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The study aim was to describe nurse anesthetists' reflections on the provision of perioperative care to patients with previous substance dependence.A qualitative approach with a descriptive design.Semistructured interviews based on clinical vignettes were conducted with 10 nurse anesthetists.The perioperative care provided to patients with previous substance dependence was perceived as balancing between professionalism and preconceptions for this specific patient group. The nurse anesthetists felt that anesthetizing this group of patients constituted a challenge with regard to knowledge, experience, and time. However, the nurses also had feelings of distrust and uncertainty because of lack of knowledge.The nurse anesthetists strove to uphold the principle that patients who are/have been substance dependent have the same right to adequate treatment and care as all patients. If guidelines were developed for this patient group, care could be made safer and nurses' sense of uncertainty minimized.