Ontario ERs Seeing More Males Visit for Gambling Disorders Since Expansion of Online Betting: Study

Online gambling disorders have become a noticeable problem in emergency departments across Ontario, with visits by males doubling since the legalization and expansion of single-event sports betting, a new study has found.

Canada legalized single-event sports betting in August 2021, and in April 2022, Ontario became the first province to allow private companies to operate in a regulated online gambling market alongside the existing government-run platform.

In 2024, Ontarians wagered $82.7 billion on gaming and betting sites through 2.6 million player accounts.  

Researchers with the Institute for Clinical Evaluative Sciences (ICES) wanted to assess the effects of these changes, so they analyzed emergency department (ED) visits for gambling disorders among Ontarians aged 10 to 105 years before and after the expansion, according to a new study from the institute.

Researchers analyzed data from January 2012 to September 2025 and found that 757 people—almost three-quarters of whom were male—made 952 ED visits in which hospital staff recorded gambling disorder as either the main or contributing reason for the visit.

In particular, the observed number of visits by the end of the study was 154 percent higher than expected among males aged 10 to 29 and 116 percent higher than expected among males aged 30 to 44, while there were no changes among females, the report said.

“More than 70 per cent of gambling disorder ED visits involved another mental health condition or heavy substance use and almost one-third of the visits led to hospital admission,” researchers wrote.

Past research has shown that individuals with gambling problems seldom pursue formal treatment due to stigma, while those who seek help often do so only after worsening health and social harms, the report said.

Researchers said the new findings offer “important complementary evidence” since neither gambling advertisements nor betting websites promote visiting emergency departments as a source for gambling support.

“Collectively, increases in both helpline contacts and severe gambling-related presentations to the ED add to evidence that the expansion of online gambling has been accompanied by an increase in gambling-related harm, particularly among younger men,” they wrote.

Ryan Forrest, the first author and a public health doctoral student at the University of Toronto, said in a news release that the increase in visits to EDs by younger males is “particularly concerning,” considering sports betting targets that demographic.

“The consequences of rising gambling involve not just harm to people who are gambling but wider effects on families and communities,” he added.

Daniel Myran—the senior author, Gordon F. Cheesbrough Research chairperson at North York General, an ICES scientist, and associate professor in the University of Toronto’s department of family and community medicine—said most people with gambling problems rarely seek care.

Therefore, he said the increase in ED visits may be revealing a much larger increase in gambling-related harm.

Myran pointed out that in July 2026, Alberta became the second province to allow private operators to offer online gambling, while “other regions of Canada are considering or facing pressure to follow suit.”

Jurisdictions that are considering offering or expanding online gambling through private operators “should carefully weigh these potential risks” and learn from what’s happening in Ontario, he continued.

Myran added that if provinces proceed, they should impose safeguards, such as restrictions on marketing and higher-risk forms of gambling, along with “better recognition and treatment of gambling-related harms.” 

The study was published in the September issue of The American Journal of Preventive Medicine.