Every game on every site listed here is built to return less than it takes over time. That is not a defect and it is not something a fast cashier changes. A site that pays out quickly is a site running its payments properly, and nothing more than that.
Gambling with money set aside for something else. Chasing losses with larger stakes. Playing longer than intended, repeatedly. Hiding how much is being spent. Borrowing to play. Feeling irritable or restless when not playing. Any of these on its own is worth taking seriously.
The National Council on Problem Gambling runs a 24/7 helpline at 1-800-GAMBLER. It is free, confidential and available in every US state. Text 800GAM to 800321 or use the chat at ncpgambling.org. Gamblers Anonymous runs in-person and online meetings across the country at gamblersanonymous.org. Gam-Anon supports family members affected by someone else's gambling.
Deposit limits set before a session are far more effective than a decision made during one. Most cashiers support them and they take a minute to configure. Session reminders, loss limits and cooling-off periods are commonly available. Self-exclusion removes access for a fixed period or permanently, and blocking software such as Gamban or BetBlocker covers the whole device rather than a single operator.
Responsible gambling tooling at offshore operators is generally weaker than at state-regulated ones, and self-exclusion at one operator does not carry across to others. Device-level blocking is the more reliable option if you need to stop. If gambling is causing harm, the fastest route to help is 1-800-GAMBLER, not a change of casino.