Ontario's betting law doubled ER visits

After Ontario legalized betting on individual sports events in 2022, emergency department visits for gambling disorders doubled. Most patients were men, and almost one third led to hospitalizations.

The rise signals wider harms ahead

Ryan Forrest, a public health doctoral student at the University of Toronto and study author, says the emergency room surge may warn of broader population harms including financial distress, family problems and worsening mental health.

“This rise in severe presentations might be a bit of a warning signal of a wider increase in harms across the general population.”

Visits were 154% higher than expected

Emergency department visits for gambling disorders were one hundred fifty-four percent higher than they would have been without the law change. The visits concentrated among men aged ten to forty-four.

Patients arrived with severe mental health crises

Many emergency department patients showed major depression and suicidality. Some had other mental health or substance abuse diagnoses, with doctors noting gambling had contributed to those issues.

Helpline calls also surged 200%

Calls to ConnexOntario, Ontario's free twenty-four-hour mental health and addictions helpline, were two hundred percent higher than expected after the law changed. Callers were almost exclusively boys and men aged fifteen to forty-four.

US faces similar risks after 2018 ruling

The US Supreme Court struck down a law barring state-authorized sports gambling in 2018. Since then, dozens of states including New Jersey, Tennessee and New York have legalized sports betting, with many also allowing online casino games.

Young Americans seeking treatment doubled

Birches Health, the largest US provider specializing in gambling disorder treatment, saw eighteen to thirty-four year old clients grow more than twofold since 2024. Cynthia Grant, vice president of clinical, says clients mention prediction markets two hundred percent more often than last year.

Gambling lacks basic safety protections

Most gambling apps lack automatic spending limits and take a hands-off approach to users showing addiction signs. Grant says online systems do not protect people prone to behavioral addictions, unlike bartenders or police enforcing drunk driving laws.

“The way that online systems work right now do not protect people at all who are prone to behavioral addictions, and that, to me, is very dangerous for my clients.”

No public health monitoring of gambling harms

The Canadian government set aside no money to track whether gambling legalization causes public health problems. Forrest notes this contrasts with cannabis legalization, which received huge grants for monitoring policy changes and their effects.

“You compare that to something like when cannabis was legalized, there were huge amounts of grants given out to monitor these kinds of policy changes.”