Ontario Gambling Disorder ER Visits Nearly Double after Online Expansion

A new study by researchers at the University of Toronto shows that emergency department visits in Ontario related to gambling disorders have nearly doubled since the province opened its online gambling market to private operators. Young Ontario Men Drive Rise in Gambling-Related ER Visits The research looked at hospital data for a 14-year period through 2025. That included Ontarians aged 10 to 105 years and examined emergency department visits related to gambling before and after the province expanded its regulated online market in 2022. Single-event sports betting was legalized in Canada in August 2021. Ontario then began to open its online gambling market to private companies in April 2022. There are now 83 regulated gaming and betting platforms operated by 43 companies in the province. The market has expanded fast ever since. In 2024, 2.6 million player accounts in Ontario bet a total of CAD82.7 billion ($59.1 billion). Researchers identified 757 individuals with gambling disorders, with 952 visits to the emergency department during the study period. Nearly three-quarters of the patients were male. The biggest increase was among males aged 10 to 29 years. By the end of the research period, the number of emergency visits related to gambling in this group was 154% higher than the level researchers would have expected had there been no market expansion. Another substantial increase was seen for men aged 30-44, with visits 116% higher than expected. A similar change was not observed in females. Researchers Warn Online Gambling Harm May Be Underestimated The results also showed gambling disorders frequently co-occurred with other serious problems. More than 70% of gambling-related emergency visits included another mental health condition or heavy substance use. Almost one in three visits resulted in hospitalization. The study is published in the American Journal of Preventive Medicine and builds on earlier research that showed a jump in gambling-related contacts with ConnexOntario after Ontario’s online market expanded. Researchers say emergency departments offer a different measure of gambling harm because betting companies and gambling advertisements do not send people to hospital emergency services for help. This reduces the likelihood that increased promotion of support services can explain the increase in hospital presentations. Researchers also highlighted the limited treatment-seeking among people experiencing gambling problems. They noted that oftentimes stigma can prevent people from seeking professional help and those who do seek help may already be suffering significant health or social consequences. The findings come as other Canadian provinces are expanding their online gambling markets. Alberta followed Ontario’s lead and became the second province to open up to private operators in July 2026. The Ontario experience could provide helpful evidence to jurisdictions considering similar changes, the researchers said. They outlined potential steps including tougher restrictions on gambling advertising, curbs on higher-risk products and improved identification and treatment of gambling-related problems. Most people with gambling problems are not in healthcare data, the authors of the study also said. Therefore, the increase observed within emergency departments may only reflect a fraction of the broader impact associated with the growth of online gambling.