Ontario gambling disorder ER visits nearly double after online market expansion

A new University of Toronto study says emergency department visits in Ontario tied to gambling disorders have nearly doubled since the province opened its online gambling market to private operators. For PSPs and acquiring banks, the useful part is not the public-health angle; it is the speed at which regulated online access can translate into measurable harm signals in the payments ecosystem.

1. The researchers reviewed 14 years of hospital data through 2025, covering Ontarians aged 10 to 105 years. They compared gambling-related emergency department visits before and after Ontario expanded its regulated online market in 2022.
2. Single-event sports betting was legalized in Canada in August 2021. Ontario then began opening its online gambling market to private companies in April 2022. The province now has 83 regulated gaming and betting platforms operated by 43 companies.
3. The market has scaled quickly. In 2024, 2.6 million player accounts in Ontario bet a total of CAD82.7 billion ($59.1 billion).
4. Researchers identified 757 individuals with gambling disorders and 952 emergency department visits during the study period. Nearly three-quarters of the patients were male, and the sharpest increase was among males aged 10 to 29 years: by the end of the research period, gambling-related emergency visits in that group were 154% higher than the level researchers expected without market expansion. Men aged 30-44 also saw a substantial increase, with visits 116% higher than expected. No similar change was observed in females.
5. The study also found that more than 70% of gambling-related emergency visits involved another mental health condition or heavy substance use, and almost one in three visits led to hospitalization. The paper, published in the American Journal of Preventive Medicine, builds on earlier research that showed a jump in gambling-related contacts with ConnexOntario after Ontario’s online market expanded.

The researchers argue that emergency departments capture a different side of gambling harm than operator support channels do, because betting companies and ads are not sending people to hospital services for help. They also pointed to limited treatment-seeking and stigma, which means hospital data can surface cases that never show up in operator-facing harm-minimization metrics.