” he said, “but it would solve a lot of the problems.”

Research to guide policy 

Michelle Malkin, sometimes described as a“true pioneer in the field of gambling research”, is a professor at East Carolina University who directs the Gambling Research & Policy Initiative. Her work focuses on gambling behaviors, harms among marginalized communities and risks. The initiative she founded and leads focuses on reducing gambling-related harms and attempts to guide policy change through academic research.

The DHHS Division of Mental Health, Developmental Disabilities and Substance Use Services has helped fund some of that work. In 2023, the same year lawmakers took legislative action to authorize sports gambling, the state awarded the ECU initiative a $750,000 grant.

Over the past two years, Malkin said, she and her researchers have seen more younger people gambling, in part because it’s become more socially acceptable. They’re also seeing growth in the number of females gambling.

When asked what she would do if she could redesign the sports betting system in North Carolina, Malkin thought for a moment before responding.

“Well the truth is…especially with the internet the way it is today, with the number of apps out there, I would rather see things being regulated by the state than not regulated,” Malkin said. “I would rather there be some safety nets than not. But I do think we should have some of these limitations we have for other things.”

Education is key

Sports betting has become “so socially acceptable,” Malkin added, “that you can’t watch ESPN without the odds showing on the screen all the time. We can’t tell people not to do something that could be risky if we’re saying, ‘Go ahead, do the over-under, here’s the odds.’”

While more regulation might be a part of the solution, education also has to be key, she said.

There should be clear communication about what it looks like to have a problem, how to budget gambling into your life if you’re going to participate and what is an appropriate amount of money given your salary and other day-to-day expenses.

“We haven’t really taught anybody that it can be an addiction,” Malkin said. “No one places their first bets thinking ‘I’m going to go down this pathway.’ So once they start going down that, they think there’s something really wrong with them — ‘Why can’t I gamble and stop like my other peers can? What’s wrong with me?’ We haven’t given them that information.”

The ECU initiative created a curriculum to help educate college students about these issues; it recently was licensed so it can be distributed and used across the country.

“We’ve had these huge curriculum for health classes that people start very young learning about drugs, alcohol, nicotine, all that stuff.” Malkin said. “But nobody’s talking about gambling.”

Malkin would like to see more lawmakers interested in the ECU research.

“If they’re going to be getting as much money as they are … a good amount of it — not just a tiny bit — should be going to prevent and then treat, and ensure that we have the resources for those who suffer.”

As North Carolina policy makers and public health advocates search for solutions to problems exposed during the first two years of legalized sports betting, Auslander has the perspective of working as a gambling counselor in Ohio before coming to North Carolina in 2016.

She came onto the scene not long after Ohio had adopted its 2009 constitutional amendment authorizing one casino in each of the state’s four largest cities — Cincinnati, Cleveland, Columbus and Toledo. Thirty-three percent of the gross revenues from those venues were directed to tax coffers. And of that stream, 2 percent had to go to a problem gambling and addictions fund.

“There was unlimited free treatment as part of that grant from the casino money,” Auslander told NC Health News. “Treating gambling disorder not only helps the financial landscape, but you’re also talking about trying to help save lives.

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