Step-by-Step Guide to Becoming a Substance Use Disorder Counselor in Your State

Written by Scott Wilson

young man during therapy session

There’s no picture of chemical dependency that’s pretty. And lot of people compelled to help know that all too well. Many have witnessed it with their own eyes.

The parent who hasnt been able to resist the bottle, losing their driver’s license, their job, and their reputation after one too many DWIs… The older sister who got hooked on prescription opioids, slipping into the abyss of full-blown addiction after turning to cheaper and more accessible street drugs… The best friend who started with cocaine at parties whose erratic behavior eventually cost them their marriage and visitation rights with their kids.

It’s not hard to find a reason to want to help people struggling with substance use disorders. And for some, its impossible not to feel a burning drive to do something about it.

For the most compassionate and the most motivated, deciding what to do is easy: become a substance abuse counselor.

A Note on Job Titles for Substance Use Treatment Professionals

Substance use treatment professionals step up to help people from all walks of life overcome addiction. They go by various names, which can differ according to the specific state or national certification they hold, and sometimes just based on the titles that happen to be commonly used in different parts of the country. The professional titles might be different, but the nature of their work is much the same:

Whatever the job title might be, it’s a role that comes with weighty responsibilities, and one that takes a lot of patience and compassion.

An Evolving Understanding of the Psychology of Addiction Helps Explain Why There are so Many Titles for This Profession

addiction counseling on wood blocksWhy so many titles for substance use disorder (SUD) counselors?

Theres a strong movement within the profession to lean away from words that are seen as judgmental.

In this perspective, its not helpful to apply a loaded word like abuse to the field. Abuse implies that there is a certain, standard, safe level of use. As every counselor knows, some substances arent safe at any speed.

The stigma and negative bias associated with words like “abuse” and “addict” prevents people from seeking treatment. Thats the last thing that anyone in this field wants to happen.

The National Institute on Drug Abuse publishes a quick guide to preferred unbiased language alternatives for substance use disorder cases. For starters, it recommends substance use disorder versus substance abuse, and patient versus drug abuser.

Yet, as you can tell from the very name of the institute itself, language is sticky stuff. Most people arent reading the literature. Communication only works if everyone understands the terms being used. People naturally go with terms they’re already familiar with, and always prefer shorter phrases over longer ones.

So although substance use disorder (SUD) counselor is now the most appropriate term to describe the profession, dont expect the world to change overnight.

You’ll still hear people with substance use disorders referred to as addicts – many still refer to themselves that way. And when those people look for help, they are likely to start by searching for substance abuse counselors.

Many different professions have a hand in dealing with the scourge of chemical dependency. Physicians treat the physical damage done by dangerous substances and prescribe medications that can ease the path to sobriety. Psychologists can help people past the mental hurdles of addiction and help repair relationships and social development. Social workers handle the fallout and practical challenges of recovery and support.

By any name or job title, only substance use treatment professionals specialize in bringing together the various kinds of expertise and proven treatments that patients truly need to recover from the darkness.

The sensitive and high-stakes nature of this work is why youll need specific training and experience to become a substance use disorder counselor, no matter which state you live in.

The Steps Before Your Steps: Figuring Out What Kind of Counselor You Are Meant to Be

young woman in therapy with counselorNaturally, there are certain prescriptive steps to take to become a substance use disorder counselor. But you’ll quickly find that a list of steps laid out on a web page doesn’t really line up with how things go in real life.

Often, that’s because coming to this kind of work is a deeply personal journey. For many counselors, that journey comes with a few turns, and maybe even a crossroads or two along the way.

More than a few substance use disorder counselors come to the profession after touching the void of addiction themselves.

Maybe that speaks to a kind of step that comes before the steps that lead to your certification and professional employment. Maybe the nature of being called to this challenging job is a kind of requirement that you can’t check a box for. It’s something buried in your soul, a sum of experience, duty, and talent that gives you the drive to get through every other step.

At the other end is something more than a certification and a job. It’s a lifeline going out to hundreds and maybe thousands of people in trouble who you’ll save over the course of your career.

With a maze of requirements, different processes in every state, and options for both state-level and national certification, you will need to carefully plot your path to the front lines of the battle with Americas substance use crisis.

We’re here to help. It might be hard to imagine now, but by the time you’re meeting with patients, you’ll have both the first-hand experience and the counseling skills to save lives. We’ll help you get there.

Step 1. Earn a College Degree or Certificate Covering the Science and Psychology of Substance Use Disorder

gathering of people in group meeting

Education is always the cornerstone of counseling.

Even if you got your first lessons on the streets, you know that substance use disorder is a complex subject. It hinges in part on science: the chemistry of psychoactive compounds, the biology of addiction. Psychology is a big part of it too.

Treatment requires a firm grounding in the psychological aspects of addiction.

Yet it also requires an understanding of sociology and culture. Solutions to the crisis are larger than individuals. To offer effective treatment, it’s important to be able to see the people suffering from the disease of addiction in the context of culture, politics, and society.

While there is generally some flexibility in the specific degree focus or major required for certification, states typically require the degree to cover a certain number of credits in areas critical to substance use disorder interventions. This makes degrees in substance use disorder counseling a natural choice.

Associate Degree (AA, AS, and AAS) in Substance Abuse Counseling

A two-year associate degree in substance use disorder counseling, human services, or a related field is the standard minimum for entry-level certification in many states. But an increasing number of states are requiring full four-year bachelors degrees for non-supervised counseling roles and a full scope of practice that includes the ability to diagnose substance use disorder and create treatment plans for individual patients.

But that’s not always the case. In fact, four states recognize an associate degree as the educational minimum for attaining the highest level of licensure available, qualifying SUD counselors to work as supervisors and independent practitioners:

A higher degree will certainly take you further in your career, opening up opportunities to manage state and community programs or private treatment facilities, but an associate degree is all the state requires for licensure here.

Bachelor’s Degrees (BA, BS) in Substance Abuse Counseling

A bachelors program, of course, has more to offer than an associate degree in both the sciences and liberal arts, so it’s worth considering even if it isn’t a requirement for certification in your state. Holding a bachelor’s will also reduce the number of pre-professional practice hours you’re required to complete, while providing more in-depth study of:

At the same time, the critical and very human ability to feel empathy and to communicate are cultivated through more liberal studies courses. You also have the opportunity to broaden your understanding of substance use disorder through studies of history, sociology, and even politics. Thats all knowledge that can make you a stronger advocate and a better partner for patients going through the depths of addiction.

Five states plus Washington, DC recognize a bachelor’s degree as the educational minimum for attaining the highest level of licensure available, qualifying SUD counselors to work as supervisors and independent practitioners:

You can still enter the field in these states with a lower degree, but a bachelor’s should be on your radar as you consider long term career goals here.

Master’s Degree (MA, MS) in Substance Abuse Counseling

A full masters degree or graduate certificate in addiction or chemical dependency counseling doesn’t come into play as a requirement until you start looking at becoming an independent practitioner or supervisor.

Though it exceeds the minimum requirement for typical counseling roles, a master’s or graduate certificate can be a natural route to gaining specialized counseling knowledge if you already hold a bachelor’s degree in an unrelated field. 

Holding a master’s will also reduce the number of practice hours you’ll have to accumulate to become certified, so it comes with the benefit of more advanced knowledge and opportunity without necessarily adding to the total time commitment.

Thirty-six states recognize a master’s degree as the educational minimum for attaining the highest level of licensure available, qualifying SUD counselors to work as supervisors and independent practitioners:

You can still enter the field in these states with an associate or bachelor’s degree, but a master’s will be in your future here if you intend to progress to roles with more responsibilities.

Certificate and Diploma Programs in Substance Abuse Counseling

Undergraduate certificates or diplomas from community colleges can offer an entry-level education to counseling without the expense of earning a full degree. Taking less than a year to complete, these aren’t intended for fully licensed counselors. But in many states, one of these may be all the education you need to become a peer counselor or treatment technician.

Just four states require only a high school diploma or have no stated college education requirements for SUD counselors with the full scope of practice allowed in the state under a substance use disorder counselor license:

Here, an undergraduate certificate or diploma from a vocational school or community college would a be great way to build knowledge and skills, even if not required.

Step 2. Build Clinical Experience Working Directly With Patients

sitting in a circle at group meeting

There is no amount of classroom training that can fully prepare you for the reality of dealing with patients in the throes of addiction.

Theres a chicken and egg problem with getting practical counseling experience just like there is in other psychology and social services professions: youre not allowed to work with patients until you get the green light from your state licensing authority, but you cant get the credentials you need until you put in a lot of hours working with patients.

This is resolved, in part, through your degree program. Your studies will often include supervised practicum hours that often count toward practice hour requirements for licensure or certification. Internships may also be available.

In some states, low-level certification as a technician or assistant counselor can be a path to accumulating clinical hours that count toward full substance use disorder counseling certification or licensure.

In other cases, practical experience hours are built into the employment process. Prospective counselors may be offered a position while granted probationary or trainee license status while they work toward accumulating the required practice hours.

The Different Kinds of Experiential Hours Substance Use Disorder Counselors Need To Accumulate

Experience isnt just about putting in hours on the job, however. The training has to be supervised by currently licensed counseling professionals. They offer guidance through the rough spots and conduct evaluations of your performance.

Many states base their number of required supervision hours on the level of education you have achieved. The higher the degree, the fewer the required hours. So an applicant with an associate degree may have to put in 2,500 hours, while someone with a masters would only have to do 1,500.

There are different types of experiential clock hours to account for, as well. Your time may be split in defined blocks between:

In general, however, most states have three categories of training hours youll need to meet requirements for:

Its always best to consult your state licensing authority for their definitions. Some only count direct patient contact toward practice hours; others may not count supervised hours toward the total practice hours required.

Its common for the first 50 or so hours to require direct, in-person observation by the supervisor. After that, you will have more freedom to find your own way—but always backed up by experts and mentors so you provide the most effective counseling for patients and learn the right lessons from your experiences.

Step 3. Pass an Exam Demonstrating Your Knowledge and Skills of Substance Use Disorder Counseling

taking an online exam

On-the-job experience and college education are where you collect the skills and knowledge needed to become a substance use disorder counselor; standardized national examinations are where you prove it.

Passing these tests is a requirement for state licensure or certification. The states themselves do not typically administer the tests, however. Instead, there are two major professional bodies at the national and international level that administer the exams and report the results back to state boards.

National Association of Alcoholism and Drug Abuse Counselors (NAADAC):

Peer recovery and support specialists, who do not need a full degree, will usually be required to pass the IC&RC Peer Recovery Exam instead.

Not every state accepts exams from both organizations, although they may make exceptions for reciprocal licensing by honoring the results of exams that other states use. Additionally, some states have their own exam, although they usually closely resemble these standards.

The ADC  and NCAC I are the most common tests used nationally to qualify for entry-level substance use disorder counselor licensing.

For the basic tests, youll be facing around 150 multiple choice questions which you have three hours to complete. The questions are weighted toward assessment and treatment, but cover the full range of knowledge and skills required of substance use disorder counselors:

These exams arent just rubber stamps. IC&RC data shows that only around 70 percent of test takers pass the ADC, and only 60 percent pass the AADC. Its a serious role you’re being certified in, so expect a real challenge when it comes to proving your knowledge of substance use disorder diagnosis and treatment.

Nor can just anyone show up and take the test. You first have to establish eligibility, a process that is generally left to state-level boards and licensing departments.

These may not be the only tests you have to take before certification, either. In some states, a required jurisprudence exam tests your knowledge of state-specific laws and regulations covering substance use disorder counseling.

Step 4. State-by-State Guidance: Get the Credentials You Need to Become a Substance Use Disorder Counselor in Your State

young man talking with female counselor

Licensure (through a state government licensing authority) or certification (through a state-level non-government professional board) is handled on a state-by-state basis.

Each state has at least three different credentials in substance use disorder licensing; some have as many as 16. So this is a step where it really pays to dive into detailed information on how to become a substance abuse counselor in your state:

AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY DC

While every state has requirements for practice, not all states directly certify or license individual substance use disorder counselors. Instead, they 1) recognize counselors certified by a state-level non-governmental professional certification board, and 2) require those counselors to be employed by state-certified treatment programs. In these instances, it’s the state-certified program that’s responsible for vetting the counselors they hire, making sure they have the certification the state requires.

For example, though states like California and Florida dont directly license or certify individual counselors, they do certify treatment agencies and facilities. And they have strict standards that those certified facilities must follow when hiring counselors.

Other states go in the opposite direction, requiring counselors to hold both certification through a non-governmental professional board AND licensure from a state government licensing body. Commonly, however, the certification effectively covers most of the steps to licensure so once you earn your certification you won’t have any trouble becoming licensed by the state.

Some states offer reciprocal licensure, which means they recognize certification from other states with roughly equivalent requirements.

Credentialing Based on Scope of Practice and Independent vs. Supervised Practice

All states offer credentials at different levels. A 2019 study published by SAMHSA (Substance Abuse and Mental Health Services Administration, a branch of the US Department of Health and Human Services) identified six levels of practice found at the state level under various professional titles. By focusing on the scope of practice (whether allowed to assess, diagnose, or design treatment plans) rather than title, SAMHSA identified the different levels of practice across states and put them into a few categories ranging from technician to supervisor:

Level

Requirement

Supervised/Independent

Peer Recovery Specialist

Specialist exam

Supervised practice

Substance Use Disorder Technician

High school diploma

Supervised practice

Associate Substance Use Disorder Counselor

Associate degree

Supervised practice

Substance Use Disorder Counselor

Bachelors degree

Supervised practice

Clinical Substance Use Disorder Counselor

Masters degree

Supervised practice

Independent Clinical Substance Use Disorder Treatment Counselor/Supervisor

Masters degree

Independent practice

It’s important to note that supervised practice doesn’t necessarily mean direct supervision during client interactions. It simply refers to working for a program or in a clinic under the general supervision of an independent practitioner who will review assessment findings and offer input and guidance on treatment plans. Independent practitioners, on the other hand, have the experience and proven skills to be granted the authority to practice without additional reviews and input.

Not every state offers a credential in every category. Some mix and match responsibilities at different levels. And they dont all exactly match the SAMHSA model. But it does offer you an idea of the general hierarchy of qualifications that are commonly used in the substance use treatment field coast to coast.

Other Professional Licenses Can Offer a Path To Practicing Substance Use Disorder Counseling

Because of the crossover between substance use disorder therapy and other kinds of healthcare and psychology fields, some states also offer other educational paths to certification. You may be able to apply alternative training toward fulfilling licensure requirements if you happen to be licensed as a:

  • Physician or physicians assistant
  • Marriage and family therapist
  • Clinical social worker
  • Mental health counselor
  • Clinical psychologist

For professionals already licensed in these other fields, states may offer regulatory carve-outs that allow them to practice counseling under their existing professional license, or as an option that allows them to easily get a substance use disorder counseling endorsement without going through the entire process of becoming trained as a substance use disorder counselor.

Its actually quite common for individuals in these related professions to offer substance use disorder therapies as part of their own practice. In fact, the National Board of Certified Counselors offers their own Master Addiction Counselor certification, which comes through an entirely separate path from most SUD counseling credentials.

Many of these professions are also eligible for national certification in addiction counseling, and some states recognize that certification as covering the qualifications for SUD counseling licensure.

That process may require a special, abbreviated educational course in substance use disorder counseling or documenting coursework on the subject that was part of their own degree program. They can usually count existing professional clinical contact and supervision hours, as well. In some cases, they may have to go through additional supervision under a current SUD counselor, however.

Step 5. Get a Job as a Professional Substance Use Disorder Counselor

young man talking with a youth and teen counselor

Its a long road to becoming legally certified to perform substance use disorder counseling. But in many ways, thats just the beginning.

Its an unfortunate truth that there is a big and diverse world of substance use issues to specialize in.

There are roles categorized by:

Because substance use has such a broad crossover with various other health and social issues, counselors may also find themselves working in agencies specializing in:

The workplace for these kinds of jobs can both vary and overlap with one another. Many SUD counselors work in dedicated rehabilitation facilities. But they also staff hospitals, correctional facilities, social service agencies, or work in private practice.

Both in social service settings and private practice, counselors may find themselves going to where the patients are. That means out on the city streets, or in group housing or shelters.

While most substance use counseling credentials dont specifically align with different specialty areas, the reality is that you are most likely to secure a job in the same locale you gained your pre-certification experience, serving a similar community with similar issues. It may even be in the same neighborhood, and could even be the exact same employer.

Its wise to find a career path you are interested in early and make sure both your degree and your supervised experience happens in that field. Youll learn the right lessons, make the right contacts, and understand the job so you can hit the ground running.

What Does a Day on the Job Look like for an Addiction Counselor?

There are no boring days on the job when you’re a substance use disorder counselor. In general, most counselors spend their days immersed in:

Picking a Population or Specialization Area in Substance Use Counseling Work

prisoner talking through glass

Substance use doesnt have boundaries when it comes to different races, ages, or genders. While it hits some groups harder than others, there are people who need help from almost every imaginable background and status – from homeless veterans to teenagers in middle-class suburbs.

All of them deserve help.

In many cases, these are the roots of specialized areas of practice within substance use treatment. Its a reality that different groups respond better or worse to different types of treatment.

The same is true with different substance addictions. Getting someone off the bottle is a different journey than helping someone in the throes of a fentanyl addiction, which is different from working with someone who uses amphetamines daily.

So its not uncommon for SUD counselors to adopt certain specializations and master the tools and techniques that work best. Since many treatment centers are similarly specialized, this often just comes with the territory. But you can make it easier at every step by angling your education and experience to match.

Step 6. Continuing Education To Keep Your License and Your Edge in Substance Use Disorder Counseling

class full of college students

The state of substance use disorder counseling changes all the time. New laws, new treatments, new drugs, and new research are always changing the ways the profession is practiced.

While counselors and specialists will naturally pick up on a lot of these changes just through the normal course of their work, there are also requirements in most states that they fulfill a certain number of continuing education (CE) hours in order to keep their certification.

CE can be accumulated in a number of ways:

In some states, you may have to cover certain subjects to meet CE qualifications, such as a particular number of hours in suicide assessment and prevention.

Most state licensing or certification boards have a list of approved providers for CE hours. Its possible to have other sources recognized, but you have to go through an approval process. Generally, big organizations like NAADAC offer trainings accepted pretty much everywhere.

Most states require from 20 to 40 hours a year of CE. The most common renewal period for licenses is two years, so thats anywhere from 40 to 80 hours of continuing ed to keep your credential current.

Step 7. Consider National Certification to Advance Your Expertise in Substance Use Disorder Counseling

therapist in a meeting together

The word certification gets tossed around a lot in substance use disorder counseling. It most commonly refers to the process of becoming legally allowed to practice counseling at the state level. That may be the most important goal, and its enough to make a big difference wherever you live.

But on top of state board certification, substance use disorder counselors looking to improve their skills and be recognized for their expertise can also pursue national certification.

NAADACs tests are a key part of licensing at the state level, but they are also the first step on the way to becoming a National Certified Addiction Counselor.

Just like the tests, there are NCAC I and NCAC II levels.

For NCAC I, the entry-level, you must:

IC&RC, the other major national exam organization, does not offer national certification, but can facilitate reciprocal state board certification among various members.

You can climb the ladder, too, moving up to NCAC II or even earning your Master Addiction Counselor credential as you get more education and experience.

NAADAC also offers specialty certification in common specialization areas and for counselors without college degrees:

Any of these can boost your career potential. More importantly, they offer assurance to patients and their families that you have the expertise they need to pull through the hardest parts of substance abuse.

Growing to Fill Your Potential as a Substance Use Disorder Professional

You may also pursue the NAACAC’s National Clinical Supervision Endorsement, which validates your expertise to train and oversee the next generation of substance use disorder counselors.

These credentials, along with the higher college degree levels that are required to earn them, also mirror the progression of professional licenses available in different states. With those higher license levels comes greater ability, and greater responsibility.

Putting your knowledge to work rescuing patients and society from substance use disorders is what brought you to the job in the first place. Transferring that knowledge further and to greater purpose is what will keep you climbing the ladder.

What’s Your Starting Point? … Just Getting Started or Do You Already Have a Degree?

starting the walk upstairs

Every story that leads to a career in substance abuse counseling is unique. But as you figure out what motivates you on your path, you will probably find that one of the scenarios below resonates. Each can lead you along a different route to becoming a counselor, and sometimes even down a path to become a different kind of counselor qualified to work with people struggling with substance use disorders.

All of them lead to valuable positions helping patients with substance use disorders.

The human mind and human choices fascinate you. A deep well of empathy drives you to help the less fortunate. So you’ve known for a long time that some kind of career in psychology, therapy, or human services is in your future.

Toward that end, you’ve picked up one of the common degrees in those fields… anything from psychology to counseling to social work serves as a ticket into more advanced studies.

With high standards for licensure, it’s time to pick a master’s degree. And now it’s time to make a choice.

Substance use disorder and addiction therapy is calling. A master’s degree in this field cuts down on the hours required for licensure in many states, and qualifies you for independent practice and leadership roles in treatment programs.

The kind of advanced knowledge and leadership skill that comes   with a master’s degree is in high demand across the country and in all human services fields. It opens more doors to make a clear difference working for an array of agencies and population specializations.

To learn more about how to build on your bachelor’s and take the fast-track to substance use disorder counseling, see our guide here.

Like many social ills, substance abuse hits disadvantaged populations harder. Maybe that’s where you’re from, and maybe it’s why you are motivated to work in substance use disorder counseling. You see the people behind the addictions. You’ve lost friends, or maybe even family, to that darkness. Maybe you’ve even been there yourself.

Now is the time to set things right. You want to know the fastest and most affordable path to become a substance abuse counselor.

This path still calls for an education in substance abuse and addiction. But it also draws on lived experience. You have ways to connect with patients and an innate understanding of the problem that no amount of classroom education can bring.

To find out more specifically about meeting the minimum degree requirements to become a substance abuse counselor, see our guide here.

For many people coming out of the depths of addiction, rebuilding also means atoning.

For others, maybe those who have experienced loss, or had success in helping a loved one back from the abyss, there may be a realization: you know what to do. You have ways to help others lost in that dark place.

Whether it’s a formal part of a recovery program or just something you know you need to do to give back, you may feel drawn to sharing your way out of the darkness. There’s no one who knows better the challenges of recovery—or the ways to beat them.

If you’re in this group, you may think of substance abuse counseling as more of a calling than a career. It may come later in life; it may even be something you mostly do on the side. So you may not feel like a degree is in the cards.

You might change your mind after getting a taste of what professional SUD counseling can do. But for now, check out our guide on how to become an entry-level substance use disorder assistant or technician without a degree.