Self-help groups such as AA and NA, also known as 12-step programmes, are not given enough importance by local authorities, according to Anthony Girard, a warranted social worker in the field of drug and alcohol addiction.

If they were given more importance, there would be more chance of long-term recovery from alcohol and drug addiction, he believes, insisting that "they simply work. "Something special happens when two people meet and discuss common problems... It is hard to put your finger on it, but something does happen," Mr Girard says.

AA is the natural and most effective step to remaining sober after rehabilitation, but it is not pushed enough - neither by the law courts, nor by the medical profession, Mr Girard maintains.

"Staying sober does not necessarily have to be a battle if you are on a programme, but it is if you are on your own... Stopping is not the problem; 'staying stopped' is. Being around people who are 30 years older and hearing their experiences and the consequences they suffered because they started using alcohol and did nothing about it is a strong deterrent," he believes.

While the courts and doctors rightly refer alcohol and drug users to the relevant agencies, the self-help groups should not be forgotten. Overseas, AA is an automatic step for those suffering from such problems, and it does not cost the Government anything.

"We still have lots to catch up on in this area: more can still be done to give exposure to the resources available for suffering alcoholics," he says.

AA and NA need more awareness and referrals, says Mr Girard, who headed San Blas, the Caritas drug rehabilitation service, from 2002 to 2006. He is now retired, but works part-time with the families of people with drug problems.

His experience has shown him that the culture of alcohol use in Malta has developed and changed over the years, especially where youngsters are concerned.

People have always used and abused alcohol, but until 25 years ago they drank primarily for enjoyment. However, his impression today is that it has become something of a 'cult' among youngsters. "They only drink to get drunk, and the logic seems to be that they would rather not drink at all, unless they know they are going to get drunk!"

Mr Girard fears youngsters have reached the point where they need to be anaesthetised to fight reality, and blames the fact that they are so "uninterested", as well as education pressures and social poverty.

Things have changed, but not necessarily for the better: 35 years ago, the stigma surrounding alcohol addiction was another story. "If there was an alcoholic in the family, the secret would remain in the family. Doors and windows would be shut until the situation deteriorated to the point that the person would end up in and out of Mount Carmel Hospital - the only facility available."

AA was established in Malta in 1966. But at the time it was considered to be some sort of a secret society and few joined. The recognition of a drug problem brewing on the island spurred the opening of San Blas in the late 1980s, and the situation for alcoholics changed dramatically in the early 1990s, with the opening of Sedqa, which saw the stigma start to fall apart. The problem is that drinking has also become fashionable, and has been glamorised over the years - something that goes down well with youngsters, Mr Girard points out.

The problem is that the vast majority of young people with drug problems also have severe alcohol problems. From experience, Mr Girard maintains that alcohol is the gateway to drug addiction in 90 per cent of the cases he has seen.

"Almost 200 drug users, who entered San Blas when I was head started their substance abuse with alcohol, and many at the ages of 10, 11 and 12. The pathway invariably leads to cannabis, ecstasy, cocaine and heroin.

"Those who undergo a rehabilitation programme and relapse normally do so via alcohol. Being legally and socially acceptable, and readily available, it eventually leads back to the drug of choice," Mr Girard says, convinced that the legal age to buy and consume alcohol should be 18.

It is a known fact that boys, especially, have not yet matured at 16, he says, describing them as being in  "no man's land - a dangerous time".