Alcohol and drug abuse among physicians are important and persistent problems. The aim of this study was to highlight the magnitude of the problem and the factors related to alcohol and/or drug abuse, and to underline the importance of methods for prevention, early recognition, and treatment. The literature shows that the problem has a multifactorial origin. Occupational stress and ability to manage it play an important role. Easy access to drugs and the possibility of self-prescribing may have a contributory role. Anaesthesiologists, surgeons, and general practice physicians are the most vulnerable specialties, probably because of the stressful and competitive environment in which they work. The consequences may be devastating to users and their families, and may be life-threatening to their patients. Establishment of monitoring programmes may help define the magnitude of the problem, the contributory factors and prevention and early identification. Additionally, initiation of special education in medical schools about alcohol and drug use and management of the occupational stresses are all of paramount importance and may help thwart problems at earlier stages.