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Changing the game for kids before it’s too late.

Published: May 5, 2022

Youth gaming isn’t just fun and games anymore.

Chris J. Tuell, Ed.D, LPCC-S, LICDC-CS is the Clinical Director of Addiction Services at the Lindner Center of Hope. He is also an Assistant Professor in the Department of Psychiatry at the University of Cincinnati. At the Lindner Center of HOPE, Dr. Tuell oversees areas of chemical addictions (drugs & alcohol) as well as behavioral addictions (gambling, gaming, and the Internet). Part of his past work has involved the review of federal grants reflecting the emerging trends within the fields of mental illness and addiction.

One of the trends Dr. Tuell is seeing: Youth gaming can evolve into problem gambling later in life, and there is a lack of awareness from most care providers on the issue.  

“If you go to a casino, slot machines of today are very much like video games – there is not much of a difference,” said Dr. Tuell “Many of our young people have been raised on video games and the Internet. Unfortunately, we expect that some gamers will make the transition to problem gambling in the future.”

Dr. Tuell said there is a strong correlation between gaming, gambling, and mental illness, which revolves around the use of the Internet and its instant accessibility and rate of reinforcement of the addictive behavior.

Why is youth gaming such a problem?

Dr. Tuell said young people are vulnerable to risky behaviors and are not always informed about the potential impact on their decisions. This is due in part to the continuing development of the prefrontal cortex into the late twenties. This area of the brain allows us to make healthy and rational decisions and to have control of our impulses. That was before everyone had a smartphone in their hand.

“Gaming triggers many neurochemicals in the brain, especially dopamine, which is the survival pleasure chemical. In addiction the brain begins to believe that this behavior is something that it needs to function, to survive. The brain creates the cravings and the urge to engage in the behavior. In addition, if a youth or an adult is also struggling with areas of mental illness (i.e., depression, anxiety, trauma, ADHD), it’s like pouring gasoline on a fire,” Dr. Tuell explained.

Tuell states, “Most young people can play video games, engage in social media, surf the Internet, and the behavior may never become problematic.” But for some, gaming can become a behavior which becomes out of control, compulsive, and is continued, despite the negative consequences.

What’s new about youth gaming that is such a problem?

A recent survey of 24,000 Ohioans found 13% of men 18-24 are at a high risk for problem gambling. Dr. Tuell said this supports the theory that adults are being conditioned to gambling behaviors in childhood. Between 60% – 80% of high school students report having gambled for money during the past year, and 15% of Ohio’s youth ages 12-17 report lying about or hiding how much they gamble.

“We know children who gamble before age 12, are four times greater risk for problem gambling,” Dr. Tuell said. Fantasy sports, card games, lottery tickets, and gaming and gambling apps can be a gateway to a problem.

How bad can youth gaming addiction get?

Comorbidity is a main reason problem gambling can turn into crisis according to Dr. Tuell. Many with mental illness and substance abuse issues, see gaming and gambling as a release and a way of coping with stressors of life that many users want to escape from.

“One of my first cases was with a 15-year-old boy who was gaming 8 to 10 hours a day,” Dr. Tuell recounted. “I asked the boy’s parents what one goal they had for their son’s therapy?” They replied, “Can you help our son to stop defecating in his pants while playing video games?” 

Many video games are designed to keep the user engaged in the game. It becomes very difficult for the youth to stop the game, pause for dinner, take a break, or go to the bathroom. Well known websites offer various instructional (DIY) videos on how to build devices so that a user can urinate or defecate, while still playing the game. Dr. Tuell said, “My patient resorted to wearing adult diapers so the gaming would not be interrupted. This is how serious this issue can become.” 

What can parents do?

Experts say it starts at home; national studies show 66% of parents rarely or never have conversations with their children about gambling, while 86% of parents believe that their children play video games excessively. The American Psychological Association recommends that a child between the ages of 3-5 should not spend more than one hour a day on a device.

Dr. Tuell said that parental conversation should go beyond gaming and include the dangers of the Internet, social media, sex and pornography and online bullying. “We need to keep in mind that the Internet has the good, the bad and the ugly,” Tuell stated.

“It’s not easy as a parent to set these limits,” he admitted. “But we know that research has indicated that too much screen time has been linked to depression, obesity and sleep problems. Rates of youth suicides have increased every year for the past 20 years, and we see a correlation between suicides and when social media began,” Tuell states.

What are the warning signs that a child may have a problem with gaming?

Ohio for Responsible Gambling created a program called Change the Game Ohio. Organizers say it raises awareness of the realities of youth gambling and connects parents, educators and children to resources that help identify potential problems like:

  • Is there a preoccupation with gaming?
  • Is there increased time spent on gaming?
  • Is the child more agitated and irritable when they stop playing?
  • Is there a change in relationships?
  • Have they given up important things or activities?

Change the Game Ohio also connects families to available prevention and treatment options.

“It is possible for people to play responsibly, most do,” Dr. Tuell stressed. “Still, we need to realize that the possibility for a fun game to turn into a life-changing problem exists on electronic devices and on the devices of those you love.” Together, we can reverse the trends and change the game back in our favor.

Know the signs. Become familiar with the facts surrounding problem gambling. And know that Ohio for Responsible Gambling is here to help.

If you or someone you know may have an issue with problem gambling, please explore our website,, for free resources and information. You can also call the Problem Gambling Helpline (1-800-589-9966), or text “4hope” to 741741 to find free, confidential resources in your area.

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