For some people, online sports betting is a few taps on a phone. But new research from Canada suggests that when gambling becomes a problem, the consequences can end up far beyond a depleted bank account. Sometimes it can land a gambler in a hospital's emergency department.

Researchers from an independent, non-profit research institute in Ontario, Canada that studies healthcare systems and population health — ICES, the Institute for Clinical Evaluative Sciences — examined emergency department visits for gambling disorders before and after the province expanded its regulated online gambling market to private companies.

Canada legalized single-event sports betting in August, 2021. In April of 2022, Ontario became the first Canadian province to allow private companies to operate regulated online gambling sites alongside the existing government-run platform.

Gambling-related emergency care more than doubled following the changes in Ontario's sports betting market.

The team analyzed emergency room visits among Ontarians ages 10 to 105 over a 14-year period, comparing gambling-disorder visits before and after the changes. During that period, 757 people made a total of 952 ER visits in which a gambling disorder was recorded as either the primary reason for the visit or a contributing factor. Nearly three-quarters of the people making the emergency room visits were male, and the increase was concentrated particularly among younger men.

By the end of the study, the number of gambling-related ER visits was one and a half times or 154 percent higher than expected among males ages 10 to 29; it was 116 percent higher than expected among males ages 30 to 44. Researchers found no corresponding change among females.

The seriousness of these emergency visits is noteworthy. More than 70 percent involved another mental health condition or heavy substance use, while nearly one-third resulted in hospital admission.

These findings suggest that at least some of the people arriving at emergency departments were dealing with gambling problems alongside other significant health or substance-use concerns.

"The concentration of the increase among younger males is particularly concerning given the rapid growth and promotion of online sports betting, which target this demographic," said Ryan Forrest, the study's first author and a public health doctoral student at the University of Toronto's Dallana School of Public Health, in a press release. "The consequences of rising gambling involve not just harm to people who are gambling but wider effects on families and communities,” he added.

The number of gambling-related emergency department visits was 154 percent higher than expected among males ages 10 to 29 and 116 percent higher than expected among males ages 30 to 44.

The research team had previously found a substantial increase in gambling-related contacts to Conex Ontario, Ontario's mental health and addiction helpline, after online gambling expanded. But that increase could potentially have been influenced by greater promotion of the helpline, since gambling advertisements and websites are required to provide its contact information.

The findings provide another measure of harm, and it's one that isn't directly influenced by gambling advertising. The researchers say that, taken together with the increase in helpline context, the findings add to evidence that the expansion of online gambling has been accompanied by increased gambling-related harm, particularly among younger men.

These numbers may underestimate the problem. People with gambling disorders often do not seek formal treatment, in part because of stigma. Some may wait until gambling has contributed to serious financial, social or health consequences before seeking help. The researchers therefore caution that emergency-department visits represent only those cases serious enough, or circumstances difficult enough, to result in emergency medical care.

In 2024, online sports wagers totaled $82.7 billion Canadian through 2.6 million player accounts.

It's worth noting that the study does not establish that the expansion of online gambling directly caused the increase in emergency department visits. Rather, the researchers found that the rise in gambling-related emergency care occurred following the changes in Ontario's gambling market. That distinction is consequential because other factors could potentially have contributed to the increase.

The findings also confirm that Ontario's online gambling market has grown substantially. According to the study material, the province now has 83 gaming and betting sites operated by 43 private companies. In 2024, Ontarians wagered $82.7 billion Canadian dollars through 2.6 million player accounts.

For consumers, the study underscores that gambling can have consequences beyond money. When betting begins to affect mental health, substance use, relationships or everyday life, it may be a health problem rather than simply a recreational activity.

The study is published in the American Journal of Preventive Medicine.