On Gambling Disorder: A Hidden Crisis in the Age of Online Betting

In this episode of On the Mind, host Dr. Daniel Knoepflmacher speaks with Dr. Jonathan Avery, Vice Chair for Addiction Psychiatry at Weill Cornell Medicine, about gambling disorder — a condition that is far more prevalent than most people recognize, yet frequently overlooked and misunderstood. Dr. Avery traces the history of gambling disorder as a diagnosis and explains the neurobiology behind why gambling can become addictive, including how it activates the brain’s reward pathways in ways that parallel substance use disorders. Their conversation explores how the explosive growth of online and sports betting has expanded the reach of problematic gambling, particularly among younger adults. Dr. Avery also discusses the warning signs clinicians and loved ones should watch for, the shame and secrecy that often delay help-seeking, and the full range of evidence-based treatments available, including psychotherapy, 12-step programs, and medications such as naltrexone and GLP-1 agonists. This episode offers a clinically grounded and compassionate look at a disorder that is hiding in plain sight.