How to Become a Substance Abuse Counselor in North Carolina

Created by SubstanceAbuseCounselor.org Contributing Writer

With the Charlotte-Mecklenburg Police Department dealing with the daily fallout of lives impacted by fentanyl addiction out on the city streets, and area ERs struggling under the weight of an increasing number of opioid-related emergencies, North Carolina is reeling.

It’s no longer a problem isolated to the back alleys of Charlotte. From North Tryon to South Charlotte, fentanyl is menacing the entire greater metro area. And the rest of the state is far from immune. Watch the news coming out of Raleigh, Greensboro, Durham, Winston-Salem or Fayetteville and the headlines are the same. From affluent areas to deep within the rural heart of the state, right now fentanyl and other opioids have emerged as a significant threat to public health and safety throughout North Carolina.

But to lose hope would be to let the scourge of opioid addiction win. If you’re here to learn how to become a substance abuse counselor in North Carolina, then you’re in the right place to do something about it.

In North Carolina substance abuse counselors are required to be licensed. There’s a low bar for entry in this field, allowing you the option to start building your career straight out of high school, while the highest level of licensure that you can work towards requires a master’s degree.

You’ll start out as a Certified Alcohol and Drug Counselor (CADC), and from there you’ll work your way up with education and supervised work experience to become a Licensed Clinical Addiction Specialist (LCAS).

As a CADC you’ll always work under supervision. Becoming an LCAS allows you to provide substance abuse counseling services independently, so you can help those who need you without having to be supervised.

Steps to Becoming Certified as a Substance Abuse Counselor in North Carolina

The North Carolina Addictions Specialist Professional Practice Board (NCASPPB) is the state-recognized body responsible for issuing the CADC, LCAS and other substance abuse counselor credentials, though it is not a state government agency.

The NCASPPB also issues the following supervisor and specialty credentials. We’re mentioning them here just so you’re aware of all credential options in North Carolina and how they fit in, though in this guide we’ll be focusing on getting started with the CADC and eventually moving up to the LCAS:

Certified Clinical Supervisor (CCS) – You’ll be working under the supervision of an LCAS who holds a CCS designation on their license as you accrue hours to become a CADC and LCAS yourself. The designation of Clinical Supervisor Intern (CSI) is for CCS candidates-in-training.
Certified Prevention Specialist (CPS) – These professionals fight substance abuse through community education and guidance counseling aimed at the prevention and reduction of substance abuse. Their scope of practice does not include on-on-one or group substance abuse counseling.
Certified Criminal Justice Addictions Professional (CCJP) – This credential is for those who want to work in law enforcement, the judiciary, or corrections. You must be either a CADC or LCAS first to qualify for the CCJP.

Now that you’re aware of the landscape of credentialing options, let’s talk about the steps to become a CADC and then an LCAS in North Carolina:

1. Consider Earning an Associate or Bachelor’s Degree in Addictions Counseling

2. Register with the NCASPPB

3. Become a CADC Intern by Passing the ADC Exam

4. Complete Education and Experience Requirements for Full CADC Licensure

5. Become an LCAS with a Master’s Degree and Pass the AADC Exam

Throughout the credentialing process you’ll be accessing forms and submitting materials to the NCASPPB through an online account you create with LearningBuilder, a third-party company NCASPPB has contracted with to manage the application process.

Step 1 – Consider Earning a an Associate or Bachelor’s Degree in Addictions Counseling

In North Carolina, on-the-job training and the accumulation of documented supervised experience hours is the foundation for developing the skills you need to become a substance abuse counselor.

Though an associate or bachelor’s degree in substance abuse counseling is not a requirement to become a CADC in North Carolina, there’s a number of reasons why earning a degree provides the ideal way to prepare for a career in the field, and also makes good sense on a very practical level:

It will fulfill the education requirements for becoming a CADC
It often includes a practicum that can fulfill the 300-hour supervised experience requirement to become a CADC Intern
When it’s time to complete your supervised work experience you’ll have a higher qualification and potentially better job prospects than CADCs who don’t have a degree
Credits completed as part of degree program can transfer to other schools. For example, you can stack a master’s degree on top of a bachelor’s degree as you move on to . Education completed through private training organizations is far less likely to be transferable to an academic program, and you must earn a master’s degree if you want to become an LCAS.

There are plenty of schools offering online associate or bachelor’s degrees in substance abuse counseling and related majors. The NCASPPB recognizes online education programs through accredited schools as being equal in every way to campus-based programs.

Step 2 – Register with the NCASPPB

Registering with the NCASPPB and being approved allows you to start accruing the hours of supervised work experience you need to qualify for full licensure as a CADC.

To register with NCASPPB, you’ll first need to land a job with a public or private organization that provides substance use disorder counseling and treatment.

This is a longstanding, standardized process in North Carolina, so employers here are accustomed to hiring untrained candidates new to the field so they can register with the NCASPPB and ultimately get the experience they need to start earning their credentials. It’s a great arrangement for everyone involved. Job candidates get the training they need with an established employer while earning a living, and employers get the benefit of being able to foster loyal counselors and train them to the exact standards, processes, and client types they specialize in working with.

Your employer will provide you with a mentor who you’ll work with closely while learning the ropes and gaining the experience you need. Your supervisor will be an LCAS with a Certified Clinical Supervisor (CCS) or Clinical Supervisor Intern (CSI) designation.

As part of the hiring process, your supervisor will fill out a supervision agreement form, which can be found in your online LearningBuilder account.

To activate and register through your LearningBuilder online account, you’ll start by paying a $25 fee. At that point you’ll also:

Provide documentation of a high school diploma or equivalency
Agrees to the NCASPPB’s ethical principles of conduct
Submit to a background check through the NC State Bureau of Investigation and FBI. Instructions for how to proceed with this are provided in your online account. You’ll need to be fingerprinted at a local law enforcement office. Results typically take 10-15 business days.
Upload your résumé
Upload proof of completion of three clock hours of ethics training

The NCASPPB maintains a list of approved providers of ethics trainings. For example, here is a qualifying three-hour self-study ethics course you can complete online for $35.

You can also count hours of ethics education that are part of a degree program if they are clinical in nature. For example, a course on philosophy and ethics doesn’t count, but a course on HIPAA ethics does.

Your registered status is valid for five years and you’re allowed to renew registration once for an additional five years if you need more time to accrue the required experience.

Step 3 – Become a CADC Intern by Passing the ADC Exam

The first thing you’ll need to qualify for Intern status is 300 hours of supervised work experience at a rate of one hour of supervision for every 10 hours of work experience. This should take you roughly two months to complete if you’re working full time. Your supervision needs to cover these 12 core functions:

Screening
Intake
Orientation
Assessment
Treatment planning
Counseling
Case management
Crisis intervention
Client education
Referral
Report and record keeping
Professional consultation

You can also complete these 300 hours as part of a supervised practicum experience that’s included in an academic degree or certificate program.

You and your supervisor will keep track of your supervised experience through your online account.

If you completed your 300 hours as part of an academic practicum then at this point you’ll need to find an employer who’s willing to hire you and provide you with a supervisor. You need to have a supervision agreement on file to proceed with the next steps.

With your 300 hours complete, your online LearningBuilder account will prompt you to pay for the required exam. This indicates that the NCASPPB has determined you’re ready to take the Alcohol and Drug Counselor (ADC) Exam, sponsored by the International Certification and Reciprocity Consortium (IC&RC).

ADC Exam

Once you pay the $150 exam fee, NCASPPB will send you the information you need to register for the ADC Exam with the IC&RC. You’ll select an exam site through their partner company ISO Quality Testing, which operates testing centers in most major cities throughout the state.

You have three hours to complete the 150-question multiple-choice exam. Exam content covers these four domains:

The IC&RC offers study materials to prepare for the ADC Exam, and there are plenty of free practice tests and study guides available through third-party websites.

Once you pass the exam the IC&RC will notify the NCASPPB, at which point your licensure status will be updated to CADC Intern.

Step 4 – Complete Education and Experience Requirements for Full CADC Licensure

To earn full CADC licensure you’ll need a total of 6,000 hours of supervised substance use disorder work experience and 270 hours of qualifying education.

Once you’ve completed the education and supervision requirements you can apply for full CADC licensure by paying the $200 certification fee on your online account. You must become fully licensed as a CADC within 10 years of registering with the NCASPPB.

Supervision

You can count your initial 300 hours of supervised work experience towards the 6,000-hour total (approximately three years).
Your supervisor must be an LCAS with a CCS or CSI designation.
You and your supervisor will keep track of your supervision and work experience on your online LearningBuilder account.
You need to have one hour of supervision for every 40 hours of practice.

Your supervisor has the option to supervise you individually or as part of a group, and via telehealth when you’re providing services over a platform like Zoom or Teams.

Education

Your 270 hours of education can be completed as part of an academic degree or certificate program. You need 270 clock hours, which are equivalent to 18 semester credits (15 clock hours is equal to one semester credit).

You can also find private training organizations that offer courses that fulfill this requirement. For example, the Connecticut-based Center for Addictions Studies and Research offers a qualifying 270-hour online training course for $2,160.

Your 270 clock hours of education must be distributed as follows:

190 hours of education on substance use disorders; up to 80 hours covering general skill building topics for counselors are permitted
6 hours on clinical ethics
6 hours on at least one of these topics: HIV, AIDS, STDs, TB, or blood borne pathogens (BBP)
6 hours on at least one of these topics: psychopathology, evidence-based treatment, or addictions as it relates to nicotine, domestic violence, veterans, or older adults

You’ll keep track of your education through your online LearningBuilder account.

With a Master’s Degree and More Experience Comes Advanced Certification Options in North Carolina

You’re not required to upgrade your CADC and become an LCAS, but doing so will allow you to work independently and move up to higher positions with more responsibility.

The first important thing you need to qualify for the LCAS license is a master’s degree. It must be in a field such as:

Once you’ve earned a qualifying master’s degree you can apply for LCAS Associate status through your online LearningBuilder account. You’ll upload your education info and then receive instructions on how to arrange for your school to send your transcripts to the NCASPPB.

When the NCASPPB approves your transcripts you’ll have the option to pay a $25 application fee, which will unlock your online LCAS Associate application.

As an LCAS Associate you can take the exam you need to qualify for full licensure: the AADC Exam. You’ll sign up through your online LearningBuilder account and pay a $150 exam fee, at which point the NCASPPB will send you information for registering.

AADC Exam

The Advanced Alcohol and Drug Counselor (AADC) Exam is sponsored by the IC&RC. It’s offered at ISO Quality Testing center sites in major cities throughout North Carolina.

You’ll have three hours to complete the exam’s 150 multiple-choice questions. Subjects covered on the exam are divided among these four main areas:

As you prepare to take this exam you’ll find study materials offered by the IC&RC and third-party test prep sites.

After passing the exam, C&RC will notify the NCASPPB. When the NCASPPB receives your passing exam score, you’ll be able to pay a $200 fee and become fully licensed as an LCAS!

Substance Abuse Counselor Jobs in Charlotte, Raleigh, Greensboro, and Throughout North Carolina

The setting is near a church and community college campus in Charlotte. The date is November 2023. The suspect: an alleged drug trafficker going by the alias Fat Man. He was arrested in a sting, accused of purchasing ghost guns, an assault rifle, and almost four pounds of meth, cocaine, and fentanyl.

Unfortunately that’s just par for the course. The bad news is that virtually all signs of North Carolina’s addiction epidemic are on the rise. The good news is that as more people are touched personally by this epidemic, more people are becoming motivated to do something about it.

Over the four years between 2019 and 2023 the number of substance abuse counselor jobs in North Carolina increased by 12%.

Within the substance use disorder counseling community in North Carolina, a number of employers have become household names:

Anuvia operates facilities in Charlotte that are divided among a main campus, an adolescent center, and a residential and detox center. Its history dates back to 1957, and today it offers services that range from assessment and outpatient treatment to medication-assisted therapy and in-patient care.
SouthLight operates four facilities based in Raleigh, Durham, and Fayetteville. Every day it provides over 700 people with opioid treatment. Outpatient services include counseling and community treatments, in addition to a women and children’s residential program.
Fellowship Hall is based out of Greensboro and uses a 12-step model to address drug and alcohol addiction. With a history going back to 1971, treatment options include personalized care, gender-based treatment, a residential program, detox, young adult treatments, and a multitude of outpatient services.

Substance Abuse Counselor Salary in Charlotte, Raleigh, Greensboro, and Throughout North Carolina

North Carolina offers one of the highest average salaries for substance abuse counselors in the region. At $56,510, that’s over $5k more than what’s offered in South Carolina, Alabama, Tennessee, or West Virginia.

Representing those in the mid-range of their careers, the salary for the top 25% came in at $63,910 in 2023. For those at the top, earning within the 90^th percentile salary, that number increases to $79,440 or more.

How Much Do Substance Abuse Counselors Make in Metro Charlotte

How Much Do Substance Abuse Counselors Make in Raleigh

How Much Do Substance Abuse Counselors Make in Metro Greensboro

How Much Do Substance Abuse Counselors Make in Durham-Chapel Hill

How Much Do Substance Abuse Counselors Make in Winston-Salem

Substance Abuse Counselor Degree Options in North Carolina

Most North Carolina undergraduate substance abuse counseling programs are offered at the associate and certificate levels. If you’re looking to fulfill the 270 clock hours of education to become a CADC through an academic certificate program, make sure it’s at least 18 semester credits. Associate degrees are typically 60 credits, easily meeting this requirement.

There are plenty of associate degree programs in substance abuse counseling that you can apply toward the first two years of a bachelor’s degree. And if you opt for a bachelor’s degree, you’ll find many options for online programs from schools throughout the nation.

Knowledge is power, and now you know what you need to do if you want to become a substance abuse counselor in North Carolina!

Blue Ridge Community College

Accreditation: SACSCOC
Campus

Associate Degrees

Cape Fear Community College

Accreditation: SACSCOC
Campus

Undergraduate Certificates

Associate Degrees

Central Carolina Community College

Accreditation: SACSCOC
Campus, Hybrid

Undergraduate Certificates

Associate Degrees

Central Piedmont Community College

Outpatient and Simulation Division
Accreditation: SACSCOC
Campus

Undergraduate Certificates

Human Services Technology Certificate with a Specialization in Substance Abuse
Human Services Technology Certificate with a Specialization in Substance Abuse Counseling
Human Services Technology Certificate with a Specialization in Substance Abuse and Behavioral Health Prevention
Human Services Technology Certificate with a Specialization in Substance Abuse & Criminal Justice

Associate Degrees

Davidson-Davie Community College

Accreditation: SACSCOC
Hybrid, Online

Undergraduate Certificates

Associate Degrees

East Carolina University

Department of Addictions and Rehabilitation Studies
Accreditation: SACSCOC
Hybrid

Bachelor's Degrees

Master's Degrees

Graduate Certificates

Gaston College

Accreditation: SACSCOC
Campus

Associate Degrees

Guilford Technical Community College

Human Services Technology Department
Accreditation: SACSCOC
Campus, Hybrid

Master's Degrees

Western Piedmont Community College

Accreditation: SACSCOC
Campus

Undergraduate Certificates

Associate Degrees

2023 US Bureau of Labor Statistics salary figures shown here for Substance Abuse, Behavioral Disorder, and Mental Health Counselors. Job growth projections are from the US Department of Labor-sponsored resource, CareerOneStop. Figures are based on state data, not school-specific information. Conditions in your area may vary. Data accessed August 2024.