A significant piece of legislation is moving through the Illinois General Assembly that could reshape how the state identifies, funds, and delivers treatment for one of the most underaddressed addictions in public health. For the hundreds of thousands of Illinois residents struggling with gambling disorder, and the many more managing both gambling and substance use, this bill represents a meaningful shift in how the state recognizes the scope of the crisis.
The Illinois Gambling and Substance Use Disorder Act would formally expand the state’s existing Substance Use Disorder Act to include gambling disorder as a recognized public health issue. It passed through committee with a unanimous vote and continues advancing through the legislature at a moment when the data on gambling addiction in Illinois has never been more urgent.
What Is the Gambling and Substance Use Disorder Act?
The Illinois Gambling and Substance Use Disorder Act folds gambling disorder into the same legal and public health framework Illinois already uses to address substance use disorders. By amending the existing Substance Use Disorder Act, the legislation formally recognizes that problem gambling deserves the same infrastructure of prevention, treatment, and recovery support as drug and alcohol addiction.
Under the bill, the Department of Human Services would coordinate gambling disorder services statewide, covering prevention, treatment, and long-term recovery support. Public awareness efforts would be mandated, ensuring warning signs and available resources remain visible across communities. A toll-free helpline and counseling referral website would give residents direct access to help, and operators would be required to post gambling risk statements on their premises and digital platforms. Grants would also become available to support local prevention and recovery projects, extending the reach of the legislation into the communities where gambling disorder is felt most directly.
How Lawmakers Are Addressing Gambling and Addiction Together
The timing of this legislation is not coincidental. Illinois has experienced a dramatic expansion of legalized gambling over the past several years, and the public health data has followed closely behind.
According to the Illinois Department of Human Services, approximately 3.8% of adult Illinoisans, roughly 383,000 people, currently have a gambling problem. An additional 7.7%, representing approximately 761,000 more residents, are at risk of developing one. Illinois now ranks 14th nationally for gambling addiction severity, with problematic gambling behavior estimated at around 14% among residents aged 18 to 30.
In State Fiscal Year 2025, treatment providers conducted over 64,000 gambling screenings and assessments across Illinois. The state also ranks fourth nationally in total calls, texts, and chats to the 1-800-GAMBLER helpline. Both figures reflect a crisis growing faster than the public health resources dedicated to addressing it. The Illinois Gambling Act is designed to close that gap.
The Link Between Gambling Addiction and Substance Use
The relationship between gambling and addiction is neurological, behavioral, and deeply documented. Understanding this connection is central to understanding why this legislation matters and why treating these conditions in isolation so often produces poor outcomes.
Gambling disorder is the only behavioral addiction classified in the DSM-5 alongside substance use disorders, and that reflects a biological reality. Both gambling and substance use activate the brain’s dopamine reward system in similar ways. The anticipation of a bet, the near-miss, the win, all of these trigger dopamine releases that mirror what occurs with drug and alcohol use. Over time, the brain requires more stimulation to achieve the same effect, producing compulsion, tolerance, and withdrawal. Brain imaging research confirms that both disorders originate in the same area of the brain and share overlapping neurological roots.
The overlap extends beyond brain chemistry. Problem gamblers and individuals with substance use disorders share common risk factors, including high impulsivity, sensation-seeking behavior, early trauma, depression, anxiety, ADHD, and bipolar disorder. Research shows the rate of co-occurring problem gambling among people with substance use disorders is four to five times higher than in the general population. Additionally, 94% of people with gambling problems will have at least one co-occurring mental health or addiction disorder, and people with gambling disorder are approximately six times more likely to be dependent on alcohol or drugs.
The consequences of co-occurring disorders compound quickly. The average Illinois household lost $1,500 in legal gambling net of winnings in 2025, while problem gamblers spent a median of $16,750 on gambling annually. Twenty percent of problem gamblers nationally will file for bankruptcy as a direct result of losses. The mental health toll is equally severe, with suicide rates among problem gamblers 15 times higher than in the general population. When gambling disorder and substance use co-occur, the risk for mental health crisis, financial ruin, and long-term harm increases dramatically.
The Growth of Legalized Gambling in Illinois
In 2019, a landmark expansion bill legalized sports betting, authorized new casinos, and expanded video gaming statewide. Illinois now operates 17 casinos, multiple licensed sportsbooks, and approximately 50,000 video gaming terminals in taverns and convenience stores across the state.
The financial scale is significant. The state’s gaming industry “hold” reached $7.5 billion in fiscal year 2025, generating $2.2 billion in state tax revenue. The industry is also positioned to grow further, with efforts to legalize online casino gaming currently active and Bally’s Chicago set to open as the city’s first permanent casino.
Accessibility has fundamentally changed who gambles and how often. Eight active online sportsbooks and daily fantasy sports platforms are currently available to Illinois residents. Around 80% of gamblers used mobile devices to bet in 2025, and mobile access is directly correlated with higher addiction rates. As one certified problem gambling counselor described it, the legalization of sports betting was like putting gasoline on the fire, with bettors able to move money directly from their bank accounts into gambling apps in seconds.
Understanding Co-Occurring Disorders
When a gambling disorder and a substance use disorder exist simultaneously, clinicians refer to this as a co-occurring disorder, sometimes called a dual diagnosis. Co-occurring disorders create a treatment challenge that neither condition alone poses. If only the substance use disorder is treated, the untreated gambling disorder continues generating stress, financial chaos, and high-risk impulsivity, all powerful relapse triggers. If only the gambling disorder is addressed, substance use continues to erode health and stability.
Dual-diagnosis treatment treats both conditions concurrently within a single, coordinated clinical program and is increasingly recognized as the standard of care for individuals managing multiple co-occurring conditions.
How the Bill Could Impact Treatment and Prevention Efforts
If the Illinois Gambling Act becomes law, the structural impact on treatment and prevention would be meaningful and far-reaching. Formally designating gambling disorder as a public health issue creates state-level accountability and opens doors to funding and clinical integration that have been inconsistently available.
Treatment providers navigating complex insurance billing for gambling disorder services would benefit from clearer classification and state support. State-funded prevention programs would expand, and grants would flow to local organizations. Over the past five years, more than 950 clinicians have been trained to provide gambling disorder treatment in Illinois. The Illinois Department of Human Services has already budgeted $4 million in FY2026 for public awareness campaigns alone. This bill formalizes and builds upon that existing infrastructure.
The Importance of Integrated Addiction Treatment
The advancement of the Illinois Gambling Act puts a spotlight on integrated care, a treatment philosophy in which gambling disorder, substance use disorders, and co-occurring mental health conditions are addressed together by a coordinated clinical team working from a unified treatment plan.
This matters because addiction is rarely a single, isolated condition. The thought patterns, emotional triggers, and coping deficits driving gambling behavior overlap significantly with those driving substance use. A person who manages alcohol cravings but leaves their gambling disorder unaddressed has only resolved part of the problem, and the remaining untreated condition becomes a direct pathway back to relapse. Effective integrated treatment builds a complete clinical picture and addresses all of it simultaneously, ensuring no single condition undermines recovery while another goes untreated.
Gambling Addiction Treatment at NIRC
Effective treatment for co-occurring gambling and substance use disorders draws from a range of evidence-based approaches, typically combined into a personalized plan that evolves as the individual progresses through care.
Cognitive-behavioral therapy (CBT) is among the most well-researched interventions for both gambling disorder and substance use disorders. CBT helps individuals identify thought patterns, cognitive distortions, and emotional triggers driving compulsive behavior, including irrational beliefs about luck, control, and chasing losses. Dialectical behavior therapy (DBT) addresses emotional dysregulation through four core skill areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Motivational interviewing and group therapy round out a comprehensive behavioral approach, providing peer accountability and social connection that individual therapy alone cannot replicate.
For individuals recovering from opioid or alcohol use disorders, medication-assisted treatment is a highly effective component of care. FDA-approved medications such as buprenorphine, naltrexone, and acamprosate reduce cravings and withdrawal symptoms. Notably, naltrexone has also shown clinical promise in reducing the urge to gamble, given the shared role of the opioid reward system in both types of addiction, further reinforcing the logic of integrated treatment.
For individuals managing both a gambling disorder and a substance use disorder, specialized gambling and dual-diagnosis treatment provides the most comprehensive path forward. Depending on individual needs, treatment may occur across different levels of care. An intensive outpatient program (IOP) offers structured, multi-day-per-week treatment while allowing individuals to maintain work and family responsibilities. Outpatient drug rehab provides ongoing support for those maintaining stability in daily life. The right level of care is best determined through a comprehensive intake assessment.
What This Means for Illinois Residents Seeking Help
For Illinois residents struggling with gambling disorder, substance use disorder, or both, the advancement of the Illinois Gambling Act sends a clear message: this is a public health crisis, it is treatable, and the state is working to ensure resources match the need.
Over 80% of people with a gambling addiction never seek treatment. Stigma, shame, and the perception that gambling is a moral failing rather than a medical condition are barriers this legislation is designed to break down. Recognizing gambling disorder as a public health issue signals to those suffering that reaching out is not a sign of weakness. It is the most important step a person can take.
Gambling Addiction Treatment is Available in Northern Illinois
If you or someone you love is experiencing signs of problem gambling, chasing losses, hiding behavior from family, using gambling to escape emotional pain, or facing financial consequences, help is available right now. If substance use is also part of the picture, integrated treatment can address both conditions simultaneously. Contact us today to get started.
