Of all the addictions gambling is one of the hardest to treat.

There are no drugs to counter it, few people refer themselves and when they do so they are likely to be chronically addicted and at rock bottom.

But the good news is Bermuda is at last recognising the problem and offering help to the few willing to take it.

St. Brendan's Consultant Psychiatrist Dr. Kalyana Rodrigo is offering help through Turning Point which has traditionally helped those coping with substance addictions.

And his colleague David Parker, a clinical counsellor, has just started up Gamblers Anonymous sessions at the Red Cross Society building in Berry Hill Road, Paget at 7 p.m. on Sunday nights.

But Dr. Rodrigo says Gamblers Anonymous is only half full while he has yet to see a gambling client at Turning Point after moving from his native Sri Lanka two months ago.

He says this is a pattern typical across the world. Compulsive gamblers can get hooked in a few days but generally it takes several years and it can be decades before crisis point arrives. By that time the damage is done - they may have lost their job and become saddled with debt.

"By the time they are referred they are usually in their late 30s," said Dr. Rodrigo .

"Gambling as an illness has only just been recognised recently. It's an impulse control disorder. There is no specific treatment, it's mostly psychological.

"It's like substance abuse, you try to motivate a person to change their current behaviour from compulsion to complete abstention."

Patients are asked to do a self assessment and learn how to help themselves while Turning Point provides counselling and psychological analysis and treatment.

At Gamblers Anonymous attendees take the 12-step programme, common among substance abusers, where they are asked to repair broken family relationships. Group therapy is crucial as gamblers get tips on how to beat their problem, which are always far more credible coming from fellow sufferers.

Competitive games without wagers can divert attention, music and reading helps, while those with religious convictions are encouraged to pursue that to stave off the cravings.

Alternative pastimes to the thrills and spills of gambling are encouraged but Dr. Rodrigo cautions results are very variable. "Prevention is a better way to approach gambling on a population basis, getting people not to go into it in the first place.

"Unfortunately in most societies there is ample opportunity to gamble.

"In a country where there is not much gambling, like this, my advice is to keep it that way. Once you start it is very difficult to control."

He said those likely to get hooked would make the most of any opportunity available. But it is not to say he is advocating prohibition. "Then it goes underground and you are not able to control it."

He compares it to alcohol which is licensed and subject to age restrictions. World wide, between one and three percent of a country's population will become pathological gamblers while lotteries have encouraged the regular gambler, says Dr. Rodrigo.

He said 33 percent of the British population fell into this category while in the US it was nearly twice that total.

A pathological gambler he defines as someone whose whole life is preoccupied by their addiction.

And just like drug abuse, tell-tale signs are when family items are pawned to raise cash for the compulsion. Typically gamblers are competitive, energetic and successful at work, says Dr. Rodrigo.

"They tend to postpone activities until the deadline comes. They are very restless and easily bored so they turn to the adrenaline rush of trying to beat the odds. They want the excitement or buzz, they want the thrill and risk of gambling. At other times they are workaholics. Sometimes they are extravagantly generous. If someone is extravagantly generous you must think, 'why are they doing this?'"

The reasons why people get involved are not easy to explain, says Dr. Rodrigo. Winning reinforces the behaviour but when losses mount the compulsive gambler will not give up and the rot sets in. Recently more thought has been put into treating gambling and its underlying causes.

"There is some evidence there is a higher incidence of both gambling and alcoholism in the families of those who are pathological gamblers.

"There is a genetic influence - even when they grow up apart they have a higher vulnerability."

Why some gamble is very difficult to say. Unlike substance abusers there are no drugs available to those tackling their betting addictions.

"With alcohol and heroin the brain becomes hardwired to depend on those substances so craving-reducing drugs are a necessary response along with psychological treatment. Hopefully someone will find the gambling pathology might be able to use a pharmaceutical treatment. At the moment nothing is available. But help is available through counselling at Turning Point and if you don't want to go because it is based in St. Brendan's there is Gamblers Anonymous."

Turning Point can be contacted on 239-2038.