How to Become an Addiction and Substance Abuse Counselor

Never has there been more of a need in the United States for well-educated substance abuse counselors than there is today. Consider as evidence the drug abuse epidemic that continues to plague the nation. Drug overdoses killed 63,632 Americans in 2016, according to the Centers for Disease Control and Prevention (CDC). Opioids and other prescription drugs made up 66 percent of those deaths. The CDC also reports that alcohol is implicated in 88,000 deaths each year between 2006 and 2010. Illegal drug death rates continue to increase. The latest reports show cocaine-related deaths were up by 52.4 percent, heroin-related deaths by 19.5 percent and deaths related to psycho-stimulants were up by 33.3 percent.

Substance abuse counselors also referred to as addiction counselors, are among the professionals who are on the front lines of the nation’s expanding drug abuse epidemic, working diligently to help mitigate and solve the issue.

These experts offer support, empathy and guidance to people who are attempting to overcome their addictions. Effective substance counselors play a key and necessary role; most addicts have trouble quitting on their own. By providing therapy, education, coaching and overall support, substance abuse and addiction counselors help patients make the daily decision not to use or succumb to their addiction. Counselors also help their patients learn real-world coping skills and adopt new behaviors. The goal is to avoid any relapse from taking place and help patients finally become mentally and physically independent of their substance or addictive behavior.

A report published by the Substance Abuse and Mental Health Services Administration (SAMHSA) provides a well-rounded picture of the substance abuse counseling role. It identified competencies that effective counselors must possess, described many of the day-to-day responsibilities with which they are tasked, and outlined the skills necessary to complete these tasks. The following is a non-exhaustive list, referenced from the SAMHSA, that provides a sampling of the knowledge and responsibilities that substance abuse counselors must master.

1. Knowledge:

  • Comprehension of how psychoactive substances affect people
  • In-depth understanding of how people become involved in, and quit, drug use (from initiation and intoxication, through abuse and dependence and the road to recovery)
  • The symptoms of substance abuse disorders that are similar to those of other medical and/or psychological disorders and how those disorders interact
  • The methods for differentiating substance use disorders from other medical or psychological disorders
  • The role of family, social networks and community systems as assets or obstacles in the treatment and recovery process
  • Where service gaps exist and appropriate ways of advocating for new resources

2. Responsibilities and Skills:

  • Establish treatment priorities based on all available data
  • Communicate with clients in an effective manner that is sensitive to cultural and gender issues
  • Effectively elicit feedback and work creatively
  • Build lasting partnerships with patients and their support systems
  • Be able to time, sequence and prioritize tasks related to a patient’s recovery plan
  • Refer patients to the proper legal authority when necessary

As one might expect based on the deep knowledge and specific skills that are required, the typical process of becoming an addiction counselor requires both rigorous education and accreditation by a state-certified agency.

Each state has its own set of certification requirements, and some states use a tiered accreditation process. According to the U.S. Bureau of Labor Statistics (BLS), most positions for substance abuse counselors require a bachelor’s degree, while others require a master’s degree followed by an internship or practicum hours. Certain positions also require continuing education to stay current with changes in the field, ensure optimum patient care and keep current with evolving best practices.

For those who choose to pursue a career as an addiction counselor, BLS predicts “much faster than average” job growth (23 percent) and expects 60,300 new positions will become available through 2026. The median annual salary for substance abuse counselors is currently reported at more than $43,000 per year.

As addiction- and drug-related deaths continue to increase in the United States, so does the need for qualified, effective substance abuse counselors. By using a combination of proven and innovative therapeutic techniques, counselors are helping people overcome their dependence and lead healthy, full lives.

The University of Cincinnati offers a 100% online Substance Abuse Counseling degree. The program prepares students for a rewarding career in a high-demand profession in as little as two years. And, the University of Cincinnati’s bachelor’s degree in Substance Abuse Counseling is ranked #4 as the Best Online Addictions Counseling Bachelor’s Degrees on

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