The Massachusetts Legislature recently passed a law that effectively legalizes sports betting in the state. Though it's sure to garner quite a bit of profit, many other aspects remain in flux — especially those regarding gambling addiction. Approximately 2.6% of the adult population in the United States has a severe gambling problem, and it's estimated that over 80% of people who suffer from some type of gambling addiction never seek treatment.

Keith Whyte, executive director of the National Council on Problem Gambling, joined Arun Rath on GBH’s All Things Considered to give some more insight into the consequences of the recently passed law, as well as options on how to treat gambling addiction. What follows is a lightly edited transcript.

Arun Rath: So before we talk about the law in Massachusetts, I almost feel like the debate over this was almost more over how the law is going to get carried out — and it didn't seem like there was a lot of conversation about people facing problem gambling and how they would be affected by this. Can you give us just a broad sense of what people who have gambling problems, what it's going to mean for them in Massachusetts to have legalized sports betting?

Keith Whyte: Sure. And I do think a lot of those conversations were going on behind the scenes, and certainly at the legislative level. There was a great deal of interest among legislators about measures to prevent addiction and mitigate the impact of legalized sports betting. And one of the reasons that that conversation was able to happen there is the exemplary work that the Massachusetts Council of Gaming Health did around the [new] casino laws. Massachusetts is better positioned to deal with the expansion of sports betting than, probably, any other state due to the work that's been done over the past six, seven years on casinos.

Rath: And I want to talk a bit more about this — well, help us with the terminology first. There is this thing that's called "self-exclusion." Tell us what that is, how that works with the law and how that helps people who are facing this?

Whyte: Well, voluntary self-exclusion is a great concept in that it allows someone to say, "I have a gambling problem and I am entering into this agreement with the gambling operator, a casino, a sportsbook, even in some cases, the lottery. And what I would like you to do is to keep me off your premises, take all reasonable efforts to prevent me from gambling further. And if I'm caught, then escort me off the property and hopefully into treatment."

And so these self-exclusion programs are powerful because it's initiated by the individual themselves. It's someone who's taking responsibility for their problem, but then also asking those who profit the most from gambling to share that responsibility.

Rath: And is that something that has worked in other states? And talk about how it may have worked so far in Massachusetts.

Whyte: I think there are some real concerns about how self-exclusion works. In some cases, it may place too much responsibility on an individual who may have an out-of-control gambling problem. In some cases, it may well let the operators off the hook — because, again, they're placing a lot of burden on the individual. We know in a jurisdiction like Massachusetts, where there are lots of options just across the border, as well as illegal offshore gambling websites, that self-exclusion — which is often state-specific — there are some gaps.

But probably the most important one is that people who self exclude should have problem gambling treatment that is available, accessible, affordable. And while that is the case in Massachusetts, it is not the case in surrounding jurisdictions, much less nationwide. So you really have to have a strong, comprehensive problem-gambling services program to make self-exclusion effective.

Rath: And talk a bit more about that because the details, I believe, are still being worked out in this. I don't think that there will be sports betting until late this year, maybe early next year. What would be the ideal way for it to be carried out in Massachusetts once sports betting becomes legal?

"We may be able to craft an even better safety net for people with gambling problems using this technology that the gambling industry has adopted."
Keith Whyte, executive director of the National Council on Problem Gambling

Whyte: The technology of sports betting is such that it can have a lot of negative effects, obviously. You know, it's highly available. It's on your phone. It's 24/7. It's rapid. But that same technology can also be used to do things like have a, perhaps, statewide self-exclusion list that is tied to your phone, it's tied to your credit card that is shared by all the operators in Massachusetts. And so, you know, with a one-database approach, if you will, you might voluntarily exclude yourself one time, and that information could be shared but protected by all the gambling operators in Massachusetts. So it does create more of a safety net with fewer gaps in it.

That technology can also provide reminders. We've even seen apps where the warning will go off if you're going near a casino where you've excluded from. So you know, it's a cat-and-mouse game with the technology. The technology can increase gambling problems, but it can also provide better services to prevent and treat. It depends on how the state gambling commission, you know, what responsible gambling efforts they require. It depends on the Department of Health to really make sure treatment's available. So there's a lot of stakeholders in this, but working together, we may be able to craft an even better safety net for people with gambling problems using this technology that the gambling industry has adopted.

Rath: In Michigan, where sports betting is legal, their self-exclusion is for a two-year duration — before it had been a lifetime-only ban. Can you talk about how you work out what's right, what's too harsh, what's the right amount of time?

Whyte: Well, you've hit upon one of the central questions of self-exclusion. There's not a whole lot of research to tell us what's more salient — a year-long, versus two years. Is that different from five years? Many jurisdictions offer lifetime. Some jurisdictions offer only lifetime, which we think is too onerous. We think it discourages people with gambling problems from seeking help. So this is partly a call for more research, but it's partly a call to say that, if you're having a severe gambling problem, getting onto the self-exclusion list gives you that time to sit down in a calm state of mind, then decide going forward: what's the best option for you?

So, yes, we don't know exactly what the best menu of options to offer excluders is, but it's probably a one-year, probably mid-term, a five-year and that there should be a lifetime option. Because for some people, this is a chronic disease that is never cured, you're only in recovery. And we need to honor that, those who feel that way, and make sure that if they ban themselves, they are able to do so for life.

Rath: We're talking about so many people, but for the majority of people that we mentioned at the top of this — that most people don't seek help who are facing severe gambling problems — What about the people who are not able to ask for the help in terms of self-exclusion? What are your fears about what might happen with them once this comes on the books or what can be done to help them?

Whyte: We certainly think that young men, especially young men of, interestingly enough, higher education and higher income are much more likely to bet on sports and much more likely to develop problems for betting on sports.

Their family members, their employers, their friends. Problem gambling is an addiction, much like drug abuse, where it's not just the individual who's negatively impacted by it. It impacts anywhere from 17 to 25 members of their family and community. And the substance that problem gamblers abuse, if you will, is money. And so you can have people who've lost millions and millions of dollars, who've embezzled and stolen to feed their addiction. So it can be a devastating disorder. And those impacts ripple to the community and society at large.

So Massachusetts has to continue to carefully weigh the cost/benefits of expanded gambling, and spend as much money mitigating possible increases against problems as the operators do promoting and marketing.