Substance abuse counselors deliver care and support to people who are experiencing substance use disorders (SUD), making use of everything from the classic methods of psychotherapy (talk therapy) to education to referrals and service coordination with other healthcare and social services providers.
These days the preferred term for substance abuse counselors is substance use disorder (SUD) counselors. But you will also find the job listed or licensed under all kinds of different titles:
- Alcohol and drug counselor
- Addiction counselor
- Addiction therapist
- Alcoholism and drug abuse counselor
- Chemical dependency counselor
- Addictions practitioner
- Substance use disorder professional
Rather than just representing one job, substance abuse counseling contains many.
Every state recognizes different levels of expertise and practice within the field of substance abuse counseling. These range from peer counselors, who have experience with substance use disorders themselves and bring their experience to the table to help other people struggling through recovery, all the way up to master addiction counselors and supervisors, who have master’s degrees in the field and independent practice authority.
Yet despite their differences in qualifications, experience, and expertise, all of these professionals fulfill that core mission of providing care and support—the key ingredients to helping people experiencing addiction find their way to recovery.
To Define What a Substance Abuse Counselor Is, You First Have To Define What Substance Use Disorder Is
Most people have a fairly clear idea of what is meant by substance abuse. You know it when you see it. The trouble is that those ideas aren’t always the same from person to person or culture to culture.
Both the substances themselves and the level that rises to abuse are often in the eye of the beholder.
This all speaks to the many types and varying degrees of substance use disorders that counselors confront:
- Misuse of legally available products like nicotine and alcohol
- Illicit use of substances with no legal use or availability, such as heroin or methamphetamines
- Illegal or overuse of controlled substances such as opioid painkillers or prescription amphetamines
While some of these are clear-cut evidence of disorders, some are more borderline. Substance abuse counselors learn to diagnose problems by becoming familiar with all the many horrifying ways these substances cause harm.
There are often genuinely debilitating health effects that come with the overuse of certain substances. Heart disease, pancreatitis, stroke, tooth loss, liver disease, cancer… poisoning the body over the long term doesn’t end well.
Sometimes directly tied to physical damage, and sometimes the cumulative psychological damage that comes from being trapped in a cycle of self-destructive behavior, mental health issues also commonly co-occur with substance abuse.
Finally, there is the social blowback of substance use disorders. Substance abuse counselors aren’t usually responsible for handling the social fallout from substance abuse, but they surely see it up close and in living color. The secondary effects of substance abuse are sometimes the worst — families torn apart, crimes committed, neighborhoods destroyed.
While there are certain stereotypes about their patients, substance use disorder counselors know the truth: anyone, of any age, social background, cultural or ethnic heritage, can have a substance use disorder. They treat all kinds.
One thing should be clear: when the use of any substance gets to the point where a counselor needs to be involved, it’s definitely a problem.
How Substance Abuse Counseling Has Become the Key Response to America’s Addiction Crisis… and the Job Everyone is Talking About
When you get right down to it, substance abuse counselors are a lifeline for millions of Americans who are experiencing a substance use disorder.
America fought a war on drugs and lost. Policing its way out of chemical dependency caused terrible collateral damage. All the while, the country saw the inflow of dangerous drugs only increase and the numbers of people experiencing addiction and dying from it skyrocketing.
Substance abuse counselors are on the front line of a better way to handle addiction issues. Today they do it through the spectrum of public and mental health.
They work with both individuals and groups experiencing addiction. They may also counsel the families and friends of people with substance use disorder, assisting them in using evidence-based approaches to supporting loved ones on the path to recovery.
Substance abuse counselors are a ray of light in the darkness for individuals and families going through the depths of addiction.
In every single state, substance abuse counselors are licensed professionals. They have to prove they have the education and the experience to treat people who may only be hanging by a single thread of hope.
It’s a job with great responsibility. But it also offers the one true hope the country has to escape from the addiction crisis it is in.
Peer Support Specialists Are a Unique Kind of Substance Abuse Counselor
Just the fact you’re visiting this website may mean you are already aware of it, but there is a notable trend where many substance use disorder counselors are themselves former patients. Having found a way to recovery themselves, these individuals are more committed and have more first-hand understanding right from the start than someone without that kind of lived experience.
This fact has created a role that is pretty unique in behavioral health fields: the peer counselor.
Peer counselors have a qualification you can’t get in school or on the job: they or someone close to them has gone through addiction.
Most states have created an official role for these substance use treatment professionals that has a shorter path to getting credentialed. To get into this kind of role, you will typically only need between 40 and 100 hour of specialized training in a certificate program, often available online.
How Substance Abuse Counselors Are Succeeding in Leading America to Recovery
You’ve heard about what a substance abuse counselor is and learned about what they do. Your next question should be, how are substance abuse counselor’s doing?
Although it’s true that the numbers of untreated substance use disorder patients remain staggering, there’s some evidence that a surge in treatment is starting to have some impact in the opioid overdose crisis.
- Drug use among adolescents has receded to pre-pandemic levels and appears to be holding steady.
- After enormous spikes during the COVID-19 pandemic, overdose deaths at least seem to have leveled out according to 2022 data from the CDC (Centers for Disease Control and Prevention).
- The National Institute on Drug Abuse (NIDA) shows marked declines in both heroin overdoses and prescription drug overdoses since 2021.
More importantly, against the backdrop of death and devastation that shows up most frequently on the evening news, the real news is this: substance abuse counselors help the vast majority of substance use disorder patients recover.
Recovery from addiction is the norm for substance abuse counseling patients, not the exception.
A study published in 2021 found that around 10 percent of Americans—more than 20 million adults—had successfully recovered from a substance use disorder. And CDC and NIDA research from around the same period showed that roughly three quarters of people who experienced addiction manage to come through it. Every single one of those individuals has the opportunity to go on to live a full and productive life, free of the damage of substance abuse.
So if you are still trying to figure out what a substance abuse counselor is, maybe it’s this: people that help give other people their lives back.