Background This paper presents the findings from an exploratory study on alcohol and other drugs (AOD) nurses’ views on current career opportunities and challenges and on how their role has been affected by clinical and structural changes in service delivery.

Methods The paper is based on qualitative interviews with a purposive sample of twelve AOD nurses in the UK. A narrative approach to interviewing aimed to encourage emergence of new insights and suggest theories for future examination. Interview domains were informed by the research team’s knowledge of AOD nursing and by themes from published literature. Interviews were recorded, transcribed, and coded and a reflexive thematic analysis was conducted.

Results Key themes emerging focused on the growth, advantages, and challenges of non-medical prescribing (NMP), and the impact on AOD nursing of changes in workforce structures and environments. The findings indicate considerable doubts about career opportunities for nurses in AOD services although NMP may offer some limited routes to career advancement.

Conclusions Some long-standing issues around the identity and professional status of AOD nurses persist and current clinical and structural changes have created a “liminal space” within which the nursing role and AOD nurse identityare disrupted and in transition.