Substance Abuse Counselor Career Guide

There are about 310,880 substance abuse and behavioral disorder counselors in the US (included in the same group as behavioral disorder and mental health counselors).¹ Substance abuse counselors provide alcohol counseling, drug counseling, and counseling for related addictions. Other common terms for substance abuse counselors include drug abuse counselor, drug counselor, alcohol abuse counselor, and addiction counselor. They can be found working in a wide variety of settings including private treatment centers, group treatment centers, and community health centers, as well as in doctor’s offices and hospitals. The majority (19%) of substance abuse counselors work in outpatient centers, though many (15%) are employed in individual and family services; 10% are employed in hospitals; 9% are employed in inpatient facilities; and another 8% are employed in government positions.² This guide provides detailed information on how to become a substance abuse counselor, common requirements, and salary and career outlook information for substance abuse counselors.

What Does a Substance Abuse Counselor Do?

Drug and alcohol counselors provide treatment and guidance on behavior to clients who are struggling with addictions. Addiction counseling can take place in one-on-one or group settings. An addiction counselor may choose to focus on the treatment of one particular addiction or related group of addictions or may treat the spectrum of addiction disorders. There are a variety of treatment approaches for counseling those with addictions, and addiction counselors will typically specialize in certain approaches to therapy.

Addiction counselors may work in private practice or independently or they may be found working within a group practice. They may also be found on the staff of hospitals and other large health centers that treat a range of health issues as part of a patient care team. For example, an individual with alcoholism may be suffering from physical ailments such as liver failure that can be related to alcohol abuse, and the substance abuse counselor may treat the mental aspects of addiction while doctors and others on the care team treat the physical disorders.

Substance Abuse Counselor Requirements and Common Tasks

In most states and circumstances, substance abuse counselors must be licensed or certified by the state in which they intend to work. Unlike what is seen in most other types of counseling, substance abuse counselors can become licensed or credentialed in some states with as little as a high school diploma or associate degree plus supervised experience working in alcohol and drug counseling. However, this can vary widely by state; in some states, a bachelor’s or master’s degree is required. Many states have more than one level of credentialing, with entry-level credentials requiring practitioners to be supervised. In some states, addiction counselors must sign a statement attesting to their sobriety and must maintain that sobriety in order for their license to remain valid.

In addition to providing direct counseling and group therapy, substance abuse counselors spend a large part of the day on routine tasks such as paperwork. Thoroughly documenting what occurs in counseling sessions and keeping track of patient outcomes is a critical part of this job. Drug and alcohol counselors may also provide referrals to other professionals such as medical doctors and psychologists when clients have problems that fall outside of their scope of practice.

Continuing education is a common requirement for substance abuse counselors, as they usually are required to complete a certain number of hours of formal training each year in order to maintain their license. Many substance abuse counselors also choose to work towards additional certifications and/or higher education.

How to Become a Substance Abuse Counselor

Since substance abuse counselors occupy a position of trust with their clients and the public at large, all 50 states have set requirements governing counselor licensure. As noted above, licensure may or may not require a college degree. However, earning a degree will usually qualify the prospective counselor for higher levels of licensure, and therefore, expanded career opportunities. The steps to becoming a substance abuse counselor typically involve:

1. Earn a degree or certificate that fulfills the substance abuse counselor training required by your state.
2. Gain supervised experience in substance abuse therapy while working under the direction of a licensed counselor (if required in your state).
3. Take any counselor exams required for your desired license.
4. Apply for a license.
5. Begin applying for substance abuse counselor jobs.

The license and job title for drug and alcohol counselors can vary by state. Common terms include certified addiction counselor, licensed clinical addictions specialist, certified substance abuse counselor, licensed alcohol and drug abuse counselor, licensed substance abuse counselor, and certified drug and alcohol counselor.

Substance Abuse Counselor Education and Job Training

In some states, you can work as a substance abuse counselor, sometimes called a technician, trainee, or assistant, with a high school diploma if you are working under the direct supervision of a licensed counselor. However, it is more common for states to require licensure based on at least some formal training in alcohol and drug counseling, be that a certificate or degree program. Fortunately, there are a wide variety of substance abuse counselor degree programs that can help you meet these requirements.

If you already have an associate’s or bachelor’s degree, but not a substance abuse counseling degree, you can typically qualify for licensure as an addiction counselor by completing a certificate program. A master’s degree is another option that can help you launch a career in this field. Be sure to check your state’s requirements before committing to a program.

Substance Abuse Counselor Careers by Degree Level

According to a survey from O*NET OnLine, 41% of respondents working in the industry said that a master’s degree is required to be a substance abuse counselor, while 24% said that a high school diploma or equivalent is required.³ Since the type of career you can expect with a degree in substance abuse varies by degree level, we have designed the table below to help you research common jobs and requirements. State licensing standards for substance abuse counselors also vary from state to state, so there are also significant differences in the degrees required for certain job titles from state to state. In addition to state standards, you will also find variances in how employers define a given role. With this in mind, the below table outlines the general relationship between a given degree and associated careers, though requirements in your area or for a specific job posting may be higher or lower.