Ontario Gambling-Disorder ER Visits Hit 2× Expected Rate by Mid-2025
The finding comes from a study published September 16 in the American Journal of Preventive Medicine. Researchers examined health records for 17.35 million Ontario residents aged 10 and older, covering January 2012 through June 2025.
Ontario launched its competitive regulated iGaming market in April 2022. The researchers used the years before that date to establish a baseline and then compared it with what appeared in hospital records afterward.
ER Visit Rate Kept Rising After Market Launch
Ontario recorded an average of 1.28 gambling-disorder emergency visits per million residents per quarter before April 2022. The post-launch average was 1.68 per million.
More notable was what happened over time. The pre-2022 rate showed little movement. Once the new market was operating, the study calculated an increase of roughly 7% from one quarter to the next.
The gap had become much wider three years later. During April-June 2025, the actual rate stood 99% above the study's counterfactual estimate.
That estimate is not a count of cases that researchers attributed directly to online gambling. It is the difference between the recorded rate and the trajectory generated from Ontario's earlier hospital data.
Biggest Gap Was Among Younger Men
The dataset contained 952 emergency visits from 757 individual patients. Men made up 72% of the group.
Age produced a particularly large split. For males aged 10-29, the rate at the end of the study was 154% above the expected level. Among men aged 30-44, the gap reached 116%. The researchers found no statistically significant change for women.
Many of the patients also arrived with other health issues recorded alongside the gambling disorder. More than 70% of the visits involved another mental health condition or heavy substance use. Almost one-third resulted in admission to hospital.
A Different Signal From the Earlier Helpline Data
Ontario has already produced another post-2022 gambling-harm signal. The same research group previously found that contacts to ConnexOntario increased after the private online market launched. There was an obvious caveat to those numbers: gambling companies and their advertising direct customers to the support service, so more promotion can generate more calls even without an equivalent change in severe cases.
Hospital records avoid much of that issue. Emergency departments are not a gambling helpline promoted on operator websites or in betting advertisements. The new ICES dataset therefore captures a separate route into the health system.
The two studies are measuring different things, but both show an upward shift after Ontario's April 2022 market opening. That gives the findings wider relevance in Canada. Alberta opened its regulated private iGaming market in July 2026. It is far too early for comparable hospital trends there, but Ontario now offers a set of health indicators that can be checked as Alberta's market develops.