This paper describes the perceptions of boat owners and regional health workers about the use of alcohol and illicit substances within the West Australian mid-west coast fishing industry. It also reports on a survey conducted among fishing industry workers concerning their consumption of alcohol and illicit drugs while at sea and in port. Boat owners and health workers perceived that cannabis and alcohol were the most commonly used substances, a perception borne out by the results of the survey. While the levels of illicit drug use for this group were lower than those reported in the fishing industry in an eastern Australian state (Queensland), they were nevertheless considerably higher than those recorded for the general population aged up to 35 years in a National Drug Survey. Cannabis was indeed the most frequently used illicit drug and injecting drug use was minimal. Alcohol use was particularly high and binge drinking described frequently. The results are compared with other industry findings and discussed in terms of occupational health and safety. Recommendations are suggested for future prevention programmes.