As Online Betting Expands, Gambling-Harm Indicators Rise Sharply
16 September 2026
The growth of online gambling and private online betting markets is coinciding with rising indicators of gambling-related harm, with some of the strongest increases seen in emergency room visits and helpline contacts from young men.
A 2024 study in the American Journal of Preventive Medicine analyzed over 950 gambling-related ER visits across Ontario from 2012 to mid-2024, revealing a 99% increase in ER admissions from what would have been expected, following Ontario's April 2022 expansion and rule changes allowing private operators to offer regulated online gambling and single-event sports betting.
The Ontario helpline study echoes the situation in the United States, where NBC News reports an over 60% increase in identified gambling disorder cases since 2018, as seven major states moved to legalize sports betting, and online betting apps saw surging usage.
Parents, health officials, and community leaders are warning that countries are moving fast to regulate online gambling, without fully understanding or taking adequate steps against the rise in associated harms, ranging from addiction to serious depression, substance use disorders, and even suicidal ideation.
Ontario's Statistics Link Gambling-Related Harm to Boys, Young Men
According to Ontario Health, an overall 99% increase in ER admissions was observed due to gambling addiction alone, after the introduction of an open, regulated online gambling market in April 2022. The effects appeared as soon as the expanded market became available.
In the 29 months from April 1, 2022 to June 30, 2024, Ontario Health recorded 952 gambling-related visits to ERs in the province, with 88% of those visits happening since the new market opened, The Globe and Mail reports.
The increase in ER visits wasn't universal, said University of Toronto professor and senior research scientist for the Center for Addiction and Mental Health Amir Afkham. Gambling-harm admissions rose 99% overall, but the further breakdown shows that the increase happened almost exclusively among boys and men between 21- to 44-years-old.
More on this is available via Safe online casinos in the UK.
As explained by Afkham, who co-authored the analysis published in the August issue of the American Journal of Preventive Medicine, the study only identified the 29-month period's gambling-harm visits to ERs, representing 952 individual Ontarians. So while the 99% increase is statistically significant, the number of individual Ontarians in that time frame remains under 1,000.
Illustrating what "under 1,000" actually means, The Globe notes that over three-quarters of Ontario adults report some level of gambling in a typical year. On helping phone lines, the most common problem gamble is sports betting, which 1/3 report here.
The Ontario study found the largest increase in ER visits was observed among males aged 10 to 29 years old, with a 154% increase in gambling-related ER visits. This age group also saw the most significant increase in gambling-related contacts to Ontario's mental-health helpline.
The study also found that gambling-related ER visits were more likely to involve other mental-health conditions or substance-related harm, such as major depression, alcohol use, or self-harm. In 30% of ER cases involving males 21 to 44, gambling addiction was associated with alcohol dependency. Alcohol abuse often plays a role.
The study also suggests that young males between 10 to 44 are the most likely to take risks and are easiest targets for online companies marketing their products. Consequently, accidental serious repercussions, including suicide attempts, are highest in this group.