Online Gambling in Ontario Coincides With Growing ER Visits for Gambling Disorders
16 September 2026
September 16, 2026. ICES data show a surge in emergency-department visits for gambling disorders, especially among younger men, as Ontario's online gambling industry expands rapidly. Regulators and operators say existing safety tools are underutilized as millions wager online.
The Ontario Institute for Clinical Evaluative Sciences (ICES) report found that gambling disorder-related emergency department visits nearly doubled in Ontario since the province allowed private companies to enter the regulated online gambling market in 2022. The surge coincides with a growing market: in 2024 alone, Ontarians wagered $82.7 billion CAD on 83 gaming and betting sites operated by 43 private companies, through 2.6 million player accounts, according to ICES data.
"Given the growth and accessibility of online gambling, it's crucial to ensure that effective harm-minimization tools are used to safeguard consumers," said Dr. Tyler Crandall, program lead at ICES.
Expand Access to Self-Exclusion and Limiting Tools
The ICES report showed 757 people made 952 emergency department visits in a 14-year period, with a dramatic increase among younger men. males aged 10 to 29 and 30 to 44 saw 154% and 116% more visits, respectively, than expected. In contrast, females saw no change, and older men (over 65) saw a 38% reduction in visits, the report found. Three-quarters of the visits were in the male group, nearly a third led to hospital admission, and more than 70% involved another mental health condition or substance use, highlighting the need for accessible treatment and prevention tools.
"Particularly alarming is that almost one-third of those visits led to a hospital admission, really highlighting the severity of these issues," said Dr. Tahira Singh, lead author of the study.
With over 70% of gambling disorder emergency department visits involving another mental health condition or heavy substance use, regulating and monitoring these sites is crucial, argues Peter Wood, Senior Manager at the Ontario Gaming Agency, which sets the policy framework for gambling in the province. The agency has emphasized player protection and introduced measures like deposit and loss limits, time-outs, and self-exclusion from sites.
Gambling commission regulators say online gambling sites provide tools for players to set time and money limits, request self-exclusion, and check historic account activity. The Gambling Commission and industry body also promote blocking gambling payments, and viewing playing history to monitor and control gambling behavior.
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Over 1.5 Million Use Safer-Gambling Tools
There is evidence that such tools are used, especially when promoted. Safer Gambling Week 2024 saw a 22% year-on-year increase in the use of safer gambling tools, with over 1.5 million accounts using tools like deposit limits during the campaign. 47% of those were first-time users. The Safer Gambling Week website alone received over half a million visits, signposting help, advice, and self-exclusion options.
"This saw a surge in over 1.5 million accounts setting deposit limits and other safer gambling tools. It also signposted help to a wider audience than ever before," said Michael Underdown, Chief Executive of the Betting and Gaming Council in the UK.
Yet with millions now gambling online in Ontario, the number using these tools appears low compared to overall participation. The use of these tools may still not be building screen time or spending limits strongly enough to prevent conflicting with other mental health conditions. Regulators and medical professionals are seeing the number of people finding themselves in ER after gambling, especially young men, as a spike and a signal.
"That's really concerning, especially because these cases so often involve other mental health conditions or substance use, which need to be treated at the same time," said Singh.
The Gambling Commission requires online gambling sites to post details about limits and self-exclusion on their sites, so players already know to look for that control, but whether and how often they really do set and monitor those limits themselves, or get to that step early enough, remains an open concern in the field today. That is one area regulators, operators, and medical bodies plan to assess, in 2027.