Medical visits related to gambling disorders in Ontario have surged following the province's 2022 decision to privatize online betting. A study in the American Journal of Preventive Medicine indicates that these visits are 99 per cent higher than expected without the market expansion.

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A 154% spike among males aged 10 to 29

The expansion of the private online gambling market in Ontario has disproportionately impacted young men. researchers found that males between the ages of 10 and 29 saw a 154 per cent increase in emergency-department visits related to gambling disorders. As the report says,this was not an overnight explosion but a steady, gradual climb,with visits increasing by roughly seven per cent every three months since the April 2022 market shift.

Daniel Myran, a senior author of the study and a scientist at the University of Toronto,noted that newer forms of gambling, such as play-by-play and rapid wagering, may specifically appeal to this demographic. The study, which analyzed 952 emergency-department visits, highlights that younger males are now the population most acutely affected by the digital evolution of betting.

The $82.7 billion wagering market's human toll

The financial scale of Ontario's gambling industry stands in stark contrast to the rising clinical costs observed in hospitals. In the 2024-25 fiscal year, operators in the province recorded $82.7 billion in total wagers. This massive market, which includes 49 operators and 84 different websites, provides constant, digital access to casino games and sportsbooks.

According to the researchers, Ontario hosted 2.6 million player accounts across 83 betting sites in 2024 alone . This high level of accessibility is a central component of the study's findings, suggesting that the ease of placing bets during live events via digital technology may be driving the increase in gambling-related health crises.

Mental health and substance use in 70% of cases

Gambling disorders rarely exist in a vacuum, often appearing alongside other severe health crises. The study published by the Institute for Clinical Evaluative Sciences indicates that more than 70 per cent of gambling-related emergency visits involved either heavy substance use or another mental health condition . The clinical impact is often severe, with approximately one-third of these patients requiring hospital admission.

Common comorbidities identified in the patients included:

  • Major depression
  • Alcohol-related harm
  • Self-harm

    • Daniel Myran warned that these gambling disorders can have a profound mental-health impact that extends far beyond the individual to their families and communities.

    The "iceberg" of unrecorded gambling harm in Ontario

    Significant questions remain regarding the true scale of gambling-related harm in the province. Daniel Myran suggests that the current emergency-department data represents only the "tip of the iceberg" because many individuals avoid formal treatment due to the social stigma associated with addiction.

    There is also an ongoing debate regarding whether the rise in calls to ConnexOntario, the province's mental-health helpline, reflects a genuine increase in addiction or simply a higher level of public awareness of available services. While legal gambling advertisements direct users to the helpline, they do not explicitly instruct users to seek assistance in an emergency department, leaving a gap in the crisis response framework.

    Ontario's role as a Canadian "natural experiment"

    Ontario's decision to become the first Canadian province to privatize online gambling has set a precedent that other regions are now following. Alberta began regulating private online gambling operators this summer, and the social implications are already visible in younger demographics. A recent Ontario Student Drug Use and Health Survey found that one in eight students reported gambling online during the previous school year.

    The data suggests that the risks are particularly high for young adults; 69.4 per cent of online-gambling young adults aged 18 to 29 met the criteria for problem gambling. As other provinces consider similar models, the Ontario experience provides a critical warning regarding the potential health and social harms of gambling liberalization.