In April 2022, Ontario, Canada, began allowing private companies to offer online gambling services in the province. Three years after this gambling liberalization, emergency department (ED) visits involving gambling-related harm had doubled, according to a study published in the American Journal of Preventive Medicine.Why It’s Relevant
Several studies have found that the rapid rise of online gambling and sports wagering has been associated with a concurrent rise in problem gambling and other mental health problems, especially among young men. However, existing research has focused on proximate issues—such as increased calls to gambling helplines. There is less knowledge about the downstream health ramifications of this new era of gambling.
By the Numbers
- Between January 2012 and June 2025, there were 952 ED visits in Ontario where clinicians coded problematic gambling as the main or contributing reason for admission. For example, a patient might have been involved in a car crash because they were gambling all night and sleep deprived.
- Overall, average ED admissions per quarter were 31% higher after the April 2022 gambling expansion than before (1.68 versus 1.28 events per 100,000 people, respectively).
- ED admissions showed a steady rise over time, increasing by about 7% per quarter. In the April-June 2025 quarter, gambling-related ED admissions were 99% higher than expected if gambling had not been expanded.
- The rise in ED admissions was driven by younger males: In April-June 2025, ED admissions were 116% higher than expected in males ages 30 to 44 and 154% higher in males ages 10 to 29.
The Other Side
Ontario had made other policy changes to liberalize gambling prior to April 2022—for example, allowing single-event sports gambling through a government website in August 2021—so the observed changes in ED admissions likely reflect a cumulative impact of various market factors. More than 70% of admitted individuals had a comorbid psychiatric or substance use disorder, which may have also contributed to the ED visit.
Takeaway Message
Though the total number of gambling-related ED visits was small, the researchers cautioned that this data may represent the tip of the iceberg. Gambling is likely still underrecognized as a contributor to injury, so many gambling-related incidents may not have been coded. Further, only a small percentage of individuals experiencing health problems due to gambling will seek formal treatment.
Related Information
Source
Ryan Forrest, et al. Emergency department visits for gambling disorders after the legalization of single-event sports betting and rapid expansion of online gambling. American Journal of Preventive Medicine. Published online September 15, 2026. doi:10.1016/j.amepre.2026.108551
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