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T hirty-nine years ago, I graduated from nursing school and began seeking employment. My first job was as a nurse working on an alcohol rehabilitation unit, and little did I know that I would not only receive a job, I would receive a ‘‘calling’’ that became my ‘‘passion’’Vaddictions nursing. At that time, bringing together nurses with my type of ‘‘calling’’ and ‘‘passion,’’ to accomplish great things in addressing the public health challenge of addictions, was achieved through organizational development by nurse leaders who acted, dreamed, planned, and believed. With the vision they came up with and then put into action, the International Nurses Society on Addictions (formerly the National Nurses Society on Addictions) continues to place a huge fingerprint on the ever-changing landscape of addictions. Because the current landscape of addictions around the world has undergone such a tremendous change, as addictions nurses, we must act, dream, plan, and believe, so that the benefit of the richness that we bring to the table through our personal experiences, best practices, research, education, and policy work can be felt globally. The purpose of this editorial is to share a snapshot of current addictions concerns here in the United States and around the world and motivate us as addictions nursesVboth individually and corporatelyVto think outside the box, dream, devise, and create and then plan and act in concert with leaders around the world to affect the changed landscape of our current global public health addictions challenges. At the core of all addictions remains the initial search for a high and altered state of mind and/or feeling or absence of mental and emotional existence in the face of life as it exists for an individual. In addition, there is loss of control over the behavior being used to achieve this mental and/or physical state, accompanied by resulting chaos in all aspects of life. The United Nations (2016) at their general assembly said it best: Drug dependence is a complex, multifactorial health disorder characterized by a chronic and relapsing nature with social causes and consequences that can be prevented and treated through, interalliances, effective scientific evidence-based drug treatment, care and rehabilitation programs, including community-based programs, and strengthened capacity for aftercare for and the rehabilitation, recovery and social reintegration of individuals with substance use disorders, including, as appropriate, through assistance for effective reintegration into the labor market and other support services. At the beginning of my career, addictions included various types of substances/drugs and processes such as gambling, food, sex, and shopping. There were, in most cases, anticipated steps of progression, symptoms, and approaches to treatment, which included those based on evidence and those based on experience. However, the current addictions challenges being experienced worldwide seem to defy what has been known and used in the past, with the exception of the end point of all addictive behaviors, its impact on the brain, and the fact that recovery is possible. New addictive problems and processes have been emerging at unprecedented rates. An example of a new and emerging process in addiction is the phenomenon of choking to get high. This addictions phenomenon has increased to such a level that a reporter from a local CBS news station in St. Louis shared the following: The ‘‘Choking Game’’ has sparked a social media craze with teen-agers posting photos and videos of people choking themselves for a brief high that causes people to pass outVor in some cases die. This involves strangulation and often fainting in order to induce a temporary feeling of euphoria caused by a lack of oxygen in the brain. It was also reported that medical professionals told KTVI-TV that teens cause the self-induced hyperventilation in order to achieve an adrenaline rush. (Fearnow, 2014) Karen Allen, PhD, RN, FAAN, Dean and Professor of Nursing, College of Nursing and Health Professions, Valparaiso University, Indiana. The author reports no conflicts of interest. The author alone is responsible for the content and writing of the article. Correspondence related to content to: Karen Allen, PhD, RN, FAAN, College of Nursing and Health Professions, Valparaiso University, 836 LaPorte Avenue, LeBien Hall, Room 106, Valparaiso, IN 46383. E-mail: [email protected] DOI: 10.1097/JAN.0000000000000227