It’s no secret that the nation’s opioid epidemic has hit Tennessee with a vengeance. According to the CDC, Tennessee ranks eighth in the nation for opioid overdose deaths. In 2023 alone, more than 3,800 people in the state died from a drug overdose – 75 percent of those are attributed to illicitly manufactured street grade versions of the synthetic opioid fentanyl.
Sure, Chattanooga, Jackson, Knoxville, Memphis, and Nashville have all see the ugly side of the opioid crisis, but so have the Tennessee Hills. Throughout Appalachia, drug addiction has been prevalent and persistent for decades, reaching a fevered pitch during the height of the COVID epidemic.
The Road to Recovery: How a Mobile Clinic is Bringing Hope to Rural Tennessee
When it comes to the fight against drug addiction, the lion’s share of resources tend to be funneled to urban areas. And while the major metro areas of Tennessee undoubtedly need extensive support to combat the drug abuse epidemic, the rural counties here also have immediate and pressing needs.
With a focus on ensuring all regions of Tennessee get the help they so desperately need, two Middle Tennessee organizations announced they’re partnering up to take their services on the road. Their goal? To help remove barriers to treatment and ensure everyone has access to substance use disorder services, regardless of their ability to pay.
The Middle Tennessee State University’s Center for Health and Human Services (CHHS) has teamed up with Mt. Juliet-based Cedar Recovery to bring help to people within their communities. Thanks to a nearly $3 million federal grant from the Health Resources and Services Administration (HRSA), they were able to create a mobile clinic to bring much-needed services to Tennessee’s rural counties.
The Cedar Recovery mobile addiction treatment clinic is focused on those living in the state’s rural regions, who often have poor access to healthcare services. They’re bringing substance abuse counseling services and resources directly to the people living in Giles, Hickman, Lawrence, Franklin, and Marshall counties.
The cost of treatment is covered by the grant, and patients won’t need to leave their communities to receive it. Care here is largely focused on FDA-approved medication-assisted treatment.
But in Tennessee, fortitude and determination are woven into the state’s tapestry, and no one has any plans to sit idly by and let drug addiction win the fight. The Volunteer State isn’t just a moniker – people giving of themselves to help other people is something that happens here every day. From grassroots efforts to state-led initiatives, Tennessee is making strides to help conquer opioid addiction and the many lives it claims.
There are homegrown efforts like We Fight Monsters, a Memphis-based nonprofit that was formed by Ben and Jess Owen. The couple, along with their growing team, turn crack houses into safe housing for recovering mothers and children in need. There are regional efforts like the Tennessee Rural Community Opioid Response Program (TN-RCORP), an initiative between the Rural Health Association of Tennessee and more than 200 partners that’s focused on prevention, treatment, and recovery education and advocacy. And there are massive, statewide programs like Tennessee’s Opioid Abatement Council which, through targeted grants, supports projects aimed at fighting the opioid epidemic.
At the heart of the state’s opioid battle are Licensed Alcohol and Drug Abuse Counselors (LADAC), who are committed to serving their communities and state by ensuring that those suffering from substance use disorder and the people who love them receive counseling, education, and care throughout their journey from addiction to recovery.
Steps to Becoming Certified as a Substance Abuse Counselor in Tennessee
The Tennessee Department of Health is the agency responsible for licensing substance abuse counselors in Tennessee. Becoming a substance abuse counselor in Tennessee means earning the Licensed Alcohol and Drug Abuse Counselor (LADAC) credential.
Note: The Tennessee Certification Board (TCB), a nongovernment professional association and local affiliate of the IC&RC, also offers a voluntary credential — the Certified Alcohol and Drug Counselor (CADC) certification. But since Tennessee is a licensure state, the state government issued LADAC is the standard for gaining the legal authority to practice. The voluntary IC&RC certification is optional and can add another layer of professional recognition. In fact, you can only qualify for the voluntary certification through TCB if you first hold the LADAC.
There are two levels of LADAC licensure available through the Tennessee Department of Health:
- LADAC I: May provide alcohol and drug abuse counseling services in an alcohol and drug abuse treatment program or a recovery support program, or any program providing alcohol and drug abuse services other than a private practice.
- LADAC II: May provide alcohol and drug abuse counseling in an alcohol and drug abuse treatment program or a recovery support program, or any program providing alcohol and drug abuse services or in private practice. Level II LADACs may also apply to the Board to become a Qualified Clinical Supervisor.
The LADAC I is the natural starting point for anybody learning how to become a substance abuse counselor in Tennessee, so that’s what we’ll be covering in this guide. However, we’ve also detailed how to become an LADAC II in the final section, With a Higher Degree and More Experience Comes Advanced Certification Options.
Follow these steps to become an LADAC I in Tennessee:
1. Complete a 270-Hour Certificate Program in Alcohol and Drug Abuse Counseling and Consider Earning a Degree to Streamline Your Path to Licensure
2. Complete 6,000 Contact Hours of Supervised Clinical Counseling Experience (of fewer with a degree)
3. Apply for the LADAC I Credential Through the Tennessee Department of Health
4. Pass the NAADAC National Certified Addiction Counselor (NCAC) Level I Written Exam
Becoming a substance abuse counselor in Tennessee is an involved process, but much more attainable than in many other states that require a degree. We’ve taken all the necessary information you’ll need to know and broken it down into easy-to-follow steps that will allow you to pursue licensure as an LADAC with confidence.
1. Complete a 270-Hour Certificate Program in Alcohol and Drug Abuse Counseling and Consider Earning a Degree to Streamline Your Path to Licensure
First things first: you’ll need to be at least 21 years old, and you’ll need a minimum of a high school diploma or GED to become an LADAC in Tennessee.
You’ll then need to complete a formal course of training that’s at least 270 hours in duration –at least six of these hours must be related to alcohol and drug abuse counseling ethics. You can meet this requirement through a technical certificate program like the Substance Abuse Counseling Technical Certification offered at Southwest Tennessee Community College.
Even without strict degree requirements, there are benefits that come with earning a bachelor’s degree or higher in a field related to substance abuse counseling. Not only will it put you on the road to fulfilling the required clinical supervised training hours, thanks to embedded practicums/internships, it also dramatically reduces the total supervised experience hours required to qualify for the LADAC:
- No Degree - 6,000 contact hours required
- Bachelor’s Degree - 4,000 contact hours required
- Master’s Degree - 2,0000 contact hours required
A degree also allows you to begin meeting the education requirements you’ll need to qualify for the LADAC II credential (see With a Higher Degree and More Experience Comes Advanced Certification Options). Plus, many colleges and universities help students connect with local agencies where they can begin accruing their clinical supervised training hours.
2. Complete 6,000 Contact Hours of Supervised Clinical Counseling Experience (or fewer with a degree)
Now it’s time to put that formal education to use and begin accruing the 6,000 hours (about three years) of clinically supervised experience in the field covering the eight domains:
- Clinical Evaluation
- Treatment Planning
- Referral
- Service Coordination
- Counseling
- Client, family, and community education
- Documentation
- Professional and ethical responsibilities
As noted above, you can substitute 2,000 hours of experience for a bachelor’s degree or 4,000 hours for a master’s degree, dramatically reducing the time it takes to become licensed.
The experience may be paid or unpaid, and it must be under the direct supervision of a Qualified Clinical Supervisor.
It’s routine for employers throughout Tennessee to hire license candidates to fill either paid or unpaid internships. This provides an opportunity for the employer to train candidates in specific populations and treatment methods, as well as the culture of the organization. Not only does this arrangement provide candidates with the supervised experience necessary to qualify for licensure, it allows the employer to foster a sense of familiarity with the organization that often leads to interns wanting to continue working there after becoming licensed.
3. Apply for the LADAC I Credential through the Tennessee Department of Health
Once you’ve met the educational and supervised clinical supervision requirements, it’s time to apply for the LADAC I credential. The Tennessee Department of Health has transitioned to an online application process that allows applicants to easily apply for their initial application through their Licensure and Regulatory System online portal. You can upload all necessary documents and pay for licensure through this portal.
The application process also involves submitting a philosophy of treatment statement that speaks to your motivations and goals in the service of clients with substance use disorders.
A state jurisprudence exam is included in the application packet. You’ll need to take and pass this exam as part of your application process. This is an open-book exam, and you’ll need to answer 90 percent of the questions correctly to pass.
Once you’ve applied for the LADAC I, you’ll wait for notification from the Department of Health that your application has been approved. You’ll then receive a code and link that you’ll use to apply to take the NCAC exam.
4. Pass the NAADAC National Certified Addiction Counselor (NCAC) Level I Written Examination
Now that your application has been approved and the Department of Health has provided you with an exam code, you’ll need to apply to take the National Certified Addiction Counselor (NCAC) Level I written exam through the NAADAC – the Association for Addiction Professionals. You’ll submit an NCAC I application and pay the fee and wait for approval to schedule your NCAC I exam. Once your application is approved, you’ll receive a code and link to schedule your exam at a testing center near you.
The exam consists of 150, multiple-choice questions that cover the following topics:
- Treatment admission (screening, intake and orientation)
- Clinical assessment
- Ongoing treatment planning
- Counseling services (individual, group, family, crisis intervention and client education)
- Documentation
- Case management
- Discharge and continuing care
- Legal, ethical and professional growth issues
- Physiology and psychopharmacology
You’ll have three hours to take the exam. A score of 100/150 (67 percent) is needed to pass the exam. After passing the exam, the NAADAC will send the Department of Health your test scores, and your license will be issued.
To maintain your LADAC I license, you’ll need to complete at least 15 contact hours of continuing education every year. Nine hours must be face-to-face; six hours may be multi-media; and at least three hours must be related to ethics.
With a Higher Degree and More Experience Comes Advanced Certification Options in Tennessee
The Tennessee Department of Health offers the LADAC II for substance abuse counselors who want to provide counseling services in a private practice setting:
Licensed Alcohol and Drug Abuse Counselor II
- Earn a bachelor’s degree in a behavioral health related field or a graduate degree in a non-behavioral health related field
- Complete at least two years (4,000 hours) of experience providing alcohol and drug abuse counseling services under the direct supervision of a Qualified Clinical Supervisor
- Take and pass the NCAC Level II written exam or the Master Addiction Counselor (MAC) written exam
OR
- Earn a master’s degree or higher in a behavioral health related field
- Complete at least one year (2,000 hours) of experience while providing alcohol and drug abuse counseling services under the direct supervision of a Qualified Clinical Supervisor
- Take and pass the NCAC Level II written exam or the Master Addiction Counselor (MAC) written exam
Substance Abuse Counselor Jobs in Tennessee
According to the Centers for Disease Control (CDC), opioid overdose deaths in the majority of Tennessee counties soared past the national opioid overdose death rate of 30.8 deaths per 100,000 people between February 2023 and January 2024.
And in some counties, the rate of opioid overdose deaths were nearly six times the national rate:
- Lake County (Tiptonville): 173.3 deaths per 100,000 people
- Hardeman County (Bolivar): 125.2
- Roane County (Oak Ridge): 115.9
- Trousdale County (Hartsville): 114.1
- Knox County (Knoxville): 100.3
- Davidson County (Nashville): 93.1
- Morgan County: 88.1
- Cocke County: 85.6
- Anderson County: 71.0
- Hamblen County: 71.0
- DeKalb County: 66.0
- Sullivan County: 66.0
- Wayne County: 62.2
- Shelby County: 60.8
- Campbell County: 59.7
- Clairborne County: 58.2
- Green County: 55.1
Substance Abuse Counselor Jobs in Nashville, Memphis, Knoxville, and Chattanooga
Jobs for substance abuse counselors in Tennessee are found in urban and rural regions and in a variety of settings, including massive, hospital systems; small, independent facilities; and community-led programs.
Tennessee’s substance abuse counselors work for agencies like Centurion Health in Nashville, the provider of healthcare services for the Tennessee Department of Correction. They lend their talents to private companies like Memphis Recovery Centers, where they provide counseling and support services in adult and adolescent residential addiction rehab facilities. They serve as valuable members of treatment centers like Cumberland Heights in Knoxville, an intensive outpatient program. And they’re part of major programs like the Council for Alcohol & Drug Abuse Services (CADAS) in Chattanooga, which offers medical detox, adult residential treatment, intensive outpatient treatment, halfway houses, family housing, adolescent residential treatment, sober living apartments, and more.
Substance Abuse Counselor Salary in Chattanooga, Jackson, Knoxville, Memphis and Nashville
According to the Bureau of Labor Statistics (BLS), substance abuse counselors in Tennessee earned a median salary of $45,490 as of May 2023. Early career professionals here earned about $35,240, while those with advanced credentials and extensive experience earned about $75,330.
While most regions of Tennessee reported similar median salaries, the Nashville metro area (includes Davidson, Murfreesboro, and Franklin) came out on top, reporting a median salary of $48,750. Some of the highest paid substance abuse counselors were also found in the Nashville metro area during this time. The top earners here had salaries of about $82,370 as of May 2023.
- Chattanooga: $45,350 (median), $71,840 (top – 90th percentile)
- Jackson: $44,680 (median), $74,680 (top – 90th percentile)
- Johnson City: $39,670 (median), $68,310 (top – 90th percentile)
- Knoxville: $43,940 (median), $76,120 (top – 90th percentile)
- Memphis: $44,190 (median), $65,320 (top – 90th percentile)
- Nashville: $48,750 (median), $82,370 (top – 90th percentile)
Substance Abuse Counselor Degree Options in Tennessee
You won’t find many substance abuse counselor programs in Tennessee. Southwest Tennessee Community College offers a Substance Abuse Counseling Technical Certification program. At the bachelor’s level, Mid-South Christian College offers a Bachelor in Addictions Counseling, and the University of Memphis offers the only two graduate-level options in the state: an MS in Counseling-Addiction Counseling Concentration and an Interdisciplinary Graduate Certificate in Substance Abuse.
But you’ll find an outstanding selection of programs offered outside of the state, many of which are offered in convenient and flexible online formats. Many colleges and universities today offer these programs in partially or fully online formats that allow students to earn their degree from the comfort of their home.
Mid-South Christian College
Accreditation: ABHE
Campus
Bachelor's Degrees
- Bachelor in Addictions Counseling
Southwest Tennessee Community College
Division of Humanities, Social Sciences and Mathematics
Accreditation: SACSCOC
Campus
Undergraduate Certificates
- Technical Certificate in Substance Abuse Counseling
University of Memphis
College of Education
Accreditation: SACSCOC
Campus
Master's Degrees
- MS in Counseling-Addiction Counseling Concentration
Graduate Certificates
- Interdisciplinary Graduate Certificate in Substance Abuse
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.