To become a substance abuse counselor in Maryland, one must earn a bachelor’s degree in counseling or a related field, such as health services, with a minimum of 45 credit hours in coursework related to addiction. Complete 2,000 supervised clinical hours, pass the NCAC II exam and Maryland Law Assessment, then apply for CAC-AD certification through the Maryland Board of Professional Counselors and Therapists.
Table of Contents
- Maryland’s Substance Abuse Crisis
- Steps to Becoming Certified as a Substance Abuse Counselor in Maryland
- Step 1: Earn a Bachelor’s Degree
- Step 2: Document 2,000 Hours of Supervised Clinical Experience
- Step 3: Apply for CAC-AD Certification
- Step 4: Pass the NCAC II Exam and Maryland Law Assessment
- Cost and Timeline Breakdown
- Advanced Credentials: Becoming an LCADC
- Substance Abuse Counselor Jobs in Maryland
- Substance Abuse Counselor Salary in Maryland
- Maryland Degree Programs
- Frequently Asked Questions
Maryland’s Substance Abuse Crisis: Why Your Work Matters
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 a large percentage of street opioid samples, though precise prevalence across all street drugs is unknown. This central nervous system depressant, when injected, slows respiration and heart rate and often results in life-threatening, open abscess wounds on the skin. Narcan-resistant xylazine, along with fentanyl, has been primarily responsible for the 1,079 drug overdose deaths in Baltimore in 2021 alone.
According to available CDC data, Baltimore County reported one of the highest opioid overdose death rates nationwide during this period, though no official ranking confirms it as the top. Between October 2022 and September 2023, 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 receiving significantly more national attention than Baltimore.
Baltimore’s Opioid Response: A Beacon of Hope
Baltimore County may report one of the highest rates of opioid overdose deaths in the nation, but some people 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 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 Johns Hopkins University, provides immediate care and medication for addiction to all patients, regardless of their ability to pay.
- BCHD collaborates with the city’s 11 acute-care hospitals to provide 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 are 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 people experiencing homelessness, or you’re working in one of the state’s many substance abuse treatment facilities, your hard work and expertise in substance abuse counseling make 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 the state of Maryland.
Maryland offers four levels of certification for substance abuse counselors. 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 precisely 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) – master’s or doctoral-level credential; allows independent practice with less restrictive supervision
- Licensed Graduate Alcohol and Drug Counselor (LGADC) – a graduate-level credential for those completing advanced training
In this guide, we’ve detailed the process of becoming a Certified Associate Counselor (CAC-AD). This standard bachelor’s-level credential allows you to practice substance abuse counseling in Maryland under moderate supervision in any licensed or certified state agency or facility.
We’ve also detailed the process of becoming an LCADC 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.
Step 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:
At least 33 semester credit hours in alcohol and drug counseling that include a three-semester course in each of the following:
- Medical aspects of chemical dependency
- Addiction treatment delivery
- Group counseling
- Individual counseling
- Ethics that includes issues in alcohol and drug counseling
- Abnormal psychology
Any three of the following three-semester courses:
- 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.
Suppose you haven’t completed a degree in a health and human services counseling field. In that case, 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.
Step 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 knowledge 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 a total of up to six years.
For detailed guidance on meeting supervision requirements, refer to our guide on obtaining your supervised experience.
Step 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:
- A CAC-AD Supervision Verification form (completed and signed by the supervisor of your clinical experience)
- Three professional references (forms are included with the application)
- A copy of the receipt from a criminal history record check
Step 4: Pass the NCAC II Exam and Complete the Maryland Law Assessment
Once the Board has reviewed and approved your application, it will 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 for your convenience.
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 renewed every two years upon the completion of 40 continuing education units (CEUs).
Cost and Timeline: What to Expect on Your Path to Certification
Timeline Breakdown
Understanding how long each step takes helps you plan your career path effectively:
- Bachelor’s Degree: 4 years (full-time) or 5-6 years (part-time). If you already have a bachelor’s degree in another field, you may need 1-2 years to complete the required 45 credit hours in counseling coursework.
- Supervised Clinical Experience: Minimum 1 year (full-time at 40 hours/week) to 2-3 years (part-time while working). The 2,000-hour requirement can be completed concurrently with your degree internship in some cases.
- Application Processing: 4-8 weeks for the Board to review and approve your application.
- Exam Preparation and Testing: 1-3 months. You can schedule the NCAC II exam at your convenience once authorized.
- Total Time to CAC-AD: 5-7 years from starting your bachelor’s degree, or 2-4 years if you already have a qualifying bachelor’s degree.
Cost Breakdown
Budget for these expenses as you plan your substance abuse counseling career in Maryland:
- Bachelor’s Degree Tuition: $20,000-$120,000+, depending on the institution (in-state public vs. private). Maryland community colleges offering associate degrees typically range from $ 4,000 to $8,000 per year.
- Textbooks and Materials: $500-$1,500 per year.
- Application Fees: $150-$300 for CAC-AD application to the Maryland Board.
- Criminal Background Check: $50-$75.
- NCAC II Exam Fee: $295 (as of 2025).
- Maryland Law Assessment: $50-$100 through CCE Academy.
- Biennial Renewal Fee: $150-$200 plus costs for 40 CEUs (continuing education typically ranges $500-$1,000 per two-year cycle).
Financial Aid Options: Most colleges in Maryland offer a range of financial aid packages, including federal loans, grants, and scholarships. Check with your institution’s Office of Financial Assistance. Discover our comprehensive guide to scholarships and grants for students pursuing a career in addiction counseling.
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.
The LCADC credential allows you to practice with greater autonomy, supervise other counselors, and often commands higher salaries. 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 service.s
- Take and pass the Master Addiction Counseling (MAC) exam through the National Board for Certified Counselors (NBCC) and complete the Maryland law exam.
Learn more about advancing your education with master’s degrees in substance abuse counseling.
Substance Abuse Counselor Jobs in Baltimore and Throughout Maryland
Opportunities to join 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 US Department of Labor, substance abuse counselor jobs in Maryland are projected to increase by 23 percent over the decade leading up to 2030, reaching 7,790 jobs by 2030.
Substance abuse counselor jobs in Baltimore are plentiful and constantly growing. Here, you’ll find a host of opportunities to make your mark in this rewarding profession.
Major Employers and Facilities
You may choose to become part of a major institution like the University of Maryland Medical Center, which operates three Baltimore facilities that include:
- Outpatient Addiction Treatment Services (OATS)
- UM Addiction Treatment Center
- Center for Addiction Medicine
Alternatively, you may choose to lend your talents to a public program, such as the Richards Building, the first county-owned residential substance treatment facility in Baltimore County. This facility serves approximately 300 individuals annually, offering services that include family counseling, transition planning, and referrals for aftercare.
Numerous private facilities throughout Baltimore and the surrounding region offer 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.
Explore different career paths in substance abuse counseling to find the right fit for your interests and skills.
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 $57,820 as of May 2024. Early-career professionals in Maryland earned approximately $41,160 during this time, while those with extensive experience and advanced levels of education earned around $97,050.
Substance abuse counselors in the Hagerstown metro area earned median salaries that were slightly higher than the state median as of May 2024:
- Baltimore-Columbia-Towson: $56,980 (median), $98,440 (90th percentile)
- Hagerstown-Martinsburg, MD-WV: $60,410 (median), $88,680 (90th percentile)
For comprehensive salary information nationwide, see our Substance Abuse Counselor Salary Guide.
Substance Abuse Counselor Degree Options in Maryland
You’ll find a wealth of degree programs in substance abuse counseling in Maryland at all educational levels.
At the undergraduate level, both Ann Arundel Community College and Baltimore City Community College offer an AAS in Addiction Counseling. In contrast, Frostburg State University provides an Addiction Counseling emphasis for students pursuing a bachelor’s degree in psychology or social work.
Several 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
- Addictions Certificate
Associate Degrees
- Associate’s in Human Services-Addictions, a specialized area of study
Anne Arundel Community College
Human Services Department
Accreditation: MSCHE
Campus
Undergraduate Certificates
- Certificate in Addiction Counseling
Associate Degrees
- AAS in Addiction Counseling
Baltimore City Community College
Accreditation: MSCHE
Campus
Undergraduate Certificates
- Certificate in Allied Human Services and Addiction Counseling
Associate Degrees
- AAS in Addiction Counseling
Bowie State University
College of Education
Accreditation: MSCHE
Campus
Graduate Certificates
- Advanced (Graduate) Certificate in Addictions Counseling combined concurrently with: [1) MA in Mental Health Counseling, 2) MA in Counseling Psychology, 3) MA in School Psychology]
- Advanced (Graduate) Psychotherapy Certificate-Addiction Counseling Specialization
Chesapeake College
Human Services
Accreditation: MSCHE
Online
Undergraduate Certificates
- Addiction Counseling Certificate
Associate Degrees
- AAS in Human Services-Addiction pathway
Coppin State University
College of Behavioral and Social Sciences
Accreditation: MSCHE
Campus
Master’s Degrees
- MS in Addiction Counseling
- M.Ed.d in Rehabilitation Counseling, Alcoholism Counseling, and Addiction Services specialization
Frederick Community College
Accreditation: MSCHE
Campus
Undergraduate Certificates
- Addictions Counseling Certificate
Associate Degrees
- AAS in Addictions Counseling
Garrett College
Career Advancement Program
Accreditation: MSCHE
Campus
Undergraduate Certificates
- Certificate in Addictions Counseling
Associate Degrees
- AAS in Addictions Counseling
Hagerstown Community College
Behavioral and Social Sciences/Business Division
Accreditation: MSCHE
Campus
Undergraduate Certificates
- Certificate in Substance Abuse Counseling
Associate Degrees
- AAS in Substance Abuse Counseling
Notre Dame of Maryland University
College of Graduate and Professional Studies, School of Arts, Science, and Business
Accreditation: MSCHE
Campus, Hybrid
Graduate Certificates
- Post-Bac Certificate in Alcohol and Drug Counseling
Wor-Wic Community College
Accreditation: MSCHE
Online
Undergraduate Certificates
- Chemical Dependency Counseling Certificate
Associate Degrees
- AAS in Chemical Dependency Counseling
Frequently Asked Questions About Becoming a Substance Abuse Counselor in Maryland
Can I become a substance abuse counselor in Maryland with a bachelor’s degree in a field other than substance abuse counseling?
Yes, you can become a CAC-AD in Maryland with a bachelor’s degree in a non-counseling field, but you’ll need to complete at least 45 semester credit hours in counseling coursework. This includes 33 credit hours in alcohol and drug counseling covering medical aspects of chemical dependency, treatment delivery, group and individual counseling, ethics, and abnormal psychology. You’ll also need an internship totaling at least six semester hours. Submit a Pre-Application Credential Evaluation form to the Maryland Board to confirm your coursework meets requirements.
What’s the difference between CSC-AD, CAC-AD, and LCADC in Maryland?
Maryland offers three primary credential levels. CSC-AD (Certified Supervised Counselor) is an associate-level credential requiring close supervision. CAC-AD (Certified Associate Counselor) requires a bachelor’s degree and allows moderate supervision. LCADC (Licensed Clinical Alcohol and Drug Counselor) requires a master’s or doctoral degree and provides the most autonomy. Most career-focused counselors pursue a CAC-AD or go directly for an LCADC if they hold a graduate degree.
Can I work while completing my 2,000 supervised hours in the state of Maryland?
Yes, many counselors work part-time or in related positions while completing their supervised experience hours. The 2,000-hour requirement can take 1-3 years, depending on whether you work full-time (40 hours per week) or part-time in a counseling position. You may need to obtain Alcohol and Drug Trainee (ADT) status during this period, which is valid for two years and renewable up to six years total.
Do I need to live in Maryland to get certified as a substance abuse counselor there?
While you don’t necessarily need to be a Maryland resident to apply for certification, you’ll need to complete your supervised clinical experience at a Maryland-licensed or certified facility under a Board-approved supervisor. Your degree must also meet Maryland-specific requirements. If you’re considering reciprocity from another state, contact the Maryland Board directly, as requirements vary.
How much does it cost to become a substance abuse counselor in Maryland?
Total costs vary based on your educational path. If starting from scratch, expect $20,000-$120,000+ for a bachelor’s degree (depending on public vs. private institution). Additional costs include application fees ($150-$300), a criminal background check ($50-$75), the NCAC II exam ($295), the Maryland Law Assessment ($50-$100), and biennial renewal fees ($150-$200, plus CEU costs). Financial aid, scholarships, and grants can significantly reduce these costs.
Is Maryland’s substance abuse counseling certification recognized in other states?
Maryland credentials may not automatically transfer to other states, as each state has its own unique licensing requirements. The NCAC II national certification you’ll earn may help with reciprocity in some states. If you plan to work in multiple states or may relocate, research that state’s requirements and inquire about reciprocity agreements with Maryland through its licensing board.
Key Takeaways
- Maryland offers four certification levels for substance abuse counselors, with CAC-AD being the standard bachelor’s-level credential that allows moderate supervision in licensed facilities.
- The path to CAC-AD certification requires a bachelor’s degree with 45 credit hours in counseling (or a degree in health and human services), 2,000 hours of supervised clinical experience, passing the NCAC II exam, and completing the Maryland Law Assessment.
- The total timeline from starting a bachelor’s degree to CAC-AD certification is typically 5-7 years, or 2-4 years if you already have a qualifying bachelor’s degree.
- Maryland substance abuse counselors earn a median salary of $54,460 statewide, with regional variations. Cumberland and Hagerstown offer slightly higher median salaries than Baltimore.
- Job growth for substance abuse counselors in Maryland is projected at 23 percent through 2030, with 7,790 expected positions, reflecting the state’s commitment to addressing the opioid crisis.
- Maryland is home to 432 substance abuse treatment facilities, offering diverse employment opportunities ranging from major medical centers, such as the University of Maryland, to community-based programs and private treatment facilities.
Ready to Start Your Journey as a Maryland Substance Abuse Counselor?
Take the first step toward a rewarding career helping Maryland communities recover from addiction. Explore accredited degree programs, compare costs and formats, and discover the educational path that aligns with your goals and schedule.
2024 US Bureau of Labor Statistics salary and employment figures for Substance Abuse, Behavioral Disorder, and Mental Health Counselors; Psychiatric Technicians (Substance Use Disorder Technicians); and Social and Human Service Assistants (Peer Recovery Specialists) reflect state and national data, not school-specific information. Conditions in your area may vary. Data accessed November 2025.
