After noticing a doubling of the demand for treatment for gambling addiction, Capitals I went looking for information about where care is provided in São Paulo. Even though the state became the first in the country to introduce a vocational training and treatment program in appropriate centres, the experience of reporting in search of information was a real odyssey.
Combined with the widespread lack of preparedness and misinformation present in six of the seven public health facilities visited, 30 kilometers were covered in this battle. Even a joke titled “Little Tiger Addict” With laughter, the reporter heard a public official approaching.
The team only received concrete guidance at the seventh address visited. Before this, a series of failed trends in Basic Health Units (UBS), Psychosocial Care Centers (Caps) and other public health institutions had to be addressed.
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Conditional closure.
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Metropoles visited seven public health units in search of information on the treatment of gaming addiction. It was only in the last report that the report provided concrete guidance and the possibility of treatment
Gabriel Lucas / Metropolis2 of 8
AD Pinheiros hats
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Butanta hats for adults
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Villa Mariana Integrated Mental Health Care Center
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Oba Verguero
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UPS Humita
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Itapeva hats
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Caps Villa Monumento
Personal group
The search began in Caps Ad Pinheiros, west of São Paulo. Right at the entrance, the reporter told the audience that he was looking for information about treating gaming addiction. The woman reported that the service was not available there, and after asking her where she lived, she pointed to the company Caps Adulto Butantà, also located in the western region.
After traveling approximately 5 km, the report was received by the security guard at Caps Adulto Butantà. He said those interested should look for the state government’s Center for Integrated Mental Health Care (Caism), in Villa Mariana, south of the city, and provided contact details for the location. The team sent a message to the number – which does not accept calls – but was answered after only four days.
More obstacles
The road between Caps Butantà and Caism Vila Mariana is about 12 km away. By public transport, the journey takes more than an hour. the Capitals He was also unable to obtain specific information immediately. Back at the entrance, the report was informed that Caism offers treatment for gaming disorder, but only on referral from other health units. The advice was to look for the emergency care unit in Vergueiro (UPA), 2 km away.
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site, Capitals He was informed that, being a UPA, care could only be provided in the event of an “outbreak,” and was advised to seek a basic health unit (UBS).
After a journey of about 2.5 km, the report arrived at UBS Humaitá, in the central area of the city, where the advice was to look for another Caps unit, the third on this route, on the recommendation of Caps Itapeva. The route was another 2.5 kilometers and the team was greeted by an attendant who was unable to provide information.
It was the seventh and final attempt at a fourth international, at Villa Monumento, south of São Paulo, which was chosen after a personal recommendation. Only in this unit did the report obtain specific information about treatment.
The staff informed that the request was never registered on site, but after consultation, they sent the report for examination which will determine whether the service will be started on site or sent to another institution.
“time bomb”
According to the Municipal Health Department (SMS), the number of consultations related to gaming disorder has tripled in the past three years.
The capital recorded 114 consultations related to disorder gambling between January and September 2025 at UBSs and CAPS. In 2024, 67 consultations were conducted compared to 35 consultations in 2023, representing an increase of 91%.
Demand has also grown for the outpatient gambling program at the Psychiatric Institute of the Hospital das Clínicas of the University of São Paulo School of Medicine (IPq-HCFMUSP).
The USP Reference Center began treating 66 patients in 2023. The following year, screenings were suspended due to high demand, and the number of enrollments rose to 191. Screenings are still suspended today and the waiting list is 285 people.
“We have a long waiting list. We are creating a task force, but it is very complicated because the demand is very high (…) We are sitting on a time bomb and it will explode. The SUS will not be able to cope, it does not have the professionals for this and it will become more complicated,” warned psychologist Edilson Braga, researcher at the outpatient clinic for gambling disorders, at IPq.
Sports betting and online casinos were legalized in Brazil in 2018, passed through a Boom Between 2021 and April 2024 with a market growth of around 730%, but it was only regulated by law in 2023.
Last year, 40 million Brazilians placed at least one bet or game online, according to a survey conducted by the National Confederation of Retail Directors (CNDL) and the Credit Protection Service (SPC Brasil).
The Central Bank estimates that R$240 billion will be allocated to betting houses in 2024, and in the first quarter of this year alone, this fund was irrigated by R$90 billion.
Gambling addiction
The Gambling Disorders Outpatient Clinic at Hospital das Clínicas prepared 12 questions about gambling addiction. If the answer is yes to five or more questions, it is recommended to seek help.
- When you play, do you come back another day to regain what you lost?
- Have you ever claimed to be making money gambling without actually being, when in fact you were losing?
- Have you ever felt guilty about the way you gamble or the consequences of your gambling?
- Have you ever wanted to stop gambling, but thought you couldn’t?
- Have you ever hidden betting slips, lottery tickets, gambling money, or other signs of gambling from your spouse, children, or anyone else important to you?
- Have you ever argued with the people you live with about how to manage your money?
- Have you ever borrowed money from someone and not paid it back because of your gambling habit?
- Have you ever borrowed money to gamble or pay off gambling debts from banks?
- Have you ever taken money from your credit card to gamble or pay off gambling debts?
- Have you ever exchanged stocks, policies or other securities for money to gamble or pay off gambling debts?
- Have you sold personal or family property to get money for gambling?
- Have you ever used an overdraft or bad check to gamble or pay off gambling debts?
What do those involved say?
the Capitals I contacted the municipal health department about treating gaming disorder in the public network. The Ministry stated that it is promoting the continuous qualification of primary care teams and psychosocial care centers (CAPs) through continuing education procedures, which include case discussion, joint monitoring and training, in accordance with the Ministry of Health guidelines.
“In São Paulo, the 479 Basic Health Units (UBS) serve as entry points for reception and assessment by a multidisciplinary team and refer patients, when necessary, to a therapeutic project. The Psychosocial Care Network (Raps) has 103 Caps, which provide primary care without the need for prior scheduling or referral.”
Regarding the difficulties indicated in the report, SMS stated that “professionals at Caps Butantà will be redirected” and that UBS Humaitá “referred the patient to the CAPS Reference”.
The State Department of Health (SES) stated that it “supports the implementation of the policy aimed at a therapeutic approach to gambling addiction, and provides training and support to the mental health teams of the Psychosocial Care Network (RAPS) and primary care throughout the state of São Paulo.” According to the ministry, “In the coming months, measures to train professionals and strengthen partnerships will be strengthened.”
She adds, “With regard to the Center for Integrated Mental Health Care (Caism) Villa Mariana, the Ministry explains that the unit serves patients suffering from gaming addiction. Patients who need this type of care are referred by the Basic Health Network, under the administration of the municipalities.”