The billion-dollar online betting market has become popular in Brazil. As a result, the number of searches for medical care against gambling addiction has tripled in the past three years in São Paulo, according to the Municipal Health Department (SMS). However, the availability of addiction treatment has not kept pace with increasing demand.
According to SMS data, the capital recorded 114 consultations related to gambling disorder between January and September 2025 in basic health units (UBS) and psychosocial care centers (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 reference center began treating 66 patients in 2023. The following year, screenings were suspended due to high demand, and the number of registrations 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-HCFMUSP.
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 poll (Details below) from the National Confederation of Store Managers (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.
While the financial front of this sector is comfortably garrisoned, the trenches of those suffering from gambling compulsion, in its digital version in this 21st century, are seeking help from the country’s mental health clients before being slaughtered.
The day laborer grills the quitter
As Braga explains, gambling addiction is associated with comorbidities, such as anxiety, depression, and even suicidal ideation. Dependents lose control over the time and money they spend on betting and, as a result, suffer from a combination of debt, family conflicts and unemployment.
This is the routine of day laborer Wanessa Silva, who started betting on “Tigrinho” about two years ago, in São Paulo. to CapitalsShe said she lost a stable job due to her addiction and has spent R$6,000 since quitting her job on betting. Wanessa has not calculated how much she has lost since she started playing, but she claims to have deposited R$8,000 on one platform.
Naturally, Wanessa’s “sinking financial situation” created problems in her married life.
“At first, my husband helped me a lot. But more often than not the day came to pay the bills and I had already spent everything. Or we needed to buy something at the supermarket and I looked at him and said, ‘I can’t help this month.’ He already knew what was going on. My sisters, father and husband thought I had stopped gambling. He warned me that if he found out I was still a gambler, he would ask for a breakup.”
To avoid the worst, she now transfers any money she receives from work to her 13-year-old daughter’s account. Otherwise everything will go to this billion dollar market. The girl is the only witness to her mother’s suffering.
Bolsa Familia
Wanessa’s lack of financial control due to her addiction to electronic games is not an isolated case. The CNDL/SPC Brasil survey indicates that 19% of gamblers allocated their income to gambling; 17% have stopped paying bills and 29% have already had their names canceled due to spending on online gambling.
To make matters worse, 27% of the R$13.7 billion distributed by Bolsa Familia filled betting companies’ funds in January 2025, according to the Federal Court of Audit (TCU). The use of social benefits in gambling recently raised an alarm in the Ministry of Finance, recalling that Boom The fever has been reverberating among dependents since 2021. The ministry has decided that until the end of November, platforms prohibit bets made through accounts used by beneficiaries of the program and also from continuous payment benefits (BPC).
Read also
-
Sao Paulo
The law provides for treatment in Caps de SP for addiction to games such as Tigrinho
-
Sao Paulo
Tigrinho: The woman started betting R$2 and had a debt of R$100,000
-
Brazil
The Senate postpones a vote on increasing taxes on betting
-
economy
The government collects R$7.9 billion from bets in 2025, an increase of 16,000%.
The popularization of betting houses also mobilized the police. Federal Police (PF) delegate Marcelo Massera noted that some platforms were organized with illicit funds. In October, police forces launched Operation “Drug Betting” to dismantle a money laundering scheme involving betting. However, the mental health operation against the online gaming artillery continues far from the streets.
Epic 30 km
Although São Paulo has become the first state in the country to have a vocational training and treatment program in appropriate centers, especially in CAPS, the experience Capitals Searching for guidance on serving in DC was a real odyssey. In addition to the widespread lack of preparedness and misinformation present in public health facilities, 30 kilometers have been covered in this battle. Even a joke titled “Little Tiger Addict” With laughter, the reporter heard a public official approaching.
The route included seven health units over two days of the week, consisting of four HATs, a UBS unit and an emergency care unit (UPA). After a series of unsuccessful directives, it was only in Title VII that specific information and the possibility of starting treatment were offered.
8 photos
Conditional closure.
1 of 8
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
Reproduction/Google Street View 3 of 8
Butanta hats for adults
Reproduction / Google Street View 4 of 8
Villa Mariana Integrated Mental Health Care Center
Personal Collection5 of 8
Oba Verguero
Personal Collection6 of 8
UPS Humita
Personal Collection7 of 8
Itapeva hats
Personal Collection8 of 8
Caps Villa Monumento
Personal group
“Unfortunately, there are no experts in gambling disorders in Brazil. A specialized program such as an outpatient clinic for pathological gambling exists only in the HC (Das Clinicas Hospital), Braga points out.
“Specialists are not prepared, both from a medication management point of view and from a psychotherapy point of view. It is very complicated to care for SUS, and there is a shortage of specialists. Often, they do not know what to do and refer them to us,” says the IPq psychologist.
Treatment in stages
In the outpatient clinic, the first phase of care aims to provide information and support to those on the waiting list. The phase consists of four online meetings.
After that, patients undergo a psychiatric diagnostic protocol until they are admitted for effective treatment.
The researcher explained: “He will visit a psychiatrist, who will prescribe the best treatment for him, especially for comorbidities. We will treat impulsivity, anxiety and depression. At the same time, the patient will undergo group or individual psychotherapy, which lasts about six months. After that, he continues with the doctors and goes to other types of groups, such as quality of life and physical education, for continued support.”
In the event of relapse, patients are referred to the category of repeat offenders, and they can return to psychotherapy as needed.
For IPq specialists, an effective solution to the problem is based on minimal restrictions on betting house advertising, which are identified as triggers of patients’ relapses. Some of them raise exactly the weakness of those with compulsions, with a mischievous voice that wonders whether the desire to gamble has appeared today. Other measures include increased investment in treatment and prevention campaigns that emphasize the risk of addiction and other inherent losses.
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.”