Ontario Gambling Expansion Linked to Near-Doubling of ER Visits
Ontario Gambling Expansion Linked to Near-Doubling of ER Visits
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Key Points
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Ontario’s regulated online market includes 83 gaming and betting sites operated by 43 private companies, including major multinational gambling corporations. In 2024, Ontarians wagered C$82.7 billion through 2.6 million player accounts.
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Gambling-related emergency visits remained stable until Ontario launched its regulated private-operator market in April 2022, after which the visits began to rise.
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Nearly three-quarters of the people recorded in the study were male, and the visits involved Ontarians ranging in age from 10 to 105.
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The co-occurring conditions recorded in gambling-related emergency visits included major depression, alcohol use and self-harm, illustrating the severity of cases reaching hospitals.
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Lead researcher Ryan Forrest cautioned that the study captures only the most acute cases: “Any gambler can experience harm. But our data capture only the acute end of the spectrum.”
Emergency room visits for gambling disorders in Ontario nearly doubled after the province opened its online betting market to private operators in 2022, according to ICES. Researchers analyzed 952 visits by 757 people from 2012 through 2025 and found the overall rate was 99 percent higher than expected without the market expansion. The increase was heavily concentrated among boys and men, with visits 154 percent higher than expected for males ages 10 to 29.
More than 70 percent of these emergency visits involved another mental-health condition or heavy substance use, and nearly one-third resulted in hospital admission, CTV News reported. The findings capture only the most severe cases and underscore the growing harms from rapid online gambling growth and promotion.
Sports Betting Legalization Opened Floodgates
Canada legalized single-event sports betting in 2021, but the real surge came in April 2022 when Ontario launched its regulated private-operator market. Today, Gambling News reports that 83 gaming and betting sites operated by 43 private companies serve Ontarians. In 2024 alone, residents wagered C$82.7 billion through 2.6 million player accounts, driving explosive growth in the industry.
Gambling-related emergency visits remained stable before April 2022, then began rising sharply. The timing creates a clear link: the moment private operators went live, hospital visits for gambling harm spiked. Lead researcher Ryan Forrest emphasized the severity of what hospitals are seeing, noting the study captures only acute cases requiring emergency care.
Young Men Face Disproportionate Risk
The crisis is overwhelmingly male. Nearly three-quarters of people in the study were male, The Epoch Times reported. Males ages 10 to 29 had visits 154 percent higher than expected. Males ages 30 to 44 saw 116 percent higher visits. In sharp contrast, researchers found no significant increase among females, suggesting online gambling marketing and product design may disproportionately target men.
Visitors ranged in age from 10 to 105 years old, showing the problem spans decades. But the peak harm appears in young adulthood, when gambling addiction can derail education, careers, and relationships before they fully develop.
Mental Illness and Substance Abuse Fuel ER Visits
Gambling-related emergency visits rarely occur in isolation. More than 70 percent involved major depression, alcohol use, or self-harm, according to CTV News. These co-occurring conditions show that people arriving at hospitals for gambling harm are already struggling with multiple serious problems. The combination of untreated mental illness plus compulsive gambling creates a perfect storm for crisis.
Nearly one-third of visits resulted in hospital admission, meaning these patients needed inpatient care, not just emergency treatment and discharge. ICES researchers stressed the numbers only represent the tip of the iceberg. "Any gambler can experience harm," Forrest said. "But our data capture only the acute end of the spectrum." Countless others suffer gambling-related harm without ever reaching an ER.
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