Examining the social and political implications of Video Lottery Terminal (VLT) misuse, this authoritative study describes the links between financial stress, physical and mental health issues, depression, alcohol dependency, marital break-up, and suicidal desires with pathological gambling. Contrasting the social fallout from VLTs—the most addictive gambling activity—with government inaction, the lack of substantive public policy is called to question in light of the annual revenue figures derived from gambling. This perceptive report investigates increasingly politicized discussions surrounding VLTs, and serves as a clarion call to governments to take action.