by Anne Blythe, North Carolina Health News
March 20, 2026

By Anne Blythe and Michelle Crouch

When Jessica Auslander arrange her counseling follow within the Charlotte/Weddington space nearly a decade in the past, she was a real pioneer in her area.

As the one playing dependancy specialist within the state holding the premier certification from the International Gambling Counselor Certification Board, her follow rapidly turned a bustling, very important useful resource. “That was great, let me tell you,” Auslander mentioned.

A young man looking at his cell phone with sports team logos, a basketball, baseball, football and money signs swirling around his head. There's a green background with the text: High stakes. A series on sports betting's impact on North Carolina in white letters.

And that was earlier than sports betting in North Carolina had turn out to be authorized. Now that it’s, she not often has an open spot for the numerous surge in demand for drawback playing companies.

The playing panorama on this state has undergone a seismic shift over the previous two years. Sports followers who wish to wager on recreation outcomes, participant statistics and a number of different occasions now not need to depend on offshore web sites or native bookies, or to journey to playing meccas like Las Vegas.

Instead, anybody 21 and older can pull out a cellphone and legally wager on recreation winners, level spreads and prop bets akin to a participant’s whole factors or rebounds.

The almost $13 billion in wagers positioned from North Carolina in 2024 and 2025 not solely has generated greater than $262 million in new tax income for state coffers. It has additionally exacerbated a swelling public well being menace characterised by extra individuals in want of assist for playing issues in a counseling and therapy infrastructure that’s ill-equipped to deal with the flood. Calls to the issue playing hotline are up greater than 300 p.c since 2021, in line with state information. 

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

Is $2 million sufficient?

The law that the General Assembly permitted to legalize sports betting requires that $2 million of the tax proceeds go yearly to the state Department of Health and Human Services for playing dependancy training and therapy packages. Unlike in different states, that quantity doesn’t enhance as betting income grows. In North Carolina, the flat price has been lower than 2 p.c of the taxes collected from sports betting operators every year. The cash is divvied up amongst therapy companies, counselor coaching, help for the NC Problem Gambling Helpline and analysis.

Counselors, playing researchers and public well being advocates say that set greenback quantity falls woefully in need of what’s wanted.

“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, informed NC Health News.

In its price range final yr, the state Senate proposed doubling the sports-betting tax to 36 p.c, however the House stored the speed at 18 p.c. Lawmakers by no means reached settlement on a closing price range.

Several other states have bumped up their tax charges since legalization, with at the least three now gathering about half of sports guide income.

Other states ban prop bets

North Carolina’s sports betting legislation contains more than 40 regulations designed to encourage accountable playing, together with necessities for “time out” instruments, permitting prospects to set voluntary spending limits and a ban on promoting that targets minors.

Crosbie mentioned extra enforcement is required to make sure that firms are complying, notably in the case of age verification, advertising and marketing practices that concentrate on minors and different safeguards.

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

Another step North Carolina may take, Crosbie mentioned,  is to ban so-called “prop bets” on particular person school athletes, as some states have accomplished. Critics contend that this sort of guess can gasoline anger towards gamers, growing the chance of harassment or manipulation. North Carolina NCAA athletes have reported being focused on social media by bettors upset over their efficiency.

At least 17 states have banned prop bets on school athletes. Other states enable prop betting on out-of-state groups however strictly ban them on faculties inside their borders.

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

In North Carolina, lawmakers from either side of the aisle within the state House of Representatives filed a bill final April to ban prop bets on school and beginner sports. They additionally proposed banning in-person sports wagers at services earlier than, throughout and after school video games there. 

Although the invoice by no means gained sufficient momentum to get a vote, it may come up once more when lawmakers reconvene in April.

Proposed limits on adverts, reside betting

Lawmakers in a number of states are contemplating different avenues to assist rein in issues they’ve seen emerge after they legalized sports betting. 

In Massachusetts, for instance, a proposed bill would restrict playing adverts throughout reside sports broadcasts and cap wagers at $1,000 per day. 

New York lawmakers are contemplating a slate of proposals to limit betting, together with measures to require operators to provide bettors with monthly statements detailing their playing exercise and to eliminate live betting throughout a recreation.

Shane Kraus, a psychologist and dependancy researcher on the University of Nevada-Las Vegas, mentioned reside betting is among the most problematic features of sports betting as a result of it permits wagers to be positioned repeatedly, with little time to assume, which makes it simpler for gamblers to chase losses.

People additionally make riskier bets throughout video games when their feelings are excessive and once they’re extra more likely to be ingesting, he mentioned.

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

Research to information coverage 

Michelle Malkin, generally 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 playing behaviors, harms amongst marginalized communities and dangers. The initiative she based and leads focuses on lowering gambling-related harms and makes an attempt to information coverage change by means of tutorial analysis.

The DHHS Division of Mental Health, Developmental Disabilities and Substance Use Services has helped fund a few of that work. In 2023, the identical yr lawmakers took legislative motion to authorize sports playing, the state awarded the ECU initiative a $750,000 grant.

Over the previous two years, Malkin mentioned, she and her researchers have seen more younger people gambling, partly as a result of it’s turn out to be extra socially acceptable. They’re additionally seeing growth in the number of females gambling.

When requested what she would do if she may redesign the sports betting system in North Carolina, Malkin thought for a second earlier than 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 mentioned. “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 essential

Sports betting has turn out to be “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 extra regulation may be part of the answer, training additionally must be key, she mentioned.

There must be clear communication about what it seems wish to have an issue, find out how to price range playing into your life in case you’re going to take part and what’s an acceptable sum of money given your wage and different day-to-day bills.

“We haven’t really taught anybody that it can be an addiction,” Malkin mentioned. “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 assist educate school college students about these points; it not too long ago was licensed so it may be distributed and used throughout the nation.

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

Malkin want to see extra lawmakers within the ECU analysis.

“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 coverage makers and public well being advocates seek for options to issues uncovered in the course of the first two years of legalized sports betting, Auslander has the attitude of working as a playing counselor in Ohio earlier than coming to North Carolina in 2016.

She got here onto the scene not lengthy after Ohio had adopted its 2009 constitutional modification authorizing one on line casino in every of the state’s 4 largest cities — Cincinnati, Cleveland, Columbus and Toledo. Thirty-three p.c of the gross revenues from these venues had been directed to tax coffers. And of that stream, 2 p.c needed to go to an issue playing and addictions fund.

“There was unlimited free treatment as part of that grant from the casino money,” Auslander informed NC Health News. “Treating playing dysfunction not solely helps the monetary panorama, however you’re additionally speaking about making an attempt to assist save lives.

GET HELP FOR A GAMBLING PROBLEM

North Carolina provides free, confidential assist for individuals combating playing and for members of the family affected by it. 

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