Canada's 2022 decision to liberalize online gambling markets has come with a steep public health cost. A study published in the American Journal of Preventive Medicine, drawing on data from 17.3 million people over 14 years, found that emergency department visits for gambling disorders rose 31.3% on average after the policy change — and by mid-2025, rates were an estimated 99% higher than what would have been expected without liberalization.

The surge wasn't evenly distributed. Men drove virtually all of the increase, with younger males aged 10–29 and 30–44 seeing the sharpest spikes (154% and 116% higher, respectively). Visits among women remained essentially flat. Notably, the jump didn't happen overnight — rates were stable at first but began climbing at roughly 7% per quarter after implementation.

By the Numbers:

• 952 ED visits for gambling disorders from 757 unique individuals recorded over 14 years
• Mean quarterly ED visit rates rose from 1.28 to 1.68 per 1,000,000 individuals post-liberalization
• Males: rates jumped from 1.81 to 2.63 per 1,000,000; females: essentially unchanged (0.77 to 0.74)
• By Q2 2025, ED visit rates were 99% above the expected baseline

Why it matters: Researchers caution that ED visits are just the tip of the iceberg — most people with gambling problems never seek formal care. The findings serve as a stark warning about the unintended health consequences of rapidly expanding online gambling access, and may have important implications for policymakers in other regions considering similar market liberalization.