The silence surrounding chemical dependence in healthcare professionals is deadly. Not only for the professional who has fallen into the trap of dependence but for the patients that they are providing care for. A growing concern in healthcare is the rise in chemical dependence and impaired professionals. Chemical dependence or substance abuse is a broad continuum that includes alcohol, illegal or “street” drugs, and prescription drugs. It is an epidemic that does not limit itself to any socio-economic, religious, or cultural boundaries. In 1984 the American Nurses Association (ANA) reported 6 to 8% of nurses suffered from chemical dependence. In 1998, ANA reported a rise of epidemic proportion. Although it is difficult to obtain accurate numbers ANA has estimated 7 to 24 % of nurses now suffer from chemical dependence (Tinkoff & amp;amp; Storr, 1998). An impaired nurse’s practice is affected in all aspects. Their ability to communicate is altered, assessments are unreliable, decision making skills are diminished, and most importantly patient safety is jeopardized (Nurses Association of New Brunswick, 2003). Nurses have an ethical responsibility to their patients and each other. The ANA Code of Ethics, Provision 3 states “The nurse promotes, advocates, and strives to protect the health, safety, and rights of the patient”. Substance abuse is a direct ethical violation of Provision 3. Beyond the risks placed on patients, colleagues of impaired professionals are placed in jeopardy as well. Provision 3.6 “In a situation where a nurse suspects another’s practice may be impaired, the nurse’s duty is to take action designed both to protect patients and to assure that the impaired individual receives assistance in regaining optimal functioning” (ANA Code of Ethics). Nurses need to be educated on the signs and symptoms of impaired professionals, and their ethical and legal responsibilities to report. Factors contributing to the rise in substance abuse are multifaceted.