The majority of junior doctors are damaging their health through excessive drinking, according to new research.

The use of drugs such as cannabis, cocaine, LSD, ecstasy and amphetamines is also widespread.

A study of junior doctors in the north-east of England found that 60% of the 93% who drank exceeded safe limits.

Most said they drank for pleasure, but the survey also showed high levels of anxiety and depression, particularly among women.

Forty-five per cent of women and 21% of men had pathological levels of anxiety. Eighteen per cent of women had problems sleeping and 53% found it difficult to become fully awake.

Around 11% of junior doctors regularly smoked cannabis and up to 13% took drugs such as cocaine, LSD, ecstasy and amphetamines.

Screening

Writing in the Lancet, the researchers said the study raised questions about whether doctors should be screened for drug and alcohol use, as workers in the army and other industries are.

But the British Medical Association said this would raise major civil liberties implications.

"We have not seen evidence that testing all these groups of health professionals is necessary, or that it would be effective," it said.

Dr Kim Hildyard, of the BMA's junior doctors' committee, said screening would only deal with the symptoms of the problem.

"It is better to look at the reasons why they drink," she said.

She said increased patient numbers and the fact that one in five junior doctors is still working over 72 hours a week was a factor.

The study showed junior doctors drank more than medical students.

Stress

Although the doctors said they drank for pleasure rather than because of stress, Dr Hildyard said this was because they rarely complained about their workload.

Doctors work hard and play hard, says one junior doctor

She thought the number of doctors who drank on duty was very small and believed heavy drinking during time off was part of the "work hard, play hard" attitude of doctors.

"If they stop and think about what they are doing and relax and rest, it will be difficult to keep going," she said.

She added that doctors were not very good at looking after their own health.

"They have a strong sense of duty and put patients above their own health," she said, adding that she knew of many who worked while ill because they were worried about cover.

She said women doctors were more likely to complain about anxiety, while men dealt with stress in different ways.

The BMA published a report with the General Medical Council in February on how to deal with doctors who drink.

It says early intervention offers the best chance of recovery.

The BMA say the figures found by the new report are consistent with its own research. It believes stress is a major factor.

And it says the statistics on drug use tally with recreational drug use by young people generally.

Random testing call

The survey was released a day after Dr Patrick Dixon, a British AIDS expert and author, called for random drug testing of doctors because alcohol and drug abuse.

Dr Dixon, the author of book "The Truth About Drugs", said one in doctors were addicted, and claimed the problem posed a significant threat to public health because patients' lives were being put at risk.

Dr Dixon said: "With around 10% of all doctors either intoxicated or withdrawing (from drugs or alcohol) we are faced with the fact that significant numbers of doctors have impaired judgment because of addiction."

He claimed that more than 1,000 doctors in London alone were addicts, but said their colleagues were reluctant to identify them because of fear of retribution.