Ontario ED visits for gambling disorders nearly doubled after iGaming expansion

Ontario ED visits for gambling disorders nearly doubled after iGaming expansion

On 16 September 2026, ICES reported that emergency-department visits for gambling disorders in Ontario nearly doubled after the province legalised single-event sports betting and opened a private online gambling market in April 2022. The peer-reviewed study appears in the September issue of the American Journal of Preventive Medicine.

The finding matters for anyone who plays — or regulates — online books and casinos: the rise showed up in hospital data, not in a helpline that gambling ads are required to promote.

What the numbers show

Researchers tracked Ontarians aged 10 to 105 across a 14-year window. They recorded 952 ED visits involving a gambling-disorder diagnosis among 757 people. Almost three-quarters of those individuals were male.

By the end of the study period, visit rates were 154% higher than expected among males aged 10–29, and 116% higher among males aged 30–44. There was no increase among females. More than 70% of the visits also involved another mental-health condition or heavy substance use, and almost one-third ended in hospital admission.

First author Ryan Forrest, a University of Toronto public-health doctoral student, flagged the concentration among younger men as especially concerning given how online sports betting is marketed. Senior author Daniel Myran (ICES / North York General / University of Toronto) noted that most people with gambling problems never seek formal care, so ED increases may understate wider harm.

Why emergency rooms are a harder signal than helplines

The same team had earlier reported a jump in contacts to ConnexOntario, the province’s mental-health and addiction helpline, after online expansion. Helpline growth can partly reflect better promotion — licensed sites and ads must display support contacts. Emergency departments are not advertised that way, so the new paper treats ED presentations as complementary evidence of severe harm.

Market context — and a caution for other provinces

ICES places the study against Ontario’s current legal online market: 83 gaming and betting sites run by 43 private companies. In 2024, Ontarians wagered $82.7 billion CAD through 2.6 million player accounts.

In July 2026, Alberta became the second Canadian province to allow private online operators. Myran said Ontario’s experience is a caution for jurisdictions weighing similar openings: if they proceed, consider tighter marketing limits, restrictions on higher-risk products, and better recognition and treatment of gambling-related harm.

The study does not claim every player is harmed, and it does not measure problem-gambling prevalence in the whole population. It measures a severe tip of the iceberg — people who reach an emergency department with gambling disorder on the chart.

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