Dave Yeager didn’t join the US army to become a pathological gambler. But after re-enlisting as a food inspection specialist in the wake of 9/11, Yeager arrived at his base hotel in Seoul, Korea, feeling overwhelmed and restless. “I’m walking around and find a casino-style slot machine room,” says the 57-year-old former sergeant. “As soon as I sat down, the first thing I noticed was that my shoulders started to relax. Then I won, and it was like a dopamine hit. In that moment, all of the fear and anger and stress that I was feeling just went away.”

Suddenly and without warning, a night of gambling here and there became a seven-day-a-week addiction – one that had him phoning home for more money, pawning personal effects and stealing from his unit. When a demotion in rank failed to curb Yeager’s reckless behavior, his bosses threw up their hands.

“My commander, a colonel I really respect, basically said in few words, ‘We have no idea what to do with you because you’re such a stellar performer,” he recalls of the come-to-Jesus meeting that preceded his transfer to a US duty station. “Nobody ever used the word gambling. It was ‘this problem you have’.”

While the boom unleashed by the 2018 legalization of sports betting raised fears of an emerging addiction crisis, this institutional problem – at the heart of the US military – can be traced back decades, to the rooms like the one Yeager ventured into in Korea.

In 1951, Congress banned slot machines from military bases in the US. In the 70s, the army and air force pulled them from foreign bases only to slowly bring them back in the 80s – with the idea that it would keep the troops from running into off-base trouble.

Currently, the US military operates more than 3,000 slot machines on bases in 12 countries – down from 8,000 slots in 94 countries in 1999, according to the Pentagon. That’s besides the other chance games the military sponsors on bases, with service members as young as 18 able to participate.

The remaining slot machines alone rake in more than $100m annually, money that each branch steers into groups supporting “morale, welfare and recreation” initiatives on all bases such as movie theaters and golf courses. None of that money, Yeager notes, goes toward education, screening or prevention. “When you fall into a gambling problem,” he says, “it’s not treated as a mental health issue and an addiction. It’s treated as a money problem and a disciplinary issue.”

All the while, service members spiral deeper down the hole. A 2003 patient chart analysis at one Veterans Affairs (VA) medical center found that, of the patient population that had attempted suicide, 64% blamed gambling-related harms for pushing them to the brink. Three years later, the suicide death of a decorated army helicopter pilot forced the general public to somewhat reckon with the military’s gambling problem.

A 2016 survey of Iraq war veterans concluded that 4.2% had become at-risk gamblers subsequent to being deployed. According to the National Council on Problem Gambling, an estimated 56,000 active duty service members may meet the criteria for gambling disorder – which more generally affects an estimated 1% of Americans – roughly the same percentage of the adult population currently in active duty service. Both demographics skew heavily male.

In a 2021 Rutgers University study of gambling in the military, the researcher Mark van der Maas deduced that active and retired military service members were more than twice as likely to become problem gamblers than the general population – and even that may be underestimating the actual figures by quite a margin. “People tend not to think of the different things they’re doing as capital-G gambling because that’s such a morally loaded term,” van der Maas says. “A sports bettor, for example, might not think they’re gambling because they put so much time and research into it.”

Van der Maas’s research suggests a connection between military service and poor mental outcomes for women, a less-studied gambling cohort relative to men. “Generally speaking, there are fewer women with gambling disorder compared with men,” he says. “But when we talk about the reasons why people gamble, women are more likely to say that they gamble to help deal with negative emotional state.

“In both the US and Canada, women in military service or on police forces are exposed to sexual harassment and assault on the job. Understanding how being in that emotionally stressful environment potentially leads to gambling disorder for women is an area we need to pay more attention to.”

Even though gambling has been recognized in the Diagnostic and Statistical Manual of Medical Disorders since 1980, the military is no better at confronting the problem than other American institutions that don’t see gambling on a par with drugs or alcohol addiction. (Some insurance carriers have only just begun covering problem gambling treatments.)

It’s only since 2019 that the Department of Defense has mandated annual screenings for gambling disorder as part of service members’ general health assessment in addition to conducting random spot surveys of active duty soldiers. “Early detection and treatment of gambling disorder and other health-related behavioral issues is critical to maintaining the overall wellbeing and operational effectiveness of our forces,” a defense department spokesperson said. Before this statement, neither the defense department nor the VA had publicly commented on efforts to curb problem gambling within their ranks.

Still, the military’s periodic checkups for gambling aren’t as rigorous as the ones used for substance abuse, or physical fitness. “It really would just take three quick questions to at least flag if someone needed more follow-up,” van der Maas says.

This relaxed attitude makes military members especially vulnerable to gambling addiction. “When you think about military people, they’re very bonded,” says Heather Chapman, a psychologist who directs the gambling program at the Louis Stokes Cleveland VA, one of the few residential facilities in the country that focuses on the disorder. “It almost becomes like a family, and what you see is that behavior becomes integrated within the family structure, something to do when they have downtime – whether it’s slots or a Texas hold ’em tournament. It doesn’t have the immediate problematic issues that drugs and alcohol can have. There’s no obvious screen for gambling other than financial issues, which can affect a person’s clearance if they have considerable debt or declare bankruptcy.”

Gambling can seem like an especially attractive escape in a high-stress environment that conditions workers to accept risk, bottle individual issues and finish the jobs they start. “You’re taught from day one, leave your problems at the door; you have a mission to do,” Yeager says. “The problem is that, even when they fall into addiction, the mentality is ‘I have to fix this on my own. I have to keep this to myself. I can’t leave until I win.’

“One of the tenets of gambling addiction is chasing losses. You add the warrior mentality to that, and you’ve basically got gambling addiction on steroids.”

Yeager’s addiction resulted in the breakup of his young family, the end of his military career and a debt in the high five figures. (He’s further ashamed to say that he borrowed from subordinates.)

After a decade-long nosedive that included a two-week stay at a civilian psychiatric hospital, Yeager remembers the stumped counselor at his local VA handing him a packet for the VA gambling program in Cleveland. It was only after making that pilgrimage and communing with veterans in his same foxhole that Yeager turned his life around. Now remarried, reconciled with his family and out of debt, he raises awareness about problem gambling in the military, touring the country and promoting a book about his recovery all the while.

He hopes to be a light to service members. In some ways, as gambling becomes more ubiquitous and accessible, they are even more vulnerable to addiction. “Just having gambling in your pocket now changes everything,” Chapman says. “We won’t really know what the true impact will be for another five or six years down the road when things really start to boil over.”

Some federal lawmakers have shown a willingness to cooperate in the interest of heading off disaster. In 2017, the senators Elizabeth Warren and Steve Daines introduced a bipartisan bill that would force the Department of Defense to track gambling disorders in its health assessments and develop policies and programs around treatment and prevention.

Earlier this year the congresswoman Andrea Salinas teamed up with the senator Richard Blumenthal on a bill that, among other things, would funnel half of the federal taxes on gambling operators into national treatment and research programs. But both measures have struggled for traction within a divided Congress.

The inaction just deepens the sense of dread within the precincts of the military on the frontlines of the gambling addiction problem – not least Yeager, who shudders to think of the potential risks to national security if the military’s gambling problem continues unchecked.

“I’m telling you right now: it’s only a matter of time before you start seeing stories come out about the major who lost their commission, or the sergeant who committed treason because of their gambling addiction,” he says. “There’s so much more we need to do. And that’s why I don’t shut up.”

• In the US, call the National Council on Problem Gambling at 800-GAMBLER or text 800GAM. In the UK, support for problem gambling can be found via the NHS National Problem Gambling Clinic on 020 7381 7722, or GamCare on 0808 8020 133. In Australia, Gambling Help Online is available on 1800 858 858 and the National Debt Helpline is at 1800 007 007.

• This article was amended on 25 May 2024 to remove an incorrect quotation from Yeager about borrowing from subordinates.