Legalized sports betting is now live in Massachusetts. And while some Massachusetts residents — including high-profile politicians and sports figures — have already jumped into the game, gambling comes with risks. Odessa Dwarika, the chief program officer at the Mass. Council on Gaming and Health, joined GBH Morning Edition hosts Paris Alston and Jeremy Siegel to discuss. This transcript has been lightly edited.

Paris Alston: For those who are unfamiliar with the work that the Council does, can you tell us a little bit about it?

Odessa Dwarika: We work to make sure that people are able to gamble safely, and that means having prevention, harm reduction and treatment for those who are experiencing gambling harm, and support for their families as well.

Jeremy Siegel: So now that legalized sports betting is here in Massachusetts in-person, and with online sports betting coming soon, how does your responsibility change? I imagine that essentially translates to a bigger workload.

Dwarika: Yes. I mean, if you look at the other states where sports betting has gone live, you see higher levels of gambling harm, more people calling the help lines, more people experiencing distress. There are folks who really have never gambled before that are now going to start gambling because of sports betting. And they love sports and it's become part of the culture. So we are really trying to ramp up.

Alston: So Odessa, take us back to some of the initial conversations around bringing legalized sports betting to Massachusetts. I'm curious what the role of the council was in those conversations and whether you all were in favor of that happening.

Dwarika: So we are always neutral on legal sports betting. We know that the majority of people are going to be able to gamble safely. But the issue is that a gambling disorder is so devastating for about 2% of people who experience it. So we want to make sure that protections are built in to those expanded gambling laws.

Siegel: What can you tell us about how a gambling problem might develop? You mentioned you're concerned that now that sports betting is legalized, you might have people who otherwise wouldn't be gambling, you know, engaging in the market now. How can someone tell if they or someone they know, are developing a problem?

Dwarika: Well, it's a good question because I would say that gambling is the most hidden addiction, and that very often folks around them don't know there's a problem until pretty late in the game. There's no red eyes, a smell on the breath, it doesn't show up on a test. So we want to look out for things like people who are constantly thinking about gambling, talking about it all the time, even when they're not gambling. Is there secrecy? Are you finding yourself kind of hiding how much you're gambling from your loved ones? Are you experiencing withdrawal when you can't gamble? There's withdrawal in gambling: stomach pain, irritability. Is it causing problems in your work life, your personal life?

And then you have tolerance. Tolerance in gambling and looks like needing to bet larger and larger amounts of money to get that same feeling. And then chasing losses: now, this can seem really irrational to some, but it's when you lose money, and you're spending more money trying to get that money back. When you see that happening, that's a real red flag. I mean, gambling isn't fun anymore. So that feeling of starting gambling to escape, not feeling well, stressed, anxious and wanting to gamble to kind of check out.

"I would say that gambling is the most hidden addiction, and that very often folks around them don't know there's a problem until pretty late in the game. There's no red eyes, a smell on the breath, it doesn't show up on a test."
-Odessa Dwarika, chief program officer, Mass. Council on Gaming and Health

Alston: That makes sense. And you mentioned it being hidden there, and I imagine with, as Jeremy mentioned, with online rolling out later this year in March, it's going to be even more hidden for some people. Do you all have rising concerns about that?

Dwarika: Absolutely. When you have accessibility 24/7, you can bet on games all around the world. You can bet all night if you would like to. So there's no stop to sports betting. It's on your phone, it's on your computer, it's wherever you are. And that definitely increases the risk to it.

Siegel: As we've been talking about the launch of legalized sports betting in Massachusetts, I've kind of been thinking about the way that we talk about it. You know, it's obviously a huge announcement, but conversations can err on celebrating something like this happening. And I think it's similar to conversations that some people might have about something like alcohol, where for a lot of people it's fun and obviously it's legal. And now sports betting is legal, but you tread the line of knowing that there are people for whom it is a major problem. How do you think we should be having conversations about gambling, especially now that sports betting is legalized in Massachusetts?

Dwarika: Well, I think alcohol is a really good analogy because we know alcohol causes huge amounts of damage and harm, and yet it's something that many people can do pretty safely. So I think that's a great analogy, and I think that we really need to start talking about gambling addiction. There's such a stigma around it. There is a lack of understanding. Up until recently, people would still use the words 'degenerate gambler' for somebody who's struggling with a gambling addiction, and that shows a real moral judgment. It's a lack of understanding that this is an addiction, much like alcoholism or other substance misuse. And we have to start looking at it as such.

Alston: So in that same vein, Odessa, what can people do, whether it be individuals or the folks around them, before, during, and after or maybe heading to a casino to place a bet?

Dwarika: I think it's always helpful to set a money limit, spend limit, and also a time limit, because of both of those are really important. And there's a lot of tools to do that. There's tools in the apps that you're going to have. They're calling them responsible gambling tools. In the casinos in Massachusetts, you have Play in My Way, which has a feature you can add to the cards where you set a budget and it sends you messages about spend. And those are great because when you see that, you start pushing those and start ignoring those limits, that's when it's a red flag and you need to step back and kind of assess what's going on, and do you need more resources and more support?

If you or someone you know is struggling with problem gambling, help is available at 1-800 327-5057 or MAHelpline.org.