Addiction does not happen in silos, and our response to it cannot either.

My family, friends and neighbors have all lived through the consequences of both substance abuse and problem gambling. I have seen firsthand how these struggles rarely appear in isolation. They overlap, reinforce one another, and often bring mental health challenges into the picture as well.

While New York has made meaningful progress in expanding access to behavioral health services by increasing public awareness, funding and programs, outcomes remain inconsistent. 

Why? Because we are still treating these issues as though they occur in isolation.

They do not.

The data is clear. Problem gambling, substance use, and mental health challenges are deeply interconnected. Studies show that between one-quarter and nearly two-thirds of individuals with gambling problems also experience substance use disorders, and in some populations, as many as 94% have at least one co-occurring mental health or addiction condition.

This is not overlap at the margins. It is the norm.

At the same time, New York has expanded access to commercial gaming, introducing new financial and behavioral risks into communities already navigating complex challenges.

Yet our systems continue to fund, treat, and staff these issues separately.

The result is fragmentation at every level. Community-based organizations are forced to choose a funding lane—opioid prevention, mental health, or gambling—even when the needs they see cut across all three. Providers are often not trained to address co-occurring conditions. Patients and families are left to navigate disconnected systems when what they need is coordinated, whole-person care.

What we are seeing through our work every day at Eve & Co is not simply a service delivery gap. It is a systems design failure. If we want better outcomes, we need to align our approach with the reality of co-occurring issues.

That means funding integrated care models, not narrowly siloed programs. It means expanding dual-certification pathways so providers are equipped to treat co-occurring conditions. It means investing in whole-person capabilities that bring together clinical, behavioral, and financial support — recognizing that challenges like gambling addiction often require skills beyond traditional treatment models.

It also means empowering community-based organizations to act as connectors, not just service providers, giving them the flexibility and resources to respond to the full spectrum of needs they see every day.

These organizations are closest to the problem. They already understand what our systems do not: addiction does not present itself one issue at a time.

New York has the opportunity to lead on this issue. But doing so will require moving beyond incremental change and toward a more coordinated, integrated model of care.

If addiction does not happen in silos, solutions cannot either.