Gambling exists in every state, even Hawaii and Utah, where gambling is prohibited by law. But not all gamblers are the same. “Recreational” or “social” gamblers, for instance, buy the occasional lottery ticket, take the rare casino trip or bet small stakes in fantasy sports. But they also are mentally able to quit at any point and prevent catastrophic financial loss.

But when the business or pleasure gets out of control, gambling becomes a real medical condition. Gambling disorder, as it’s known, affects about 1-3 percent of all U.S. adults. According to the Mayo Clinic, “Gambling can stimulate the brain’s reward system much like drugs such as alcohol can, leading to addiction.”

That addiction can lead to serious economic consequences. For example, U.S. consumers experience over $100 billion per year in total gambling losses. Individually, a male gambling addict accumulates an average debt of between $55,000 and $90,000 whereas a female averages $15,000. Most cannot afford to pay back what they owe. As a result, gambling addicts develop a high tendency to amass even more debt, suffer from other health issues, lose their jobs, strain their relationships or even commit crimes.

The gambling problem, however, is much bigger in some states than in others. WalletHub therefore compared the 50 states to determine where excessive gambling is most prevalent.