Ontario’s private online gambling market is facing a major public-health warning. A University of Toronto-led study found that gambling-disorder emergency-department visit rates were 99% higher than expected by April to June 2025, after the province liberalized its online market in April 2022.

The increase was concentrated among males aged 10 to 29, whose rate was 154% higher than expected, and males aged 30 to 44, whose rate was 116% higher.

The findings were published in the American Journal of Preventive Medicine on September 16, 2026, according to the University of Toronto.

What the study found

Researchers examined Ontario health records for people aged 10 and older from January 2012 through June 2025. They identified 952 emergency-department visits involving 757 people who had a gambling disorder recorded as a main or contributing reason for care.

  • The average quarterly visit rate rose 31.3% after market liberalization.
  • By April to June 2025, the overall rate was estimated to be 99% higher than it would have been without the policy change.
  • The increase appeared among males, but not females.
  • More than 70% of visits involved another mental-health condition or heavy substance use.
  • Almost one-third of visits led to hospital admission.
The study shows a strong association between Ontario’s market expansion and severe gambling-related harm, but it does not prove that the policy caused every emergency visit.

The researchers describe the result as an association, not proof that market expansion alone caused each emergency visit. The study captures only severe cases that reached an emergency department.

Most people experiencing gambling problems do not seek emergency care. The hospital figures may therefore represent only part of the wider harm, the researchers warn.

Why the timing matters

Ontario launched its privately operated regulated iGaming market on April 4, 2022. iGaming Ontario conducts and manages the commercial market, while the Alcohol and Gaming Commission of Ontario regulates operators and applies the province’s gaming standards.

The model expanded access to online casino games, poker and sports betting through private companies operating alongside government-run offerings. It created a larger regulated market and placed more gambling products and advertising into everyday digital life.

The study’s strongest signal is its age and sex pattern. The largest estimated increase involved males aged 10 to 29. The research does not establish which products, advertisements or individual operators were responsible.

Safeguards have expanded, but they have limits

Ontario requires regulated operators to offer tools such as deposit and time limits, short breaks and self-exclusion.

In May 2026, iGaming Ontario launched BetGuard, a centralized system that allows people aged 19 and older to opt out of all regulated online gambling platforms in the province for periods ranging from six months to five years.

  • BetGuard can block access to existing regulated accounts.
  • It can prevent new account creation.
  • It can stop direct marketing from participating sites.
  • It does not cover unregulated or offshore websites.

Self-exclusion does not replace clinical treatment or emergency care. The Alcohol and Gaming Commission of Ontario also directs operators to identify players who may be experiencing harm and respond with measures such as breaks and limit-setting.

Alberta faces its own policy test

The Ontario findings arrived less than three months after Alberta launched its regulated private iGaming market on July 13, 2026. Alberta is the second Canadian province to allow private operators to offer online gambling under a provincial framework.

The Alberta iGaming Corporation conducts and manages the commercial market. Alberta Gaming, Liquor and Cannabis regulates advertising, responsible-gambling standards and safeguards for vulnerable people.

Alberta says its framework is intended to move players away from offshore sites, where protections may be weaker. But Ontario’s data shows why access and protection will be judged together.

Alberta cannot assume that Ontario’s results will automatically be repeated. Its first year will show whether player-protection rules keep pace with market access, product growth and marketing.

Where to get help in Ontario

People in Ontario who are worried about their own gambling or someone else’s can contact ConnexOntario for free, confidential information about gambling, mental-health and addiction services. The helpline operates 24 hours a day, seven days a week, at 1-866-531-2600.

Anyone in immediate danger should call 911 or go to the nearest emergency department. Ontario’s public-health guidance also directs people to Health811 and local mental-health and addiction services.

Ontario has shown that regulated online gambling can grow. The harder question is whether protections can stop wider access from becoming more severe harm.