Objective: To analyze science and practice surrounding nursing approaches to substance use disorders (SUDs) and make recommendations for the future. Methods: A review of literature and topics related to healthcare provider stigma, science surrounding SUDs, nursing approaches to SUDs in education and practice and evidence based treatment was conducted, analyzed and synthesized. Results: Stigma is embedded in nursing approach to SUDs, up to date information regarding SUDs is not widely disseminated or practiced in nursing. Conclusions: To reduce the impact of stigma and to bring nurses into the "turning the Tide" movement requires an understanding of how beliefs root stigma, building knowledge related to SUDs as an illness, and expansion of nurses' skill when intervening with individuals dealing with SUDs.