Ontario sports betting has grown rapidly since the province opened its regulated online market in April 2022. But new research suggests that easier access to gambling may come with serious health risks, especially for younger men.
A population-based study published online in the American Journal of Preventive Medicine on September 15, 2026, found that emergency department visits involving gambling disorders rose after the expansion. By spring 2025, the visit rate was nearly twice what researchers estimated it would have been without the market changes.
The news comes on the heels of another study that found many young adults are using risky measures to try to pay off gambling debts. Last month was also Responsible Gambling Education Month.
How Ontario Gambling Changed
Canada legalized single-event sports betting in August 2021.
Ontario then became the first province to open a regulated online market where private companies could compete alongside the existing government platform. Alberta recently became the second.
The market eventually included about 83 licensed gambling sites operated by roughly 43 private companies. During the 2024–25 fiscal year, players wagered approximately CAD $82.7 billion through around 2.6 million accounts.
These figures show the market’s scale, but they need context. Betting totals are not the same as player losses, and account totals do not necessarily represent individual people.
What the Study Found
Researchers examined Ontario emergency department records from January 2012 through June 2025. They identified 952 visits involving a gambling disorder diagnosis among 757 people. About 72% of those individuals were male.
Before the market opened, visit rates were stable. There was no immediate spike in April 2022. Instead, rates increased gradually, rising approximately 7% per quarter afterward.
Across the post-expansion period, average quarterly rates were 31.3% higher than before. By April through June 2025, the overall rate was estimated to be 99% above the expected level.
The largest increases appeared among younger males. Rates were 154% higher than expected for males aged 10–29 and 116% higher for those aged 30–44. Researchers found no significant increase among females.
Are There Similar Findings in the United States?
U.S. research shows a similar pattern. A 2026 Epic Research analysis reviewed electronic health records for about 197 million adult patients. It compared gambling disorder diagnoses in states that legalized sports betting with those that did not.
In states with legal sports betting, the quarterly diagnosis rate rose about 61% between early 2018 and early 2026—from 3.0 to 4.8 diagnoses per 100,000 patients. In states without legal sports betting, the rate fell about 29%, from 3.1 to 2.2 per 100,000 patients.
Adults ages 30–49 had the highest diagnosis rates overall. However, adults ages 18–29 saw the largest percentage increase, with their rate more than doubling. The gap between men and women was especially large among adults under 50, and young men stood out as a group of concern.
These changes followed the Supreme Court’s 2018 decision in Murphy v. NCAA, which allowed states to legalize sports betting. By early 2026, sports betting was legal in about 39 states and Washington, D.C., with online betting widely available.
Other U.S. research and reports point to related concerns:
- Searches for gambling addiction help increased after legalization, particularly when online sportsbooks opened.
- Many states reported growing demand for treatment and more calls to gambling helplines, especially among younger adults.
- Some studies linked legal sports betting, particularly online betting, to financial problems such as debt and bankruptcy.
Together, these findings raise concerns about gambling-related harm as sports betting expands. They show an association, however, rather than proving that legalization alone caused these changes.
Why These Visits Matter
Emergency visits capture only a narrow slice of gambling-related harm. Many people experiencing problems never seek formal treatment, sometimes because of stigma.
Still, the cases recorded were often serious. More than 70% involved additional mental health conditions or heavy substance use, and almost one-third resulted in hospital admission.
Although the absolute number of visits was small, researchers described the increase as a possible warning signal. Their earlier research also found rising gambling-related contacts to ConnexOntario, the province’s mental health and addictions helpline.
What the Findings Mean
The study does not prove that Ontario sports betting caused the increase. Federal legalization, online casino growth, advertising, and other changes overlapped, making it difficult to isolate one cause.
However, the timing and concentration among younger males raise important questions about Ontario gambling policy. Researchers suggest weighing potential harms carefully and considering safeguards such as marketing restrictions.
The study's findings also show that a regulated market is not necessarily a harmless market.
As online betting becomes more accessible, public discussion should consider health outcomes alongside business growth. This study offers a reason to monitor those outcomes closely, while recognizing both the seriousness of the recorded cases and the limits of observational evidence.
