Casino gambling has greatly expanded in the United States since 1988. This paper considers the public interest implications of this change, including increased social costs and state revenues from casinos that can help address these costs. We describe casino growth, including the role of the Indian Gaming Regulatory Act (IGRA) in casino development. After reviewing the research associated with casino social costs and state revenues, we select a number of states, concentrating in the northeastern United States, and describe the state revenues from casinos along with the funding that is provided for problem gambling prevention and treatment programs. We find a lack of consistency in the state casino tax rates, resulting revenues, and support for problem gambling prevention and treatment programs. Since billions of dollars of revenues are potentially at stake, state leaders should consider employing a strategy to capitalize on these revenues, given the increasingly prevalent social costs associated with casinos and the need to support problem gambling prevention and treatment programs.