Illustrations by Alex Nabaum
Photographs by Mark Ostow
Is Your Health Worth the Gamble?
In court and through proposed regulations, Northeastern Law’s Public Health Advocacy Institute argues that when it comes to sports betting, the public health stakes are too high.
BY TOMAS WEBER
In the spring of 2014, Harry Levant, then a criminal defense and personal injury attorney in Pennsylvania, arrived at the Philadelphia District Attorney’s Office. He was representing no client, and he was not there on business. He was there to turn himself in. Levant explained that he had stolen from his clients: $2 million, to be precise. And the money was gone. Levant, caught in the grips of a pathological gambling addiction, had squandered it in casinos.
Several weeks earlier, Levant’s life was spiraling dangerously out of control. He was staying in a complimentary hotel room above an Atlantic City casino — he was a solid customer — and he had taken steps toward ending his life. “I was about as impaired as a person can be,” recalls Levant. “I had lost my mind, my heart, my soul and my conscience to my gambling addiction.” But then Levant thought of his three children. And instead of committing suicide, he decided to make two phone calls. The first was to a friend, asking to be picked up. The other was to 1-800-GAMBLER, the National Problem Gambling Helpline. The person on the other end of the line explained that the helpline works with the gambling industry to identify individuals who might have a problem. Even in the depths of his crisis, Levant felt something was not right.
“As unwell as I was, I knew something was wrong with a model where an advocacy organization is working hand in hand with the industry. It felt like the fox guarding the henhouse,” says Levant, who ultimately pled guilty to financial crimes, was sentenced to 23 months of parole and eight years of probation, and was disbarred from the practice of law. Levant went to rehab and worked with an addiction psychologist. He found recovery and eventually returned to school to study and train to become a therapist and an internationally certified gambling counselor.
Today, Levant is a mental health therapist, specializing in treating patients with gambling addictions, and recently earned a doctorate in law and public policy from Northeastern University, where his research is focused on bringing a public health response to the gambling industry. He is also the gambling policy advisor to Northeastern Law’s Public Health Advocacy Institute (PHAI), which uses the tools of law and policy to shape responses to public health problems, including gambling addiction. Headed by Professor Richard Daynard, a pioneering advocate who has spearheaded legendary court victories against Big Tobacco since the 1980s, PHAI has set its sights on sports betting — which, in the scale of its harm, reminds Daynard and PHAI Executive Director Mark Gottlieb ’93 of tobacco.
“We view gambling as an addictive product similar to tobacco and alcohol,” says Gottlieb. “We don’t want to see sports betting banned, but we do want to make sure the industry is posing less of a public health risk to consumers.” This, according to PHAI, means a far more robust regulatory framework is needed.
I was about as impaired as a person can be. I had lost my mind, my heart, my soul and my conscience to my gambling addiction.”
Raising the Stakes
Since the legalization of sports betting, gambling has become more ubiquitous and accessible than ever. In 2018, the US Supreme Court opened the door to sports betting in its ruling on Murphy v. National Collegiate Athletic Association, striking down the federal ban on the practice. Since then, legislatures across the country have passed laws welcoming sports betting companies to their states. Today, 38 states and the District of Columbia offer sports betting, with 30 allowing users to place bets online — including Massachusetts, since 2023.
“Much of the revenue from sports betting,” says Gottlieb, “is derived from the small minority of players who are experiencing mental health crises.” Around one in five addicted gamblers, adds Daynard, attempts suicide — and the number of problem gamblers “is growing in leaps and bounds every year. We’re talking about a deadly product.”
Americans have been rushing to place bets online — over $220 billion worth of them since Murphy. During Super Bowl LVIII in 2023, up to 15,000 wagers per second were placed — double the previous year’s peak. And between 2020 and 2023, the number of calls to 1-800-GAMBLER doubled. “The clock is ticking as state after state allows online sports betting,” says Gottlieb.
“If online sports betting had existed in back in 2014,” says Levant, “recovering from my gambling addiction would have been exponentially more difficult.” Instead of having to travel to a brick-and-mortar casino, “I would have just had to reach into my pocket for my next fix. That’s lethal.”
PHAI’s current focus is on advertising. Daynard and Gottlieb hope to force sports betting companies to change how they advertise, promote and distribute gambling products. “Free bet offers, bonuses and gambling promotions are targeted to people in real time, based on large amounts of personal data,” says Gottlieb. “None of that was dreamed of at the time the Murphy case came down. The industry has moved very quickly to create a very powerful, dangerous and addictive product.”
Earlier this year, PHAI filed a classaction lawsuit in Massachusetts against DraftKings, a leading sports betting company based in Boston. Among the plaintiffs are Massachusetts residents Melissa Scanlon and Shane Harris, who jumped at a $1,000 sign-up bonus offered by DraftKings. But the terms of the bonus were as onerous as they were obscure. To receive the full amount (in non-withdrawable credits), Scanlon and Harris would have had to gamble at least $25,000 of their own money over three months — more than $276 a day.
PHAI alleges that the company used misleading sign-up bonuses to deceive the plaintiffs, draw them in and induce them to gamble more money than they otherwise would have. “Even if a customer did see some of those terms, I don’t think that a reasonable consumer would understand what they meant,” says Gottlieb, who argues that the bonus is an example of the enticing but deceptive marketing practices that are common throughout the industry. DraftKings is contesting the lawsuit, which was filed in the Middlesex County Superior Court at the end of last year and is now pending in the Business Litigation Section in Boston.
As part of the law school’s Public Health Advocacy Clinic, students assist PHAI with litigation and other regulatory actions, an experience some have found eye-opening. “So many of my friends use sports betting apps,” says Priyanka Chunduru ’25, who is working with Gottlieb to obtain more data from regulators about Massachusetts gamblers to help shape a public health response. “The apps are so normalized and have skyrocketed in popularity. But now that I have learned to see the issue through a public health lens, I see there is a real crisis going on.”
We don’t want to see sports betting banned, but we do want to make sure the industry is posing less of a public health risk to consumers.”
Doubling Down
The Massachusetts Gaming Commission is responsible for regulating the legal casino, horse racing and sports wagering industries with integrity and transparency. Among those on the front lines is Eileen O’Brien ’96, appointed to the commission by then attorney general and now governor Maura Healey ’98 in 2018. “The legislature made the determination that they wanted to legalize sports wagering because of the existence of the black market — and states bordering Massachusetts had taken steps to legalize,” she says. “My role as commissioner is to take that law and establish and implement a regulatory framework that meets my charge, which I view as allowing operators to maximize profits while minimizing the negative consequences of implementing a gambling product.”
O’Brien, a former prosecutor, is working on encouraging responsible gambling on sports betting platforms. The state already has a self-exclusion list for problem gamblers, says O’Brien. Another idea on the table includes using artificial intelligence (AI) to help companies better identify risky behaviors and offer help. There is also the possibility of introducing spending limits and cooling-off periods.
The legislature made the determination that they wanted to legalize sports wagering because of the existence of the black market.”
O’Brien, a former prosecutor, is working on encouraging responsible gambling on sports betting platforms. The state already has a self-exclusion list for problem gamblers, says O’Brien. Another idea on the table includes using artificial intelligence (AI) to help companies better identify risky behaviors and offer help. There is also the possibility of introducing spending limits and cooling-off periods.
Gottlieb, Daynard and Levant say that from a public health standpoint, state governments working to help gambling companies “maximize profits” is part of the problem. “The primary focus must shift to a public health perspective which seeks to minimize harm by regulating the advertising, promotion, distribution and addictive nature of gambling products,” says Levant, who notes that programs like self-exclusion tend to address harm after it occurs and people have suffered devastating consequences. Daynard, Gottlieb and Levant agree with O’Brien regarding the need to minimize harm, and they seek to raise awareness of the importance of developing meaningful public health regulation and reform.
Raising awareness with policymakers and the public is a large part of that challenge. “One of the public health issues that sports betting presents is that it’s not broadly recognized as a public health issue,” says Daynard. “So there is not the kind of organized opposition to it that you had with tobacco, where there was certainly a broad consensus, at least among professionals, that cigarette smoking was a bad thing.” Now, the press is starting to pay attention. In February, 60 Minutes featured Daynard, Gottlieb and Levant in a story about the perils of addiction when it comes to the online gambling boom.
PHAI is also working with Congressman Paul Tonko of New York on the Supporting Affordability and Fairness with Every Bet Act (SAFE Bet Act). The bill, which Tonko is preparing to introduce to Congress this year, would require sports betting companies to perform affordability checks on their customers, ban sports betting advertising during live sporting events and stop operators targeting users with sophisticated AI. “This bill can be thought of as the opening wedge for taking effective action,” says Daynard. But minimizing the dangers means getting the public on their side. “People need to start getting angry,” he says. “Some people already hate sports betting — they dislike the ads and how they have made watching live sports markedly less enjoyable. But still, most people don’t yet understand what the real dangers are.”
Levant, who last year introduced Tonko to several patients at his treatment program who were struggling with gambling addiction, is driven by a desire to make sure what happened to him, and to his patients, becomes rare.
“The industry-led responsible gaming model pulls people from the river when they’re drowning,” he says. “But our public health framework will create guardrails to ensure people don’t fall in in the first place.”
About the Author
Tomas Weber is a reporter based in London, England.
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