March Madness tipped off this week, a collection of 67 single-elimination basketball games that not only will crown a champion in 2½ weeks but also draw billions of dollars in sports bets.
Young men are particularly at risk of developing gambling problems, experts say.
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 so many games comes more opportunities to place bets, including live, in-game wagering on numerous sports betting apps at your fingertips.
Perhaps it’s no wonder the American Gaming Association estimates about $3.3 billion in legal bets will be placed on tournament games this year — a 54% increase over the past three years.
The Fairleigh Dickinson survey’s director, Dan Cassino, a professor of government and politics, said men who reported problems didn’t solely attribute them to sportsbooks, but online sports betting has made gambling more addictive, he said.
Events such as March Madness exacerbate it, he said.
“You cannot 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,” he said.
Online betting has changed the game, said Josh Ercole, executive director at the Council for Compulsive Gambling of Pennsylvania. The center monitors a statewide gambling hotline that has spiked in calls since online sports betting was legalized in 2018, Ercole said.
In 2025 the center took nearly 3,000 calls, 403 of which mentioned online sports betting, according to its yearly data report.
“It’s really become a blurred line where sports betting and gambling don’t live in separate worlds,” he said.
‘My identity is more than just being a gambler’
Dan Trolaro knows firsthand the pitfalls of sports gambling.
He began betting as a coping method after the 9/11 terrorist attacks. Friends of his who worked in New York died in the attacks.
“I saw things that I wish I didn’t see, and that impacted me. That kind of locked me up 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 this thing I now need to do to feel better.”
He began embezzling money from people he was financially advising to feed his gambling habit and served 4½ years in state prison after turning himself in.
While in prison, Trolaro reflected, tried to repair broken relationships and turned to faith.
He decided he wanted to help people struggling like himself. He completed a master’s degree in psychology while on the Intensive Supervision program, an inmate reintegration program.
Since 2016, he has worked in various gambling recovery roles. He now works as managing director of Education and Responsible Play at IC360, a technology consulting firm specializing in integrity and compliance in sports betting.
Today, Trolaro runs education workshops for college athletic departments across Pennsylvania and mentors professional and amateur athletes about risks.
He said understanding a person’s relationship with gambling is essential to reducing harm.
“We want to equip them with knowledge, and we want to equip them with an understanding of how to enjoy gambling as a form of entertainment in a safe, responsible way, if they choose to,” he said.
He also shows them where to turn for help.
Social expectations might draw young men to sports betting, he said.
“It’s cultural. I think it’s normative. I think it’s societal. It’s ubiquitous. It’s throughout culture,” Trolaro said. “You start in high school with your parents or your friends, and, in college, you have a group of friends and it’s something to do.”
Cassino researches social concepts of masculinity and how they affect male actions.
He said sports betting tends to attract men because it is allows them to prove expertise in social settings.
A modern problem
A 2026 American Gaming Association study found that sports betting advertisements actually have decreased 27% across TV and social media platforms since 2021.
Still, a 2025 study by Birches Health found that some form of sports betting advertisement was seen every 13 seconds during the 2025 Stanley Cup Finals — including on player jersey patches, broadcast studio integration and logo placement.
The gaming association study said the NHL has the most saturation of ads and that NBA broadcasts typically contain around 100 betting references.
Despite ad exposure, Cassino said it’s impossible to attribute increased gambling problems to it. But the ease of access and mid-game bets can be blamed.
Before the advent of online betting, people would have to make a bet with a bookie, unless they were at a sportsbook location such as a casino. Cassino said that form of gambling is far less addictive than online betting.
“If I make a bet on the outcome of a game, well, I’m only getting one bet in there, and I’m not getting instant feedback, and we know what makes gambling addictive is the instant feedback element,” Cassino said. “The online sportsbooks have realized this. And so that’s where we’re getting not just betting on the outcome of a game but betting on what player is going to do something during which match.”
What used to have small barriers — traveling to the casino, withdrawing money and sitting at a table or kiosk — is now frictionless, Trolaro said.
“When you’re playing games online, they’re also more immersive. They tend to keep you more engaged,” Trolaro said. “Having it in your pocket and being accessible can definitely lead someone down that path of problematic use a little bit quicker.”
Age and warning signs
Jody Bechtold, founder of Pittsburgh counseling center The Better Institute, said Pennsylvania allows interactive gambling as well as online sports betting. Interactive gambling could include sites that provide a simulated live casino setting or real-time sports betting while games are in progress.
The annual Pennsylvania Interactive Gaming Assessment study for 2025 found that up to 30% of Pennsylvania adults reported online gambling and that 78% of people who gambled solely online were men.
More than 50% of National Problem Gambling Helpline calls mentioned online gambling as a primary concern, according to the PIGA study.
Legal age limits also don’t always stop some bettors, Bechtold said. And, in some cases, she said, some turn back to in-person bookies.
“We’re seeing so many college-age students getting into significant trouble with sports betting because they’re betting with what they call bookies on campus,” she said. “So, they’re bypassing the traditional Draft Kings, FanDuel, BetMGM because they’re not of age.”
Young people struggle more to self-regulate anxiety, cope with discomfort, control impulses and understand the concept of money than in the past, she said.
“This current cohort that is in college right now is struggling more than we’ve seen since covid,” Bechtold said.
More state regulation and advocacy for consumer protection is needed, she said.
Trolaro said people should address their personal relationship with gambling.
“If it starts to create harm, if you have a family history of addiction specific to gambling, we need to have these conversations so people are aware, because there’s not enough education,” he said.