Addiction is a medical disorder that affects the brain and changes the behavior of many families in America. Scientist have identified many risk factors such as genetic, environmental, and chemical that can contribute to the development and progression of the disorder. These factors help in developing effective prevention and treatment approaches that can reduce the impact of drug use on individuals, families, and communities. In the healthcare field, many nurses choose to remain silent about a colleague who may have a substance-abuse problem because of loyalty, fear of being a hypocrite, guilt, or fear of jeopardizing a colleague’s license to practice. I think that the nursing profession should treat addiction as a disease requiring treatment rather than enforcing punishment to those who are affected by this epidemy. Addiction must be accepted as an illness so that nurses can help one another recognize and seek proper treatment that they deserve. Although opioids addiction among nurses is a serious problem, I find that throughout my clinical experience, this topic has not been fully covered by our instructors. I believe that the lack of education in this subject is likely to make new nurses like me very reluctant to work with or provide help to this group of nurses that are battling this crisis. If the attitude toward those with substance use disorders is more proactive through education and support, rather than reactionary, more people may get the help they need to overcome their addiction before losing their job.To help these substance use disorder nurses in receiving the help that they need, as we embark on our journey as new nurses, we need to know the signs and symptoms to look for in our colleagues, so they can be addressed promptly. Some health care professionals are more judgmental toward colleagues who abuse substances than they are toward others in the general population. This is probably because health care professionals are perceived to be highly educated, responsible people who have earned a position of trust with patients and patients’ family members. Non-abusing nurses often have moralistic, stereotypical, and pessimistic views about addiction. One explanation for this harsh view is that nurses expect perfection from themselves and their coworkers because they hold patients’ lives in their hands. One survey found that nurses perceive individuals who have substance abuse problems as immoral and as having character defects with low probability of recovery. Nurses who have substance abuse problems, therefore, carry the stigma associated with this breach in professionalism.Nurses who abuse drugs may support their addiction with prescription medications. Un-diverted prescriptions are obtained when a nurse asks a staff physician to write a prescription. Nurses who abuse drugs also forge prescriptions. Diverted prescription medications come either directly from patients or from the unit’s medication dispensing system. For example, sterile water or saline can be substituted for a patient’s dose when the medication is clear. The nurse then gives the remaining dose to the patient and saves the difference for his or her own use later. The nurse also may administer a partial dose to a patient and save the difference for his or her own use. Nurses also may self-administer wasted medications, which can happen when a colleague cosigns the narcotics record regarding a wasted medication without witnessing the medication being wasted.According to the ANA, nurses are responsible for responding when a colleague is exhibiting questionable practices. The ANA proposes that nurses help impaired colleagues obtain assistance by reporting suspicions or events to appropriate personnel in the employment setting. (Kunyk, D. (2015)). It is a nurse’s responsibility to respond to a coworker’s questionable practice as a patient advocate. A second major reason to report a nurse who behaves in a suspicious manner is to help that person. People who are addicted sometimes need help acknowledging and accepting treatment. Reporting a colleague could help save his or her life. To the contrary, another reason why many nurses do not report behaviors they find suspicious is because they do not believe that the incident was severe enough to report, or they believe that the nurse is a good care provider. Just as near misses should be reported, however, so should all suspicions about another nurse’s behavior be documented and reported to the nurse manager. Only as time passes will the weight of the documentation be shown to be relevant or irrelevant. In the meantime, there is no harm in collecting information. On the other hand, about 80% of nurses have not seek help for their use of alcohol or drugs because they are embarrassed, or they do not think anyone can help. Also, 53% of the nurses do not think they would be able to identify an impaired nurse, which shows the need for further education on early signs of a nurse who is abusing a substance. Education and awareness program could improve abilities of workplace peers to recognize cues as changes in nurses’ physical or emotional condition such as the use of pain medications documented in patients’ charts; and repeated absenteeism and/or excess tardiness. (Griffith, J. (2012)).The relationship between substance-related risks to patient safety, nurse health, and discipline is understudied even though the prevalence of substance use disorders is the same as the general population. (Cadiz, D. M., Truxillo, D. M., & O’Neill, C. (2015)). In this case, nurse managers can play a significant role in addressing substance-related issues among nurses and can be key to influencing the outcomes of these difficult situations. It is imperative that they identify substance abuse disorders among colleagues and aid in early rehabilitation of these nurses. Therefore, knowing the signs and symptoms of substance abuse among nurses can reassure that all nurses are fit to provide the best and safest care to their patients. This will also help nurse managers in tracking and documenting the nurses’ behavior and correct promptly any performance problems. The SPAN program is a great resource for individual nurses who are affected by a drug addiction related problem or related mental health problems. It is also a resource for schools, organizations, agencies, and healthcare facilities concerned about the effects of alcoholism and drug addiction on the nurse workforce. The program is staffed by registered nurses who understand the healthcare workplace and the psychological, professional, and legal problems that nurses affected by addiction face. Underlying every aspect of the SPAN program is the belief that every nurse deserves access to treatment, help in preserving his or her license and employment status, and ongoing support throughout the recovery process. SPAN is also designed to provide a balance between the needs of the nurse and the needs of the nurse’s patients, who are entitled to skilled and compassionate care. The aims are to restore the nurse to optimum health, preserve a career, and return a valuable resource to the healthcare community. (http://www.op.nysed.gov/prof/pap.htm) In conclusion, implementing an education program for early detection of substance abuse can lead to earlier identification of nurses with substance use disorder. If more nurses could determine if a co-worker shows signs of substance abuse, that nurse can receive treatment faster and as a result this will protect the patients in that hospital. Also, if the nursing staff is educated about the treatment options and if the hospital creates a non-judgmental atmosphere where nurses can securely seek assistance about substance use disorder, then they will be less afraid to step forward and ask for help when they know they need it.