Substance use disorder (SUD) counseling has come a long way over the past few decades. For one thing, it’s much more consistent and science-based than it used to be. What was once treated like a moral failing is now seen much more scientifically. Today, there are professionals, schools, and entire government agencies dedicated to testing new counseling techniques in the same way doctors test new medical procedures.
The same organizations exploring counseling techniques help new counselors learn the evidence-based skills they need to help their future clients find hope. Counselors and the people they serve stand to win with this structured, clinical approach.
With that being said, though, aspiring new counselors have a lot of information to comb through before they dive into this rewarding field. What degree, if any, do you need? How much will you make? Where should you look for jobs? Should you become a licensed SUD counselor or a certified counselor?
In this guide, we’ll help you answer those frequently asked questions about substance abuse counseling and more. Armed with that knowledge, you can plan your own career and become a beacon of hope for countless people in your community.
What Is an Addiction Counselor?
An addiction counselor is a behavioral health professional trained to help people through addiction recovery. They can help people one-on-one, in groups, and can even teach community classes about addiction.
While this kind of support can come from different types of professionals, addiction counselors are typically trained to provide evidence-based therapy and use clinical methods to assess and diagnose clients. And because many people battling addiction also face mental health issues, many counselors are also trained to provide therapy for anxiety, depression, and other co-occurring disorders.
In addition to being certified or licensed as a general SUD counselor, you can also be certified in a number of highly-focused specialities, too. This includes:
- Clinical SUD counseling. Clinical SUD counselors can actually diagnose substance use disorders and, in some cases, mental health disorders. A diagnosis is often crucial to helping people afford treatment through insurance.
- SUD Counselor Supervision. Supervisors are trained to help new counselors learn new skills, help organizations develop new treatment programs, and oversee treatment teams. If you’re interested in becoming a mentor to other counselors, this might be a great path for you.
- Criminal Justice Addictions. Recovering while being involved with the criminal justice system is often an uphill battle. Criminal justice addictions specialists are trained to help inmates, people on parole and probation, and at-risk communities.
- Peer Recovery. People in recovery often make excellent counselors because they can relate to clients on a deep level. Going through a peer recovery training program can help you learn how to use your own experiences to help others.
- Gambling, Nicotine, and Other Addictions. Some organizations offer training to counselors who want to help people deal with other types of disorders outside of traditional SUDs.
- Adolescent Addictions. Young people battling substance use disorders often have unique obstacles to overcome. They often deal with trauma and undiagnosed mental health disorders and are in fragile stages of their development. Becoming certified in adolescent addictions counseling can help you serve this especially vulnerable population.
To become certified in any of these specialities, you can seek training through national organizations like the International Credentialing & Reciprocity Consortium (IC&RC) or the National Association for Alcoholism and Drug Abuse Counselors (NAADAC). There might also be state agencies in your area that provide specialty training. If you earn a degree in SUD counseling, you may have the chance to specialize in one of these areas, as well.
What’s In a Name? The Many Titles Counselors Use
Whether you’ve been exploring counseling as a career or are in recovery yourself, you’ve probably noticed that addiction counselor isn’t the only title these professionals go by. Some are called substance abuse counselors while others use the more recent title of substance use disorder counselor or SUD counselor. Is there a difference?
Typically, no. All of these professionals go through the same training and provide the same services. But to many people, the terms addiction and substance abuse are highly stigmatized. They imply that a person has done something wrong, is weak, or has some sort of moral problem. In the recovery community, these attitudes can be dangerous because they can create self-loathing and make people think that they can’t recover when that isn’t the case at all.
In that sense, the term substance use disorder is a little less loaded. It’s more clinical. It implies that while a person may be battling a substance use disorder, it’s not their whole identity. It’s something they can overcome and treat. So while not every organization uses SUD counselor, more professionals are moving in that direction.
Where Do Substance Abuse Counselors Work?
While addiction counselors often work in in-patient and out-patient substance use disorder treatment centers, they have so many other job opportunities, as well. As an addiction counselor, you might work at:
- Government social service or human service agencies
- Correctional facilities such as juvenile detention centers, jails, or prisons
- Mental health centers
- Community health centers
- Nonprofits that advocate for the recovery community and support local treatment providers
- Medical hospitals
- Faith-based organizations
- Small private practices of all kinds
If you earn a Master’s degree in Addiction Counseling and pursue a high-level clinical license or certification, you can even operate your own independent practice.
How Can I Become a Certified Substance Abuse Counselor?
To become a certified substance use disorder counselor, you can go through one of the two national SUD counselor credentialing agencies: the International Credentialing & Reciprocity Consortium (IC&RC) or the National Association for Alcoholism and Drug Abuse Counselors (NAADAC).
While both agencies have their own certification requirements, the process you’ll go through with either one is generally the same:
- Earn a bachelor’s degree in a counseling-related subject such as addiction studies.
- Take classes on specific topics like evidence-based counseling techniques, case management, and the pharmacology of addiction.
- Complete supervised practice hours requirements.
- Pass a standardized exam.
You can also get certified as an addiction counselor through local state-based agencies, as well. In many cases, these agencies are local affiliates of the IC&RC or the NAADAC. Certification requirements in your own state may differ slightly from national standards.
How Can I Become a Licensed Substance Abuse Counselor?
If you want to become licensed as an SUD counselor, you’ll need to go through your state government’s counselor licensing agency. In most cases, licensing requirements are the same or at least very similar to national certification requirements.
However, certification and licensure aren’t the same thing. Certifications are often voluntary and offered through non-government counseling agencies like the NAADAC or IC&RC. Licenses are often required and offered through state government agencies. But not all states require counselors to have licenses or even offer SUD counselor licenses. You’ll want to investigate your own state’s licensing and certification laws to determine which one is right for you.
How Can I Become a Substance Abuse Counselor Without a Degree?
Whether you can become a substance use disorder counselor without a degree depends on your state’s counselor credentialing regulations. In some states, you’ll need an associate or bachelor’s degree at minimum. In others, you can become one with a high school diploma or GED.
To become a substance abuse counselor with a high school diploma or GED, you’ll likely need to:
- Take courses on substance use disorders through local colleges, universities, professional counselor training organizations, or continuing education providers. You may even be able to earn a certificate in addiction studies without earning a degree.
- Complete supervised practice hours. These are on-the-job training hours completed under the guidance of a fully-licensed counselor.
- Pass a standardized test designed for new SUD counselors.
However, you can also enter the recovery workforce by becoming a peer recovery specialist (a person in recovery trained to help others navigate the process) or a substance use disorder technician (a specialist who helps counselors carry out administrative, case management, and client care duties). These positions typically require less training and either a high school diploma or GED.
How Long Does It Take To Become a Substance Abuse Counselor?
How long it takes to become a substance use disorder counselor depends on what kind of degree (if any) you need to qualify for initial certification in your state:
- Associate degrees typically take two years to earn
- Bachelor’s degrees typically take four years to earn
- Master’s degrees typically take about six years — four years for your bachelor’s and two years for your master’s
After graduation, you’ll also likely have to complete anywhere from 2,000 to about 6,000 hours of supervised practice before you earn your full counselor license or certification. This is equivalent to about one to three years of full-time work. During this time, you’ll be able to work as a counselor under the guidance of a full-fledged professional, but you won’t earn your own full license until after you complete your hours and pass a standardized test.
Can You Become a Substance Abuse Counselor With a Misdemeanor?
It’s definitely possible to become a substance abuse counselor with a misdemeanor. For many people who battle substance use disorders, legal issues are a part of their stories. If you’ve encountered legal issues yourself, those struggles could very well help you connect with and help your clients.
However, many state counselor credentialing agencies perform background checks. You may have to discuss past convictions on your application or with an interviewer. Also, some agencies may reject candidates with violent crimes or crimes against children. These regulations vary from state-to-state so it’s important to check your own state’s SUD counselor credentialing regulations.
Can You Become a Substance Abuse Counselor With a Felony?
Like becoming a counselor with a misdemeanor, you can definitely become a substance abuse counselor with a felony on your record. Just be prepared to discuss past convictions on your application or with interviewers. Once again, violent crimes may disqualify you from licensure or certification in some jurisdictions. Also, felonies may prevent you from working in settings like schools, but this varies from jurisdiction to jurisdiction.
How Much Does a Substance Abuse Counselor Make a Year?
According to the Bureau of Labor Statistics (BLS), substance abuse counselors make a median salary of $53,710 as of May 2023. Entry-level counselors make closer to $36,700 while the highest-earning, most experienced professionals make around $89,920 and up. Keep in mind, though, that counselors in your area might have different salary expectations.
But on top of that, a counselor’s salary is often determined by their level of certification or licensure:
- Peer Recovery Specialist salary: $39,630 - $62,860.
- Substance Use Disorder Technician salary: $39,610 - $59,990.
- Associate Substance Use Disorder Counselor salary: $44,600 - $53,710.
- Clinical Substance Use Disorder Counselor Salary: $70,130 - $89,920.
- Independent Clinical Substance Use Disorder Treatment Counselor/Supervisor Salary: $89,920 and up.
Your own salary may vary, but these figures can help you get a picture of what your earning power could be throughout your career.
Is Substance Abuse Counselor a Good Career?
Substance use disorder counseling is a rewarding and, just as importantly, a high-demand career. As a counselor, you’ll be able to help people through some of the most challenging moments of their lives. Recovery almost always has its ups, downs, and set-backs, but no matter what your clients face, you’ll be there to support them.
According to the BLS, employment for substance abuse, mental health, and behavioral disorder counselors is expected to increase by 18% through 2032. That’s the equivalent of about 42,000 job openings every year. On average, the BLS expects employment in all sectors of the economy to grow by just 3%. As society breaks down the stigma of addiction and prioritizes holistic wellbeing, it’s possible that this life-saving workforce could grow even more.
Can Addiction Counselors Bill Insurance?
The relationship between substance use disorder treatment and insurance is complicated. The short answer is yes, addiction counselors can sometimes bill insurance — but only sometimes.
According to a 2014 statement from the US Office of National Drug Control Policy, the Affordable Care Act (ACA) mandates that all insurance plans sold through public health insurance marketplaces and all Medicaid plans cover substance use disorder treatment. This was a massive win for recovery in America, but it doesn’t mean all counselors can bill through insurance. Here’s why:
- ACA regulations don’t affect all insurance providers. While all Medicaid and marketplace plans must cover treatment, private insurance plans offered through employers and other sources don’t necessarily have to.
- State insurance billing regulations vary widely. According to a 2019 report by the US Department of Health and Human Services, only 11 states allow SUD counselors to bill insurance independently. In the remaining states, treatment is typically only covered when it’s provided by a psychiatrist, clinical social worker, or other licensed behavioral health professional.
- Not all types of counselors can bill insurance. In states where SUD counselors can bill insurance, they must often be licensed through the state — not just certified. And because not all states offer licensure, counselors in states that don’t offer it generally can’t bill through insurance. Additionally, sometimes only licensed clinical SUD counselors (counselors who can diagnose patients and practice independently) can bill through insurance.
So what does this mean for you as a counselor?
It means that if you become an SUD counselor through certification and not licensure, you may not be able to bill clients directly through insurance unless you work under the supervision of a licensed professional. Depending on where you live, you might be able to bill insurance after earning a master’s degree and becoming a licensed SUD counselor or a licensed clinical SUD counselor who can diagnose clients.
But don’t let that discourage you from taking this rewarding path. While SUD counselor certification, licensing, and insurance laws are inconsistent at the moment, they’ve come a long way, especially after Affordable Care Act reforms. In fact, the Department of Health and Human Services’ 2019 report advises organizations in the recovery community to collaborate and make treatment more accessible to more people.
If you become an SUD counselor yourself, you could very well be a part of that movement and use your expertise to not just help individuals, but bring hope to people across the entire nation.
2023 US Bureau of Labor Statistics salary figures for Substance Abuse, Behavioral Disorder, and Mental Health Counselors. Job growth projections 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.