Interviews and participant observation were used to generate a substantive grounded theory that explains the process of nurses becoming chemically dependent. Data collection included: reading 10 case histories of nurses who had appeared before the Board of Nursing because of a problem with chemical dependency; interviewing 20 nurses who admitted their dependence on drugs and/or alcohol and who were in the process of recovery; interviewing representatives of the Board of Nursing, Department of Professional Regulation, and nurse investigators; attending Board of Nursing hearings and meetings concerning nurses who violated the Nurse Practice Act; accompanying a nurse investigator on her rounds to do urine checks on chemically dependent nurses presently on probation; and observing meetings of a chemically dependent nurses' self-help group for a period of 1 year. Findings revealed that as a result of physical and/or psychological pain nurses who became chemically dependent embarked on a trajectory of self-annihilation. The stages and phases of the self-annihilation process are discussed.