Estimates of nurses with substance use disorders (SUDs) are approximately equal to those of the general public. Historically, nurses with SUDs faced public disciplinary action for any violations of the nurse practice act in their respective states, but now many states have alternative-to-discipline (ATD) programs available. Although the consent agreement for disciplinary and non-disciplinary programs are often similar, ATD programs are, in contrast, confidential and assist nurses to safely return to practice. As a RN and person in long-term recovery, I have first-hand experience with an ATD program. I credit the program with saving my career; however, it is not without criticism. Recommendations for improvements include increased education about ATD programs, research to evaluate efficacy of mandated interventions, including nurses in recovery within shared governance of these programs, implementing true peer support with nurses in long-term recovery, defraying the costs of the program to participants, and ensuring all staff within the programs receive standardized onboarding training followed by ongoing education. [
Journal of Psychosocial Nursing and Mental Health Services, 59
(3), 13–17.]