One third of cases involving nurses appearing before fitness to practise hearings relate to alcohol or drug abuse issues, according to new statistics.

Figures from the nursing regulatory body, the Nursing and Midwifery Board (NMBI), show that between 2006 and 2010, it carried out 115 fitness to practise inquiries, and 39 of these involved drug or alcohol abuse by nurses or midwives.

According to the NMBI, in all of these cases, there were also allegations of professional misconduct. Of the 39 cases, 28 involved drug abuse and 11 alcohol abuse.

Combined drug and alcohol abuse in these cases is rare, according to the NMBI.

According to the regulatory body, in some of the cases it heard relating to drug abuse, problems developed when nurses or midwives self-medicated instead of getting professional help for a problem such as pain, insomnia, anxiety, stress or depression.

Over time, according to a report from the NMBI, some needed larger doses or stronger medication.

"This may have led them from use to abuse of over-the counter-preparations containing codeine, or to a dependence on stronger opiate drugs."

The NMBI said some nurses who appeared before it in disciplinary hearings relating to drug abuse seemed to commence with abuse of strong mood-altering drugs.

It has warned that failure to deal with a drug/alcohol problem can pose a safety threat to patients.

Some of the drugs involved in these cases, it said, posed serious health risks, but use of 'street drugs' was not common in these cases.

The drugs abused by nurses included morphine, fentanyl, cyclomorph, pethidine, codeine, sedatives,antidepressants and steroids.

The NMBI said many of these problems in nurses were undetected for many years.

It said nurses and midwives should look for appropriate professional help if they are ill or distressed.

Self-medication can create an additional and more serious problems, according to the NMBI.

It stressed that nurse and midwife managers who suspect that a staff member has a drug or alcohol problem should take appropriate steps to deal with it.

"Early intervention protects patients and helps the nurse or midwife in question."

According to the NMBI report, problems can arise when a nurse or midwife fails to acknowledge that they have a health problem and fail to follow medical advice.

It says failing to deal with an alcohol or drug problem can lead to an application for an inquiry on the basis of alleged unfitness to practise by reason of physical or mental disability.

"A nurse or midwife with an alcohol or drug problem may also engage in behaviour that puts patients at risk, and which may constitute professional misconduct."

The NMBI says a nurse or midwife with an alcohol problem might be under the influence of alcohol while on duty.

A nurse or midwife with a drug problem might steal drugs, prescription pads, needles and syringes from the workplace and could forge prescriptions.

The doctors' regulatory body, the Medical Council, said it ws supporting 35 doctors at theend of last year last year through its Health Committee, which deals with medics who may have drug or alcohol problems.