America’s laws on sports betting have been getting increasingly permissive since 2018, when the Supreme Court struck down the Professional and Amateur Sports Protection Act of 1992. My cousin, who is in his early thirties, lives in Colorado, where it was legalised in 2019. In his twenties, he tried college, but never finished. Nor did he show a real interest in anything — including serious romance and traditional employment — except DraftKings, which has been his preferred online game since 2014. Back then, it offered nothing but virtual prizes for success in virtual sports; but as states have legalised sports betting, the company, and others like it, have launched highly lucrative gambling apps.

A hamster-wheel life going nowhere is profoundly boring. Sports betting gave my cousin meaning: suddenly every game, every event — even sports he didn’t care about — mattered. It wasn’t only the outcomes he cared about; he placed bets on various scenarios within the games. He was, and is, hooked. There are hundreds of thousands of men like him: the target audience of sports betting apps.

As of April 2023, 33 states have legal, operational sports betting, and a host of companies — including DraftKings and FanDuel — have expanded to meet consumer demand. Some libertarian-leaning think tanks, including the Cato Institute, argue that betting offers a much-needed source of revenue for financially struggling states. The figures have been staggering — since the Supreme Court’s 2018 ruling, over $20 billion has been spent on sports betting in the United States, with more than $3 billion in state and federal taxes being paid — and they look set to increase. Sportsbook revenue in the US reached a record $7.5 billion in 2022, up 75% from the 2021 total of $4.29 billion.

Unchecked gambling can have devastating consequences for both individuals and communities — consequences that were well-known even before sports betting was available at one’s literal fingertips, at any hour of the day or night. They include financial ruin, relationship strain and increased crime — including organised crime, for which legal betting operations serve as a convenient front for money laundering. Unsurprisingly, The Free Press recently labelled sports betting the “new Oxycontin”.

The comparison isn’t baseless, but the key difference is that Oxycontin ultimately “sells itself”. When people become physically and psychologically dependent on the highly addictive drug, no additional marketing is needed. Chronic gambling, by contrast, is a behavioural addiction, where individuals crave a thrill — meaning that the product has to be constantly refreshed. The apps track user behaviour, which is then minutely analysed by employees looking for ways to keep people hooked.

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In her 2012 book Addiction by Design, anthropologist Natasha Dow Schüll writes that gamblers find themselves adjusting their behaviour based on the features and giveaways provided by casinos, such as in-play betting, cash-out options, or bonus plays. In the decade since, the gambling scene has evolved — from mechanical slots in a handful of states to video slots in nearly all of them, and finally to sports betting on almost every smartphone in the US. The relationship between sports bettors and the growing industry that services them is characterised by a constant interplay, where bettors seek to maintain the ideal balance of dopamine hits, spend, and control, while the industry releases an endless stream of innovations and promotions to draw them deeper into their apps. They dangle special offers to keep time-on-app as high as possible, while draining bankrolls over time — hence the money thrown at new users to convince them to join the service: no one wants to stick around if they lose their wad all at once.

The “zone”, as my cousin describes it, is a state where bettors feel fully absorbed, achieving a balance between risk and enjoyment in which they are perfectly synchronised with the app. He, and enthusiasts like him, have noted that their betting experiences keep becoming “smoother” and more immersive. While data analysts behind the scenes make sophisticated predictions of potential value, this “zone” state keeps bettors anchored in the immediate excitement of the wager, which prevents them from making informed long-term decisions.

Predictably, the rate of pathological gambling in the US seems to be increasing. There was a 45% rise in calls, texts, and messages to the National Problem Gambling Helpline between 2021 and 2022. In New Jersey alone, the state’s Council on Compulsive Gambling’s help hotline has experienced a 200% jump over the past four years. We are staring into a potential epidemic with serious dangers: a report from the UK Gambling Commission revealed that problem gamblers are 12 times more likely to suffer from depression, and the suicide rate among these individuals is considerably higher than among the general population. The argument for ubiquitous, 24/7 sports betting often skates over these facts — as well as the financial costs of this supposedly revenue-boosting exercise. A recent study found that the annual social cost of gambling addiction in the United States is now around $7 billion.

This is partly because gambling addiction is hard to treat. OxyContin withdrawal can often be countered through medication-assisted therapies, while treatment for chronic gambling is slower. It primarily focuses on Cognitive Behavioural Therapy and self-help groups, the aim being to address the underlying thought processes that contribute to the addiction — the very same thought processes that the marketing engines of betting companies are working tirelessly to exploit.

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At the moment, the authorities don’t seem to be taking the dangers of sports betting seriously. The situation does bear a concerning resemblance to the beginning of the opioid crisis, where “deaths of despair” — fatalities related to drug overdose, alcohol, and suicide — were initially overlooked. For years, the addictive potential of OxyContin was ignored, leading to a massive public health crisis. Today, public service messages about “problem gambling” seem to be little more than lip service; state-mandated legal disclaimers are widely disregarded; and policy seems to be moving towards increasing permissiveness.

No one is talking about the best solution to this problem. Prohibition, with exceptions for legacy gambling states such as New Jersey and Nevada, could help reduce overall harm, even if it lowers overall state and federal tax revenues. This policy would aim to reduce the socially unproductive activities that tear apart lives, families, and savings; the focus would shift from profit to public health. Some compulsive individuals would continue to engage in illegal sports betting with seedy underworld bookies, of course, but that wouldn’t make the policy redundant. The era of alcohol Prohibition in the Twenties is often portrayed as a failure, because liquor was still available if you knew where to get it. But research has shown that alcohol consumption decreased significantly during this period, leading to a reduction in alcohol-related deaths and other social problems.

When I put the question of prohibition to my cousin, he shrugged. “It’s whatever,” he said, insisting that this is “just my life right now”. He claimed he would find other ways to “pass the time”, which hints at a deeper, perhaps policy-resistant malaise. Paul Goodman observed six decades ago in Growing Up Absurd that his generation had failed to encourage their kids to pursue a form of “leisure that is not a dismaying waste of a hundred million adults”. Instead, his peers had become television-addicted cogs in an immense system: apathetic and overworked drones unable to make life in America bearable for those coming of age in it. Today, the situation is starker: an ever-expanding class of perpetually online, underemployed defeatists and opted-out NEETs find themselves unable to conceptualise paying off student loans or buying homes. Indeed, there is a specific demographic that seems to be more attracted to sports betting: my cousin’s.

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In this absurd world, to repurpose the analysis of sociologist Max Weber, value-extracting tools like sports-betting apps exemplify forces of calculability and predictability — every game has a betting line, after all — while simultaneously enchanting gamblers with their slightly mysterious nature. Perhaps the underdog will pull through; perhaps my luck, so horrible in real life, is due to change. The suckers whose dollars fill the corporate coffers seem like a lost generation.

What my cousin, and others like him, yearn for is a life of both purpose and enchantment. He desires experiences to rival his grandfather’s submarining exploits in World War II. But societal shifts and technological advancements have created a landscape where opportunities for meaningful adventure, particularly for young men, often seem elusive. In the face of this reality, many, like my cousin, turn to the world of gambling as a means of filling the void. They take their chances repeatedly, hoping that, against the odds, they will find the sense of fulfilment they so desperately seek.

I stopped drinking because I knew I would die, and I wasn’t ready. I went to AA, clinging on to a willingness, if not a pleasure, to live, and recited the dogma. Jonathan Franzen said his friend David Foster Wallace, who killed himself, was so terrified of what he had seen of his id while using, it decimated his trust in his lovability. I understand this perfectly. I know I became a writer to form myself, but I wonder if I invented the person writing these words to disguise the monster that is my true self. I am 20 years sober, and this is my settled state. Fear.

Some addicts think critically about their condition: or they can try. Carl Erik Fisher, a child of alcoholics, is a psychiatrist and he was, during his training, addicted — a phrase that has no settled meaning — to alcohol and pharmaceuticals. He was, “greedily grasping after a new identity for myself”. Fisher used, denied, hallucinated, and collapsed. He believes that denial, a crucial and hitherto mysterious element of addiction, allows the addict to lie more effectively to others, and this makes perfect sense to me. He was tasered by the police in his flat in New York City, “dangerously near the peak of my heart”. He recovered, in the sense that I have: he stopped using. Instead, he wrote The Urge.

It’s a seeking, of course: an attempt to make sense of his life. It is a search for reason because he lost his, and it is as diffuse as his using was simple: just give me more of it. The Urge contains history, memoir, science, miscellanea, literature and polemic. There is a mountain of information out there about drug use — if only we could process it meaningfully — and Fisher read it all, amid his sullen, yet hopeful, quest to return to psychiatry.

It asserts the primacy of the psychiatrist over the primacy of the addict. It is Fisher’s internal conversation with footnotes, and the reader is the listener and, in my case, the patient. Addiction need not, he says — primarily, I suspect, to himself — be a mystery filled with fear.

I found using drugs a return to early childhood state because the feelings I remember are those of childhood: wild freedom; wild hunger; wild sensibility; wild terror. They are life, magnified, and life runs out. Drug use is both a metaphor and a paradigm of the human tension that exists in our consciousness: between the ego and the id (if you are a doctor) and between the sacred and the profane (if you are a priest). It is a truism that they expand our consciousness. For the addict who cannot stop taking them, it expands too much. Then — I speak for me — it dramatically contracts, and that is when I went insane.

But the terror itself moves from the internal life of the addict to society itself. Almost no one here is rational or in control. Most people do not become like Fisher and I, because drugs, he writes, drugs “are not ‘addictive’ in themselves”. They are not the draught of a demon king, then; they need a social hinterland to flourish, which we summon glibly and continually. “Pray for her,” my friend was told when he rang 999 to say I had collapsed with alcoholism, as if medicine had nothing to offer me because I was peculiarly cursed. Yet there is no definitive personality type for a drug addict and no evidence that addiction is genetically determined. Of those who become addicted — those who continue to use long after it is pleasurable and, as AA says, “unto the gates of death” — most get better.

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There is a predictable narrative to drug use. A drug is discovered and sold — morphine, cocaine, alcohol, cannabis, oxycontin, LSD. There is an epidemic, a panic, and a repression: a very metaphor for the id itself. Drug epidemics, Fisher writes, are chiefly a response to “social wounding”, which occur when familiar structures fall apart, and drugs are too-easily available. Native Americans suffered a drug epidemic as their lands were stolen. So did the women of Gin Lane,  as the population moved from country to town. America is suffering one now, chiefly among whites without a college degree. According to Fisher, there were 150,000 “deaths of despair” in America in 2017. Individual recovery, he says, should not be exempt from social change, but that seems remote.

Those with a full life do not need a fantasy one; or at least, not just a fantasy one. The addicted need treatment and societal change but rather we offer criminalisation. This didn’t happen to Fisher or to me, of course. We are both white and middle class. Yet drug laws are used to criminalise and intimidate vast swathes of society. The War on Drugs, Fisher writes, was really a war on some people who use drugs. White women suck down legal pills in their homes, or drunk themselves insensible and, though they suffer, they do so in comfort. Billie Holliday was hounded to her death by racist prohibitionists.

To wound yourself with drugs you need easy access to them, and we have that: the alcohol industry is worth $1.5 trillion and few of its profits go towards rehabilitation. It’s cheaper to punish the addict: for the manufacturers, at least, who through lobbyists, push the fault onto the individual, and the cost onto the state. Four disparate African nations, Fisher writes, have drug policies drafted by alcohol salesman, and I find that more debasing than anything in Thomas de Quincy’s Confessions of an English Opium-Eater.

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Writers tend to make addiction a mystery too thrilling to be solved. Who wouldn’t rather read Hunter S Thompson than ponder the carnage the illegal drugs trade has inflicted on the people of Mexico? The Temperance movement — a drug panic in response to a drug epidemic — commissioned novels like Ten Nights in a Bar-Room and What I Saw There. It was the second best-selling book of the time, after Tom Sawyer. Walt Whitman was paid to write Franklin Evans, a tale of a boy lost to alcohol, which he did, in three days, while drunk. I laughed at this.

Fisher asks: is addiction part of me, or is something apart from the self? Mexican American drug users in southern California, he says, speak of the “tecato gusano” – an indestructible junkie worm that brings evil on the innocent. Addiction, whatever it is, is not boring. It is a battle between good and evil, and within you: something pleasingly self-important for the essentially alienated and prone. I thought of it as a female demon, which now I think was only a strategy to protect the non-demon part: to make her stronger. It was a coping mechanism. I knew it was me. I read Fisher, and I can accept that it was me. Even so, his question is a better way of phrasing the question we have asked for as long as we have used drugs, but have never answered: whose fault is it?

The useful but disappointing answer is we don’t yet know. And perhaps we should stop asking. Perhaps it doesn’t matter. Perhaps it isn’t even a fault. To panic at the altered state of the drug user — to criminalise, to prohibit, to write cautionary, overblown memoir — is to panic at the essential state of being human. And I suspect, that is where the real fear lies.