How to Become a Substance Abuse Counselor in Maryland

Fentanyl and xylazine were barely known drugs outside of the medical community just a few years ago. But today, these deadly drugs are sweeping through Maryland, wreaking havoc and claiming lives at an alarming rate.

In Baltimore, xylazine —better known as tranq— is now found in 90 percent of all street drugs. This central nervous system depressant, when injected, slows respiration and heart rate and often results in life-threatening, open apses wounds on the skin. Narcan-resistant xylazine, along with the fentanyl, have been largely responsible for the 1,079 drug overdose deaths in Baltimore in 2021 alone.

According to CDC statistics, Baltimore County claimed the top spot in the nation for its rate of opioid overdose deaths between October 2022 and September 2023. During this time, the county reported an opioid overdose death rate of 186.9 deaths per 100,000 people. That’s nearly double that of San Francisco County, California, a place that is getting a lot more national attention than Baltimore.

Baltimore’s Opioid Response: A Beacon of Hope

Baltimore County may come in as the top county in the nation for opioid overdose deaths, but there’s people who care here, and they have no plans to allow this dire trend to continue.

The Baltimore City Health Department (BCHD) is ground zero for opioid addiction treatment initiatives, providing a range of treatment options and social services:

A 24/7 mental health and substance use helpline, which is reached by dialing 988, offers those suffering from substance use disorder with emergency counseling, referrals, and mobile response teams that can provide care for the community.
The SPOT (Special Purpose Outreach Team) mobile team, which works in partnership with John Hopkins University, provides immediate care and addiction medication to all patients, regardless of their ability to pay.
BCHD works alongside the city’s 11 acute-care hospitals to offer the Levels of Care for Baltimore City Hospitals Responding to the Opioid Epidemic program. Hospitals are ranked from Level 1 to Level 3, depending on their ability to implement evidence-based hospital interventions.
The BCHD works with all emergency departments throughout the city to offer universal addiction screening, peer recovery services, and on-demand, medication-assisted treatment for opioid addiction.

But Maryland has no plans to back down from this fight. Maryland’s Office of Overdose Response, local law enforcement and health department agencies, and advocacy organizations like Maryland Heroin Awareness Advocates and the Maryland Association of Recovery Community Organizations (MARCO) are part of the state’s efforts to connect those afflicted with drug addiction with life-saving services and resources. They’re making significant strides every day and fully committed to solving the state’s drug crisis.

Whether you’re lending your skills to the frontlines, helping mobile crisis teams provide immediate care to the homeless, or you’re working in one of the state’s many substance abuse treatment facilities, your hard work and expertise in substance abuse counseling makes you an invaluable resource in the fight against drug addiction.

Steps to Becoming Certified as a Substance Abuse Counselor in Maryland

The Maryland Department of Health, Board of Professional Counselors and Therapists certifies substance abuse counselors in Maryland.

There are three levels of certification for substance abuse counselors in Maryland. Though the credentials are usually achieved consecutively, you can earn the higher-authority CAC-AD without first earning the CSC-AD, and many career-focused counselors do exactly that:

Certified Supervised Counselor – Alcohol and Drug (CSC-AD) – associate-level credential; CSC-ADs may only provide alcohol and drug counseling under the close supervision of a Board-approved supervisor
Associate Counselor – Alcohol and Drug (CAC-AD) – bachelor’s-level credential; allows you to practice substance abuse counseling under the moderate supervision of a Board-approved supervisor
Licensed Clinical Alcohol and Drug Counselor (LCADC)
Licensed Graduate Alcohol and Drug Counselor (LGADC)

In this guide, we’ve detailed the process of becoming a Certified Associate Counselor (CAC-AD), the standard bachelor’s-level credential that allows you to practice substance abuse counseling in Maryland under moderate supervision in any agency or facility that is licensed or certified by the state.

However, we’ve also detailed the process of becoming an LCADC in the With a Higher Degree and More Experience Comes Advanced Certification Options section to provide you with information for expanding your career, if desired.

Here are the steps you’ll take to earn certification as CAC-AD in Maryland:

1. Earn a Bachelor’s Degree in Health and Human Services, Counseling, or a Related Major

2. Document 2,000 Hours of Supervised Clinical Experience

3. Apply for CAC-AD Certification with the Board of Professional Counselors and Therapists

4. Pass the NCAC II Exam and Complete the Maryland Law Assessment

The process of becoming a substance abuse counselor in Maryland can be a bit overwhelming, at times. Not to worry; we’ve broken down how to become a CAC-AD by providing step-by-step instructions that will allow you to forge ahead with confidence.

1. Earn a Bachelor’s Degree in Health and Human Services, Counseling, or a Related Major

To become a CAC-AD in Maryland, you’ll need to earn a minimum of a bachelor’s degree in a Board-approved health and human services counseling field or in a similar field deemed “substantially equivalent” by the Board.

If your degree is not in a health and human services counseling field, it must contain at least 45 semester credit hours in counseling, including the following coursework:

Medical aspects of chemical dependency
Addictions treatment delivery
Group counseling
Individual counseling
Ethics that includes issues in alcohol and drug counseling
Abnormal psychology

Family counseling
Theories of counseling
Human development
Topics in substance related and addictive disorders
Treatment of co-occurring disorders

Your education must also include an internship in alcohol and drug counseling that totals at least six semester hours. The college or university where you earned your degree will be able to connect you with agencies where you can fulfill your internship requirements.

If you haven’t completed a degree in a health and human services counseling field, you can submit a Pre-Application Credential Evaluation (CAC-AD) form to the Board to ensure you’ve met the educational requirements necessary for certification

2. Document 2,000 Hours of Supervised Clinical Experience

You must complete a supervised clinical experience of at least 2,000 hours (minimum of a year) in alcohol and drug counseling under the supervision of a Board-approved alcohol and drug supervisor.

The college or university where you earned your degree will be able to help you find an agency where you can begin earning the required experience in alcohol and drug counseling. Many times, your program internship serves as an ideal precursor to gaining the experience you’ll need to document for certification.

During this period of training, you may be required to apply for Alcohol and Drug Trainee (ADT) status. You’ll need to complete and submit an application to receive a trainee authorization letter, which is valid for two years and renewable in two-year increments for up to six years.

3. Apply for CAC-AD Certification with the Board of Professional Counselors and Therapists

Once you’ve satisfied the required education and experience, you’ll apply for CAC-AD certification with the Board. Along with the completed paper application, you’ll need to submit:

4. Take the NCAC II Exam and Complete the Maryland Law Assessment

Once the Board has reviewed and approved your application, they’ll send you a letter authorizing you to sit for the National Board for Certified Counselors’ (NBCC) National Certified Addiction Counselor, Level II (NCAC II) exam, a computer-based, multiple-choice exam of 150 questions. You’ll choose the date, time, and location of your exam (there are 25 testing centers located throughout Maryland).

You must also complete the Maryland Law Assessment (MLA), a no-fail, no-score assessment that is used to ensure you’re familiar with the state laws and ethical code. You’ll take the MLA through the CCE Academy.

Once the Board has received your passing NCAC II exam and MLA record of completion, your CAC-AD certification will be issued.

Your CAC-AD credential must be reviewed every two years upon the completion of 40 continuing education units (CEUs).

With a Master’s Degree and More Experience, You Can Become a Licensed Clinical Alcohol and Drug Counselor (LCADC) in Maryland

You can further your credentials and expand your professional opportunities and earning potential in Maryland by becoming a Licensed Clinical Alcohol and Drug Counselor (LCADC), a master’s or doctoral-level substance abuse counselor. To become an LCADC you must:

Earn a minimum of a master’s degree in a health and human services counseling field
Complete at least two years (2,000 hours) of supervised clinical experience in drug and alcohol counseling, 1,500 hours of which must be in direct clinical counseling services
Take and pass the Masters Addiction Counseling (MAC) exam through the National Board for Certified Counselors (NBCC) and complete the Maryland law exam

Substance Abuse Counselor Jobs in Baltimore and Throughout Maryland

Opportunities to become a part of Maryland’s substance abuse counseling field continue to grow. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2020 National Survey of Substance Abuse Treatment Services, Maryland was home to 432 substance abuse treatment facilities in 2020, up from 349 in 2011. In 2020 alone, the state’s substance abuse treatment facilities treated some 35,000 people.

Reflecting on the growing number of substance treatment options in Maryland, jobs for substance abuse counselors are expected to continue to increase in the coming years. According to the U.S. Department of Labor, substance abuse counselor jobs in Maryland are projected to rise by 23 percent in the decade leading up to 2030, reaching 7,790 jobs by 2030.

Substance abuse counselor jobs in Baltimore are plentiful and always growing. Here, you’ll find a host of opportunities to make your mark in this rewarding profession. You may choose to become part of a major institution like the University of Maryland Medical Center, which operates three Baltimore facilities that include the Outpatient Addiction Treatment Services (OATS), the UM Addiction Treatment Center, and the Center for Addiction Medicine.

Or you may choose to lend your talents to a public program like the Richards Building, the first county-owned residential substance treatment facility in Baltimore County. This facility serves about 300 individuals annually, and services include family counseling, transition planning, and after-care referrals.

There are also plenty of private facilities throughout Baltimore and the surrounding region that provide inpatient and outpatient counseling services. For example, TruHealing Baltimore offers co-occurring substance abuse treatment services through their inpatient detox, residential treatment, and outpatient treatment facilities. And the Powell Recovery Center, which has been offering substance use disorder services for more than 30 years, offers withdrawal management, residential treatment, outpatient services, and a unique residential treatment program designed for couples.

Substance Abuse Counselor Salary in Baltimore, Cumberland, Hagerstown, and Throughout Maryland

According to the Bureau of Labor Statistics (BLS), substance abuse counselors in Maryland earned a median annual salary of $54,460 as of May 2023. Early career professionals in Maryland earned about $45,550 during this time, while those with extensive experience and advanced levels of education earned about $86,320.

Substance abuse counselors in the Cumberland and Hagerstown metro areas earned median salaries that were slightly higher than the state median as of May 2023:

Substance Abuse Counselor Degree Options in Maryland

You’ll find a wealth of degree programs in substance abuse counseling in Maryland at all levels of education.

For example, at the undergraduate level, both Ann Arundel Community College and Baltimore City Community College offer an AAS in Addiction Counseling, while Frostburg State University offers an Addiction Counseling emphasis for students of its bachelor’s degrees in psychology or social work.

A number of schools also offer graduate degrees in substance abuse counseling. For example, Coppin State University offers an MS in Addiction Counseling.

Allegany College of Maryland

Health Science pathway
Accreditation: MSCHE
Campus

Undergraduate Certificates

Associate Degrees

Anne Arundel Community College

Human Services Department
Accreditation: MSCHE
Campus

Undergraduate Certificates

Associate Degrees

Baltimore City Community College

Accreditation: MSCHE
Campus

Undergraduate Certificates

Associate Degrees

Bowie State University

College of Education
Accreditation: MSCHE
Campus

Graduate Certificates

Chesapeake College

Human Services
Accreditation: MSCHE
Online

Undergraduate Certificates

Associate Degrees

Coppin State University

College of Behavioral and Social Sciences
Accreditation: MSCHE
Campus

Master's Degrees

Frederick Community College

Accreditation: MSCHE
Campus

Undergraduate Certificates

Associate Degrees

Garrett College

Career Advancement Program

Accreditation: MSCHE
Campus

Undergraduate Certificates

Associate Degrees

Hagerstown Community College

Behavioral and Social Sciences/Business Division
Accreditation: MSCHE
Campus

Undergraduate Certificates

Associate Degrees

Notre Dame of Maryland University

College of Graduate and Professional Studies, School of Arts Sciences and Business
Accreditation: MSCHE
Campus, Hybrid

Graduate Certificates

Wor-Wic Community College

Accreditation: MSCHE
Online

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.