That’s the conclusion of a recent study out of Ontario, published in the American Journal of Preventive Medicine, which found that after the Canadian province legalized betting on individual sports events in 2022, emergency department visits for gambling disorders doubled. Most of the people who landed in the emergency department were men, and almost one third of the visits led to hospitalizations. Emergency department visits were 154% higher than they would have been had the law not been changed, Forrest says.
The visits were concentrated among men aged 10-44. Many of the patients showed up at the emergency room with major depression and suicidality, and some had other mental-health or substance-abuse diagnoses, Forrest said. Doctors at the emergency department noted in patients’ records that gambling had contributed to those other issues.
A separate study by some of the same researchers also found that calls to ConnexOntario, Ontario’s free 24-hour mental health and addictions helpline, were 200% higher than they would have been had the law not been changed. That study found that the people reaching out for help were almost exclusively boys and men aged 15 to 44. The study is a warning to the U.S., which has seen sports gambling proliferate since 2018 after the Supreme Court struck down a law barring most state-authorized sports gambling, allowing states to decide for themselves whether to allow sports betting.
Since then, dozens of states, including New Jersey, Tennessee, and New York, have legalized sports betting. Many states also allow online casino games. Gambling has spread in Canada, too, after the country legalized betting on single sports events in 2021.
Therapists in the U.S. say they are already seeing the mental-health consequences of the legalization of sport betting across the U.S., along with the results of more exposure to prediction markets. Birches Health, the largest provider specializing in the treatment of gambling disorder in the U.S., has seen the number of 18-to-34 year old clients grow more than twofold since 2024, according to Cynthia Grant, vice president of clinical for Birches Health. Prediction markets allow people as young as 18 to place wagers; sports betting is restricted to people over 21.
It’s not just prediction markets: some kids are given lottery scratch tickets for gifts, she says, or they’ll participate in family fantasy sports wages. Kids are also exposed to gambling with online games that encourage them to chase a reward, or through hobbies like collecting Pokemon cards, in which they are betting that they’ll get a valuable card in an anonymous pack. The standard treatment for gambling disorder is cognitive behavioral therapy, Grant says, because people with a gambling addiction often have distorted thinking and believe that they can beat the system.
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