This paper will examine the prevalence/ incidence, etiology, treatment, and prognosis of nurses with substance use or abuse disorders. When a nurse with a substance disorder is first identified, the dilemma of discipline vs. treatment arises. The shift from a strict disciplinary dismissal approach to offering the option of treatment with monitored practice will be reviewed. The typical course of treatment offered through peer-assistance groups including nurse contracts will be presented in detail. Finally, current evidence on treatment and peer-assistance program success rates will be reviewed. Thus, opening informed discussion on the key question; can nurses with addiction receive treatment, return to practice, and provide safe patient care?