You drive your grandmother three times a month to her favorite casino. As she steps out, she waves a crisp $50 bill in the air and you wish her luck. Four hours later you pick her up. Sometimes she’s up a cool twenty. Other times she’s lost it all. Either way, she’s the same cheerful, untroubled woman you left at the curb. And she never exceeds her budget. Disciplined, responsible, best known for her Boston Cream Pie. But she’s not keeping the casino afloat: a multi-million dollar system built on a foundation of $50 budgets would rapidly collapse. The model doesn’t run on moderation.
Grandma is well adjusted — many of the people in that casino are not. The sobering science confirms this: national epidemiological studies make clear that a large share of casino patrons are statistically far more vulnerable to addiction, financial distress and several mental-health comorbidities than the general population. The foundational National Gambling Impact Study found that the most severe problem gamblers — just over 1% of the population — generate a staggering 30% of casino revenue. However, this figure only tells part of the story. More recent analyses, including research from Massachusetts’ own SEIGMA study, reveal that the industry’s financial model is sustained by a group of high-intensity patrons. When the category expands to include “at-risk” players, many studies find that these groups account for a majority of wagering — typically in the 50% to 70% range, with much higher local estimates in specific models.
My intent here is not to speak about gamblers or gambling establishments. Rather, I focus squarely on those who are left to pick up the pieces. We live in a free nation and Prohibition didn’t seem to work out so well. Likewise, banning legal access to gambling establishments would go just as poorly. But within this model there lies an uncomfortable economic dependency.
The National Epidemiologic Survey on Alcohol and Related Conditions and other reputable studies found that one in six people addicted to gambling attempt suicide, a rate estimated to be up to 15 times higher than the general population. Pathological gamblers in clinical samples have a rate of Major Depressive Disorder that can reach nearly 60%, and an alcohol use disorder rate of nearly 50%. Beyond depression, problem gamblers have one of the highest rates of nicotine dependence of any behavioral addiction. Additional national survey data indicates that problem gamblers are over three times more likely to have a drug use disorder.
In New Hampshire, we have a great many non-profits whose mission is to minister to those afflicted, do we not? We could use more. There is, after all, more than one type of suffering.
While national figures vary, studies consistently show that problem gambling is a significant predictor of financial ruin, with one meta-analysis concluding that a considerable percentage of personal bankruptcies — estimated to be as high as 20% in some regional studies — are directly linked to problem gambling. Problem gamblers are up to 10 times more likely to file for bankruptcy than non-gamblers. This internal crisis inevitably spills outward, creating a wave of social and economic devastation.
Research has consistently shown that over two-thirds of individuals in treatment for gambling disorder report having committed crimes to manage debt or fuel their addiction. Problem gamblers have a lifetime divorce rate over double that of the general population. The National Council on Problem Gambling reports that a single problem gambler negatively affects the lives of at least six to 10 other people, including employers, spouses and children. The level of suffering is deep. The despair is profound.
This is where the Granite State story takes a uniquely paradoxical turn. New Hampshire enacted laws requiring 35% of profits from games of chance to be distributed to qualified nonprofits. Operators are obligated to donate a significant amount of revenue, but they are given unilateral discretion over who they give it to.
According to reporting from the New Hampshire Treasurer’s Charitable Gaming annual report for FY 2024, nearly $39 million flowed from all regulated gaming to charitable organizations. The staggering growth of the charitable gaming machine is not a trickle of revenue, but a flood. In July, New Hampshire casino revenue reached $24.8 million, a 71% jump over the previous year. This massive acceleration means even greater sums of money will be flowing into the hands of nonprofits, worthy and unworthy. Many of the organizations that have received such funding perform heroic and essential work. There are many that do not.
The law is well-intentioned, but contains two critical, and perhaps fatal, omissions. It provides no criteria for how the gaming operators must select the nonprofit recipients. The selection is, by design, willy-nilly. Even worse, the law mandates no reporting on how the money is spent. A charity can receive a six-figure check with no obligation to tell the state, the operator or the public what it did with the money. The system is built on grand trust, but its accountability is little more than the shadow of smoke. At least one New Hampshire nonprofit has never been rejected as a casino partner since the law was enacted, has received hundreds of thousands of dollars in just the past two years, and depends on the casino as its only source of revenue.
This lack of transparency creates a profound moral hazard. Charities accept funds drawn from those most vulnerable among us. In accepting these funds, they become the final link in a chain that begins with documented despair. They are insulated from the source, able to fund what they consider to be good works without ever having to confront the uncomfortable reality of how the money was generated. It is not hyperbole to say they directly benefit from the losses of the most vulnerable human beings among us.
The question for every New Hampshire nonprofit that has accepted these funds is this: does the end—however noble—justify this means? What must our conscience say?
This brings us to the heart of the contradiction. The tens of millions of dollars distributed to local nonprofits are not generated by your grandmother’s $50. They are disproportionately funded by the losses of those who do not share her stability — those for whom gambling is not a pastime, but a pathology.
Let’s follow the money: a sizeable portion of the revenue generated by individuals battling severe depression, statistically at a high risk for suicide, is bundled into a donation. That donation is funneled to a nonprofit whose mission is suicide prevention. The same is true for every other affliction. We are balancing the books on the backs of those battling alcohol and substance abuse, subsidizing our charities with the losses of the suicidal and the depressed. We are extracting revenue from fractured families — and the spouses and children caught in the wake of these addictions. Is it fair to ask ourselves the hard questions? The money is laundered through a well-meaning system, but its origin remains. The funding for the cure is inextricably linked to the perpetuation of the disease.
For board members of New Hampshire nonprofits that receive these funds, this reality transforms a simple donation into a profound test of fiduciary, if not ethical duty. This is not a question of public morality, but one of governance. It demands that you make informed, prudent decisions, give undivided commitment to the organization’s mission, and ensure fidelity to your charter and its stated public purpose.
Can a board be considered fully informed if it willfully ignores the well documented, statistical provenance of its revenue? Does accepting this money truly obey the spirit of promoting community well-being when it is derived from a system that contributes to its harm? Is loyalty fractured when an organization dedicated to alleviating the harms of addiction accepts significant funding from a process that exacerbates it?
The question is no longer one of process, but of moral solvency. Every member of these boards must decide whether the financial health of their organization is worth maintaining by means of a system that creates the suffering they exist to treat. This is a demand for the difficult, necessary and meticulously recorded discussion about this serious conflict. To ignore this conversation is not prudence — it is a profound and unpardonable dereliction of duty.
Bob Comenole is a clinical therapist, former communications specialist and professor. His clinical focus includes trauma and behavioral health. He is the author of six books and has served as an advisor to multiple New Hampshire nonprofits for over two decades.