Substance Abuse Counselor Salary and Jobs

It’s hard work, no matter what kind of job you land in substance use disorder treatment and counseling. The responsibilities are huge: your shoulders take the weight of individuals, families, and communities beaten down by drugs and alcohol. There’s always some new substance or combination of substances coming your way. Continuing education is constant, and lives hang in the balance.

Yet for all the importance of this life-saving mission and the right-minded motivations you have for getting into the field, substance use disorder (SUD) counseling is a career path like any other. It has to be navigated carefully, and ultimately has to provide for your livelihood. So, like other careers, it comes with education requirements, salary expectations, important credentials to be earned, and a promotional ladder to consider.

In the guide we’ll help you to understand:

The responsibilities and scope of practice for substance abuse counselors
What the different types of roles within addiction counseling look like
What licensing or certification requirements exist for each of those roles
Where you are likely to find employment as a SUD counselor
What sort of salary you are likely to find
How you can get the education to move up into roles of greater responsibility… and higher salaries

A career in addiction counseling can be all-consuming. As the crisis of substance abuse has washed across the country, people with the skills and empathy to meet it head on are in great demand.

But it’s a position that requires training, evaluation, and official approval to perform. So it’s not always an easy kind of career to get started with.

We’re to help you get you moving down the right path and to provide the guidance you need along the way.

Substance Abuse Counselor Jobs and Salaries At Every Level of Practice

With very few exceptions in certain states, substance use disorder professions are all licensed or certified positions. And there’s good reasons for that. They all come with a serious set of responsibilities to patients and significant legal and ethical standards. That means that earning your way into these substance abuse counseling jobs requires:

A specific level of educational attainment, most often a degree
A set number of SUD education hours in specific courses covering everything from psychopharmacology to treatment methods
A set number of practice hours dealing with actual patients
A set number of hours working under the supervision of senior counselors
Passing skills and competency exams to demonstrate knowledge in the field

Each state, however, handles licensing individually. That means that standards can be inconsistent. Although each state has SUD counseling roles that roughly reflect these titles and positions, the responsibilities, required qualifications, and exact practice authorities may shift slightly from position to position.

We’ve adopted the official career ladder outlined by SAMHSA, the Substance Abuse and Mental Health Services Administration for SUD counseling in order to talk about substance abuse counselor job duties in a coherent way. While your state may not have all of these exact roles, you’ll find that the duties they take on will be scattered among whatever roles are offered.

Peer Recovery Specialist Salary and Jobs

Peer support specialists occupy a unique niche in the substance use disorder counseling world: they are, by definition, people who have experienced those disorders and gone through the wringer of abuse and recovery themselves.

With additional professional training plus the hardening fires of that lived experience, they can connect with patients on a key level. They are the ones whose phones are most likely to ring in the middle of the night with someone on the end desperately trying not to cave to the urge to shoot up. Peer recovery specialists are the shining example that shows up to group sessions as inspiration for those still working toward recovery.

That’s part of their role in the recovery process. The rest comes down to the hard details of helping people break away from addiction. They assist patients in:

Crisis management
Offering information about health, wellness, and recovery skills
Providing advice on personal development and individual concerns
Providing a conduit to resources for recover and support in the recovery process

Peer support counselors can deliver hard truths to patients who are ready to hear them in ways that other counselors may not be able to.

Although peer support specialists have to have strong ethical standards and draw clear boundaries, it’s a job that demands flexibility and an inherent empathy for every individual patient. Knowing that what works for one won’t work for all means a lot of customized support that makes every day a new adventure.

Substance Use Disorder Technician Salary and Jobs

SUD techs are the people who keep the lights on in group homes, manage the day-to-day activities and needs of inpatient facilities, and generally take responsibility for handling the gritty details of treatment plans.

This is the counseling role that gets the most daily interaction with patients. Often, SUD techs develop the closest relationships and come to have the greatest understanding of every individual under their care.

They can handle basic evaluation and pre-screening of patients, monitor compliance, lead individual and group counseling sessions under supervision, and recommend additional treatment steps to licensed SUD counselors.

Most importantly, SUD techs handle the documentation that delivers information to the larger care team. They have the most informed perspective on how any given patient is doing. Other counselors rely on that critical data to assess and modify plans for the fastest and most complete recovery.

Associate Substance Use Disorder Counselor Salary and Jobs

The role of assistant counselors is often a sort of apprenticeship for counselors in training. The license standard for these positions in some states treats it as a temporary step on the path to full SUD licensure. But it’s more often a defined role of its own, that involves supporting the work of full SUD counselors. As a permanent position, it has some of the same responsibilities as a SUD counselor but generally requires more supervision. It’s like a half step between a SUD tech and a SUD counselor in those states.

Associate substance use disorder counselor’s are crucial in making sure no detail is missed in the recovery plans for individual patients.

These roles are often responsible for keeping track of the important details of recovery:

Ensuring patients maintain schedules in methadone maintenance programs
Checking in with outpatients regularly to get updates and provide guidance in their recovery path
Providing referrals to take care of various issues of support that patients have
Coordinating and educating patient families and friends to ensure they are receiving support at home
Providing direct counseling under the supervision of a senior clinical counselor

Whether it’s the role of a lifetime or just a stepping stone to more advanced license levels, associate counselors make a big difference in any treatment program.

Substance Use Disorder Counselor Salary and Jobs

Licensed SUD counselors are the backbone of addiction treatment in the United States. Ninety percent of states clearly define the role of substance abuse counselors, complete with a scope of practice and licensing or certification standards. They do the heavy lifting in most treatment and outreach programs, with responsibilities that include:

Performing clinical evaluation and intake of new patients to form diagnostic impressions of their disorders
Planning treatment for SUD patients
Making referrals, coordinating treatment services, and documenting progress and symptoms
Performing direct counseling for individuals and groups in accordance with approved treatment plans
Educating communities and client families about issues in drug addiction and therapy

They often work one-on-one with patients to provide the maximum amount of attention and assistance. They require clinical supervision from a senior counselor, but have a lot of independence in outreach, engagement, and therapy practice.

A lot of what this job entails is simply conversation. You engage with clients to get to know the roots of their substance use and co-occuring disorders. And you deliver, with sensitivity and evidence-supported therapy techniques, the kind of guidance and advice to help them get through some of their darkest moments.

SUD counselors also are frequently responsible for overseeing SUD technicians, associate counselors, and working with peer counselors in treatment. They also participate as members of care teams responsible for the overall well-being of individual patients. That makes them a conduit for referrals and coordination in treatment plans, so there is a fair amount of paperwork that comes with the territory.

Clinical Substance Use Disorder Counselor Salary and Jobs

Clinical SUD counselor roles are where the buck stops in diagnosis and treatment for individuals with serious addictions.

With a higher level of education required and considerably more practice hours needed, no one lands themselves in a clinical substance abuse counselor career without getting the knowledge and skills needed to deal with addiction at the deepest levels.

That extra skill puts these jobs in the upper tier of responsibility. They have the authority to clinically evaluate and diagnose substance use and co-occuring disorders. They use the diagnostic impressions of other counselors and their own evaluation to develop extensive treatment plans for patients. They also provide the most in-depth psychotherapeutic counseling for those patients.

In many organizations, these jobs involve administrative supervision and oversight for other counselors and technicians. They are putting out the marching orders, overseeing treatment, and offering guidance and advice where needed. Clinical addiction counselor jobs may also involve putting together resources from other organizations and providers to meet the needs of patients struggling with a range of trouble stemming from their addiction.

Independent Clinical Substance Use Disorder Treatment Counselor/Supervisor Salary and Jobs

At the pinnacle of substance abuse treatment are the jobs held by people who have built the training, the expertise, and the experience to handle any kind of addiction issue that comes at them. These are the SUD counselors who work without a net… and act, in turn, as the supervisors for all the rest.

These jobs require a master’s degree and around five years of experience in most states.

Adolescent Addiction Counselor

The most heartbreaking cases of substance use disorders are those found in children and adolescents. Yet these are also where substance abuse counselors can bring the most hope, setting lives straight before they fully go off the rails.

Engaging and treating adolescents with substance use disorders is no easy task, though, which is why specialists certified in this field are the preferred counselors for the job. Their training helps them crack the shell and fully engage with kids who need their help. Working in schools, treatment facilities, and in outpatient counseling centers, adolescent addiction counselors help kids and their families fight and win out over substance abuse.

Criminal Justice Addiction Professional

American prisons are stuffed with substance use disorder patients… NIDA, the National Institute on Drug Abuse, reports that 85 percent of the current prison population either has an active disorder or was imprisoned on drug-related offenses.

It takes extra sensitivity and training to reach people who have been incarcerated on top of having a substance use disorder. Counselors who go the extra mile to become certified as Criminal Justice Addictions Professionals have proven they have that training and expertise. They work in both pretrial diversion programs, in prisons and jails, and as part of post-release supervision programs. Some are even engaged with police departments, building bridges to treatment instead of more prison walls.

It’s a new treatment-based approach to the war on drugs… one that might actually work.

Prevention Specialist

Prevention specialists are experts in stopping addiction from getting started in the first place. Their role is in community education, organizing, and finding the pressure points that weed out substance use disorders at the roots.

It’s a role that comes with different kinds of training and certification than counselors receive, but the impacts can be huge. By working with community organizations, public officials, and media, prevention specialists identify environmental factors and influences that lead to substance abuse and create innovative campaigns to fix them. Whether it’s publicizing fentanyl overdose rates or creating after-school programs to keep at-risk kids off the streets, these professionals support the treatment community by keeping substance use numbers in check.

Remote Peer Support Specialists and Substance Use Disorder Counselors

Remote counseling is among the latest methods being used to expand accessibility to treatment services. Telehealth has been a mainstay in healthcare and counseling for years, but has exploded in popularity to such an extent in the wake of the global pandemic that it now represents a sort of new category among substance use disorder treatment jobs. Available at all license levels depending on individual state legal requirements, remote access allows counselors to connect with clients by video, phone, or even chat to deliver immediate treatment no matter where the patient happens to be.

Although not all diagnoses and treatments can be handled remotely, this delivery method allows substance abuse counselors and peer recovery specialists to perform most of their core tasks without ever stepping foot in the clinic. As new technologies and high-speed internet reach into notoriously underserved rural enclaves and urban neighborhoods where services are needed most, this is a role that will help define the future of addiction therapy.

What Is a Substance Abuse Counselor Supervisor Job?

Supervision is a new concept for most people who are just coming into any kind of psychology or counseling role. Everyone understands what a work supervisor is: the person who gives you your assignments, approves vacation, adjudicates disputes with coworkers, and signs off on your time card.

But when it’s used in the context of providing therapy to patients, the word supervisor really means clinical supervisor. While it still implies a kind of oversight, it’s not the same kind of supervision as day-to-day worksite management.

Instead, a clinical supervisor is a resource and a guide when it comes to delivering appropriate therapy to your clients. They will review your case notes, comment on treatment choices, or act as a sounding board when you need feedback. Their job is really to make sure you are delivering a high level of care and not accidentally making any mistakes when it comes to ethics or professional responsibilities.

In some cases, your clinical supervisor may also serve as your administrative supervisor on the job, but this isn’t a requirement.

It’s also not usually necessary to become a top-level independent SUD counselor in order to become a clinical supervisor. Both national certification agencies and most state licensing bodies issue supervision credentials to individuals at the SUD counselor level and above. You may only supervise individuals at lower license levels, but there’s no need to climb all the way to the top before doing so.

Although SAMHSA drops supervisors into this role, in most states, supervision credentials can be earned at multiple SUD counseling license levels, not just in the top rank. Nonetheless, the kind of education and experience these roles require almost always makes them responsible for clinical supervision in their organizations. They may spend more time overseeing the decisions of other counselors than directly engaging clients. But the tough problems will almost always trickle up to them.

Alternatively, this kind of license allows counselors to branch out and start their own business. Independent SUD counselors hold the only role that is allowed to practice without higher supervision, this is your destination if you plan to operate your own service in SUD counseling.

What Does a Substance Abuse Counselor Do?

The overarching goal of substance use disorder counselors is to change the lives of those hobbled by addiction. They all recognize that it’s an individual battle in every case… won or lost based on motivation, medical assistance, specific support, directed therapy, and a hundred other things that may be different from case to case.

Helping patients solve those problems requires creativity and empathy. No two recovery efforts are the same. But to develop a systematic approach that uses the best scientific evidence to maximize the odds for every patient, the professional community has come up with a list of specific competencies that every SUD counselor uses.

What Are the 12 Core Functions of a Substance Abuse Counselor?

As you investigate careers in substance abuse counseling, you’re likely to come across references to the 12 core functions of substance use disorder counselors.

Originally developed in the 1980s as a way for states to assess the competency of SUD professionals for licensure, the 12 core functions later spread globally. A short addition of Global Criteria to better define the functions in context rounded out the process.

Screening
Intake
Orientation
Assessment
Treatment Planning
Counseling
Case Management
Crisis Intervention
Client Education
Referral
Report and Record Keeping
Consultation With Other Professionals

You can see broad alignment between this early effort and more current definitions for scope-of-practice. This list is still used in some places by educators or state licensing organizations, but for the most part, it has been replaced by the newer TAP 21 eight practice domains.

This is the TAP 21, the Technical Assistance Publication of SAMHSA’s Center for Substance Abuse Treatment outline for the appropriate scope of practice for SUD professionals. It’s what substance abuse counselors do every day on the job:

Clinical Evaluation - Reviewing notes and intake assessments, discussing patient cases with other counselors and professionals, and performing direct evaluations allows counselors to diagnose both substance use and co-occuring disorders.
Treatment Planning - Drawing on a wealth of evidence-based therapy options and environmental supports, counselors come up with a systematic way to address addiction issues for each individual.
Referral - With an in-depth knowledge of other available resources for everything from housing to healthcare, counselors routinely spend time referring patients out to other experts for supportive assistance.
Service Coordination - Even once other resources have been lined up for patient care, counselors have to coordinate their efforts with other providers and healthcare professionals in person, over the phone, or by email.
Counseling - The real heart of SUD counseling is the group and individual interactions that nudge patients toward a better, healthier kind of coping mechanism and away from addiction.
Client, Family, and Community Education - Counselors also work to educate the community in general on the dangers of substance abuse, symptoms and signs to watch for, and available resources for treatment. They also work more directly with families to inform them of the path forward when their loved one is experiencing addiction.
Documentation - Paperwork is critical both for coordination and billing, so every counselor will spend part of their day creating case notes, billing records, and other necessary documentation.
Professional and Ethical Responsibilities - All of the above rely on strong ethical standards and boundaries that allow for empathy and patient care without creating legal or moral concerns.

To a greater or lesser degree of responsibility, every substance use disorder professional performs tasks every day that follow the overall TAP 21 scope of practice.

These are the outlines of every sort of addiction counseling job. You’ll practice them in one form or another at every level, every day of your career. But there is more that goes into what substance abuse counselors do than just the general scope of responsibilities.

The Job Description of Substance Abuse Counselors Can Depend on Where They Work

Most jobs in substance abuse counseling are found with private companies and non-profit organizations that specialize in therapy and treatment.

These can range from small operations with a handful of staff that deal with all the counseling needs in a small community all the way up to national operations that may deal with highly specific aspects of SUD counseling, like alcohol dependency issues.

In other cases, government agencies either hire or subcontract SUD counseling specialists to run programs in prisons, for outreach efforts into the unhoused community or with various at-risk groups like kids or minority populations.

Most employers in the field hire professionals to fill the full range of roles. Because supervision is a universal requirement, there’s always a need for someone with supervisor credentials to foster other counselors completing the license candidacy process. The bulk of the workforce will be in lower level roles.

The nature of the day-to-day activities depends a lot on the mission of the organization. Inpatient treatment centers offer a whole different experience than a school-based job in teen addiction prevention.

Substance abuse counselors are also known for going above and beyond. Although professional boundaries are an important part of self-care and ethics, it’s a rare counselor who hasn’t handed out their personal phone number, answered calls in the middle of the night, and worked off-the-clock to help a patient in crisis.

For graduates who ascend to the heights of PhD in Addiction Counseling studies, two more kinds of employment options open up:

Academic and teaching positions - The ranks of SUD counselors can only be filled by people who come through the required educational programs that qualify them. Professors and instructors in those programs need even higher qualifications than the people they teach, which in many cases means holding doctoral degrees.
Substance Use Disorder research jobs - With new drugs, new psychological evidence, and new medical breakthroughs constantly coming on the scene, someone has to conduct the research to build the evidence and develop the latest techniques in treatment. That work falls to PhD graduates in labs and think-tanks nationwide.

For the most part, these roles are found at universities, colleges, and occasionally with government agencies and non-profit organizations focused on substance abuse research and response.

Different Substance Abuse Counselor Jobs Require Different Levels of College Education

One of the underpinnings of every SUD counseling role set out in TAP 21 is knowledge.

Understanding addiction and the available treatments only comes through the foundations of psychological, chemical, and biophysical science. A college education is critical for developing this kind of understanding.

College also comes into play when it comes to taking that knowledge and adapting it to effective treatment. While some people are born therapists, with a knack for talking to people, there’s no one whose skill isn’t improve with study in areas like:

Abnormal psychology
Human services and social work
Principles of counseling
Health sciences
Pharmacology

Degrees and certificates at both the graduate and the undergraduate level help deliver the unique set of knowledge needed to perform SUD counseling effectively.

College study also brings some intangible advantages to SUD counselors. Studies in the liberal arts offer a foundation in communications skills, general business and math, history, social studies, and the arts that simply makes students better at human connections and empathy. It all comes together to develop well-rounded counselors with the kind of flexibility the job demands.

Degree requirements for licensure or certification echo the level of responsibility for each type of counselor. They tend to cover the same ground, but with more depth in more advanced programs.

Undergraduate Certificates and Diplomas in Substance Abuse Counseling

Usually aimed directly at meeting the most low-level license or certification standards for the state they are in, these are fast and inexpensive. Usually designed to simply check the boxes for educational requirements, they don’t come with much field experience or any other college-level coursework outside SUD courses.

Associate Degrees in Substance Abuse Counseling

Split maybe 60/40 on the basics of addiction counseling and more general arts and sciences courses, these offer both extra detail in your SUD counseling skills and a stair-step up toward more professional practice. Sometimes known as transfer degrees, these can also be applied toward completing a full bachelor’s.

Bachelor’s Degrees in Substance Abuse Counseling

These four-year programs go in-depth on not only counseling, psychology, psychopharmacology, and assessment skills, but also deliver a full blast of critical-thinking, business communications, general knowledge, and other life skills that make the difference between pure technicians and truly capable professional counselors.

Master’s Degrees in Substance Abuse Counseling

With one or two years devoted to the most advanced coursework and practical, hands-on experience in counseling, these programs offer the most state-of-the-art training for experts who will master addiction counseling.

Doctoral Degrees in Substance Abuse Counseling

PhD programs take years to complete, but come with the kind of research background, teaching skills, and advanced theoretical mastery of addiction counseling that is needed in policy planning and future breakthroughs in treatment.

Graduate Certificates in Substance Abuse Counseling

An option for bachelor’s graduates from other fields who want to both up their expertise in SUD counseling and meet state licensing requirements, these are quick and inexpensive programs taught at a high level.

Professional Certifications Establish Your Ability to Fulfill Substance Abuse Counselor Job Duties

Professional certification is often earned as a condition for state licensing or certification. That means the state may require it before issuing the official board certification that legally grants practice authority.

Even when not required by the state, it can still be an important piece of the career preparation puzzle.

There are two organizations that certify addiction counselors nationally:

NAADAC, The Association for Addiction Professionals

NAADAC operates at the national level. NAADAC standards are constant no matter where you go.

National Certified Addiction Counselor, Levels I and II
Master Addiction Counselor
National Certification in Nicotine and Tobacco Treatment
National Certified Adolescent Addiction Counselor
National Peer Recovery Support Specialist
National Clinical Supervision Endorsement

IC&RC, the International Certification and Reciprocity Consortium

In many states, the local IC&RC board is recognized by state agencies as the responsible agency for professionally credentialing authorized SUD counselors. IC&RC cert requirements are set by the state-level boards, but tend to be fairly similar.

Alcohol & Drug Counselor
Advanced Alcohol & Drug Counselor
Clinical Supervisor
Prevention Specialist
Certified Criminal Justice Addictions Professional
Peer Recovery

Each of these organizations and each of their available certifications have specific standards for:

Education
Experience
Training
Credentialing
Testing

State boards also rely on these exams to serve as a gateway to earning state-level credentials. Pretty much every state defers to either a NAADAC or IC&RC test as part of the state credentialing process rather than developing an exam of their own. The specialist certifications aren’t required or applicable in licensing, but will boost your qualifications for certain types of jobs.

Planning Your Progression Through the Ranks of Substance Use Disorder Counselor Jobs

You may have noticed that the only path to some of the more advanced licenses and certifications in substance use disorder counseling runs through experience and education. Testing is part of it too, of course, but experience and education are how you learn to ace the tests.

Experience and knowledge aren’t things that you simply absorb overnight. Experience, by definition, takes hours and days and years to accumulate.

So it’s very common for your career in substance abuse counseling to take you through a series of different roles and credentials on the way to your end goal.

In many states, the only way that you can accumulate the experience needed for senior licenses and certs is by working at a lower level license status for some years.

Something similar often happens with the educational piece of the puzzle. You may pick up an associate degree right out of high school and qualify as a tech. You can often apply the credits earned in that associate program toward your bachelor’s degree at some point in the future, and use the combination of a four-year degree and experience to become a qualified SUD counselor.

And of course that bachelor’s in substance abuse counseling is your surest ticket to a master’s program in the field. You may get that, and your clinical license, after another couple of years.

Where you decide to stop on that career ladder is entirely up to you. But since it is a ladder, it’s wise to take the next rung up when you feel ready to meet the challenge. There’s no better way to attend to your own career while putting yourself in a position to have the most impact in the lives of people in your community.