The growth of Internet gambling sites is providing potential gambling addicts with around-the-clock ways to bet their money, a new paper from an Alberta researcher contends.

Even those who have never been to a casino and likely never will can still become addicted gamblers because of the proliferation of gambling website, argues University of Calgary psychologist Dr. David Hodgins, who runs the university's Addictive Behaviours Laboratory.

In an article in the online version of The Lancet medical journal that summarizes some of the latest research in the gambling addiction field, Hodgins writes that as gambling opportunities grow, so too do gambling disorders.

And yet there isn't much understanding of how the Internet play into these addictions.

"Most of our progress in recognizing and understanding gambling disorders has been made in the past 25 years," Hodgins said in a statement.

"Our knowledge continues to evolve in parallel with a burgeoning availability of gambling opportunities."

Canada has roughly 36,000 gambling venues across the country, but that number does not include bars with Video Lottery Terminals (VLTs) -- or gambling websites.

The temptation to gamble appears universal across time and geography, but there can still be wide variations between regions.

According to a chart this week in The Economist, based on data from H2 Gambling Capital, Canada has the fourth highest amount of gambling money spent per adult in the world, at nearly $600 per person.

Australia is at the top, followed by Singapore and Ireland. The United States, home to one of the most famous gambling cities in the world -- Las Vegas -- placed a distant 13th.

The chart looked at the net spending on legal gambling, divided by the number of adults.

Hodgins notes that gambling addiction often goes hand-in-hand with other mental health and substance-abuse disorders. Pathological gamblers have four times the increased risk of alcoholism, for example. They also have a six-times-increased risk of drug abuse, and a four-times-increased risk of having some kind of mood disorder, such as bipolar disorder.

"How concurrent disorders should be addressed in gambling treatment is not well understood and has not been empirically studied," he and his co-authors write.

Hodgins notes that it's not clear why some people develop gambling addictions and others do not. Genetic factors play a part, studies suggest. But environmental factors such as accessibility to gambling, location and type of establishment, clearly play a role too.

Hodgins estimates that shame and denial means only one in 10 problem gamblers actually seek treatment.

Cognitive behavioural therapy has proven to be about 60 per cent more effective than no treatment at all. This focuses on modifying distorted perceptions associated with gambling, including overestimating probabilities of winning, illusions of control over the outcome of a gamble, the belief that a win is due after a series of losses (the gambler's fallacy), and memory biases in favour of remembering wins.

But while drugs are approved for other addictions, such as alcohol abuse and drug addiction, no treatment has been approved anywhere for gambling disorders.

"While substantial progress has already been made, the increased visibility and awareness into gambling disorders is likely to encourage more innovative research in the field and hopefully better treatment," says Hodgins.