Written by Scott Wilson
The response to America’s substance use disorder (SUD) crisis, and any hope of resolution, starts with what counseling students are learning in the classrooms of colleges across the country.
Some 60 million people each year use illegal drugs or misuse prescriptions, and another 28 million have alcohol use disorders. Around 70,000 of those people will overdose and die. And that number is increasing by around 4 percent year over year. Meanwhile, around 16 percent of the chronic homeless population is on the street at least in part because of substance use disorders.
Well-trained addiction counselors are the only hope for these people. That hope can come in the form of a helping hand on a cold night, words of encouragement during the depths of withdrawal and self-loathing, or a phone call to line up a bed or a methadone dose when it’s needed.
It’s tough work, but it’s also more rewarding than almost anything else in the world. It’s really only something you can excel at with a degree in substance use disorder counseling behind you. Whether you find your school online or right in your own neighborhood, it will be the proving grounds that prepare you for some of the most important work to be done in the world today.
Substance Abuse Counseling is Inherently Interdisciplinary, Covering Topics from Pharmacology to Social Work
You need to understand how drugs affect the mind and body. Learning how the psychology of addiction interprets the complex combinations of genetics, neurochemistry, environmental factors, and lived experience is a key piece of becoming an effective SUD counselor. Developing the communications skills to make connections with people under the influence of various substances has to be built on expertise in therapy techniques. And spotting the telltale signs of addiction quickly comes from understanding the biological effects of various substances.
That’s why these are interdisciplinary degrees, which means they draw on a lot of different fields to bring together the right blend of expertise:
- Psychology
- Pharmacology
- Social Work
- Counseling
- Health Science
You’ll find professors who are experts in all of those fields teaching your classes. As a key part of preparing the workforce for some of the most challenging issues in human services today, substance abuse counselor education doesn’t shrink from asking hard questions and delivering actionable answers.
Substance Abuse Counselor Degrees Align with State Certification and Licensing at Every Level
Education in substance abuse and addictions counseling is highly targeted, with degrees or certificates available at every level that meet eligibility requirements for state credentials to practice. Unlike counseling, psychology, or social work, you don’t have to go all the way to a master’s or doctoral degree to become an effective and fully-credentialed substance abuse counselor.
Undergraduate Certificate in Substance Abuse Counseling
Sometimes referred to as a diploma, Certificate programs in Substance Abuse Counseling are brief college-level programs that last less than a year and leave out the more general curriculum requirements that go with full degrees. But although they are quick and inexpensive, certificates can help meet the education requirements for credentials in every state… sometimes even full licensure.
Undergraduate certificates in substance abuse counseling can lead to entry-level credentials as an Associate SUD Counselor in every state that offers credentials at that level. In four states, it’s all you need for full SUD Counselor credentials.
Associate Degree in Substance Abuse Counseling
The next step up is the entry-level two-year Associate in Substance Use Disorder Counseling. These are also very affordable degrees that can be earned in a relatively short amount of time. On top of the required coursework in psychology, therapy, and treatment, though, they include traditional liberal arts classes to build you into a more well-rounded professional and therapist.
Associate degrees in substance abuse counseling lead to licensure or certification as a full SUD Counselor in 27 states, and offer an on-ramp to bachelor’s programs elsewhere.
Bachelor’s Degree in Substance Abuse Counseling
Then there is the traditional four-year Bachelor in Substance Abuse Counseling. These are the building blocks of professional careers in America, coming with both intensive studies in counseling topics, but also a broad range of classes in the sciences, communications, social studies, and arts. You come out on the other side of these degrees with extensive addiction counseling skills, but also the broader context and knowledge to use those skills most effectively.
Bachelor’s degrees in substance abuse counseling lead to licensure or certification as a full SUD Counselor in any state, a Clinical SUD Counselor in 9 states, and as an Independent Clinical SUD Counselor in 5 states.
Master’s Degree in Substance Abuse Counseling
The highest levels of professional practice in substance abuse treatment are filled with graduates from one or two-year Master of Addiction Counseling programs. Entry requires a bachelor’s, so you are building off already intensive and effective training in SUD counseling. The expert-level skills earned in graduate programs is a requirement for advanced practice licenses and supervisory roles in addiction counseling.
In every state, a master’s degree in substance abuse counseling meets or exceeds the requirements to become an Independent Clinical SUD Counselor.
Graduate Certificate in Substance Abuse Counseling
For a dose of that advanced expertise without any frills, professionals from other fields often turn to Graduate Certificates in Addiction Studies. These come with the same essential SUD education as a master’s program, but without some of the expanded coursework in theory, specialized counseling practices, or extra field experience. That can make them a good choice for LPC (Licensed Professional Counselors) or LCSW (Licensed Clinical Social Workers) who want to stack counseling credentials on their existing licenses, or for bachelor’s graduates from related fields who decide later to become qualified as SUD counselors.
In any state, if you already have a bachelor’s degree in virtually any area of human services, psychology, or behavioral health, you can stack on a graduate certificate in substance abuse counseling to qualify for licensure as a full Clinical SUD Counselor or Independent Clinical SUD Counselor.
Doctorate in Substance Abuse Counseling
Finally, a three-to-four year course of study at the most advanced level will bring you to a PhD or PsyD in Addiction Counseling. While there is no state or national credential that requires this level of degree, it’s what both treatment organizations and schools look for when they are hiring unmatched experts in substance use disorder research and treatment. With plenty of research and theoretical explorations of addiction and counseling techniques under their belt, PhDs are the people at the cutting edge of coming up with new ideas and treatments to stem the tide of substance abuse.
Doctoral degrees in substance abuse counseling lead to roles in research, education, and leadership in addiction studies.
Specializing Your Addiction Counselor Degree To Make a Difference Where It’s Needed Most
There are few formal specializations offered in the substance use counseling field, but that doesn’t mean you won’t use your college studies to land on a specific area of expertise in addiction counseling.
For the most part, specialization in this field means landing on a specific population affected by substance use disorders, or developing expertise in a particular therapy tool or process.
Your Degree Can Help You Focus Your Counseling Skills to Serve Specific Populations
Among the things you’ll learn in your substance abuse counseling education is that different patient populations are affected differently and should be treated differently. As a result, many counselors end up building their practice around a particular group of people related in some way by their disorders.
- Age - Counseling a teen a few months down the path of drug seeking and use behavior presents a very different kind of problem than working with an older adult who has been on and off heroin for most of their lives. Various counseling methods and different personalities have better luck with people in different phases of addiction, and counselors often specialize their practices by age.
- Substance - Beating an alcohol addiction is very different from cracking a dependency on opioids. Both the psychopharmacology of the addiction and the methods used to overcome it can benefit from specialized knowledge.
- Culture - In a multicultural society, you can find a lot of different attitudes and patterns of substance use. Counselors may decide to focus on working with groups where they can develop relationships, speak the language, and otherwise bring unique cultural wisdom to bear in the fight against addiction.
- Relationship - Not all counselors work directly with patients with substance use disorders. In other cases, they may assist friends or family members through the trauma of SUD. They also can develop expertise in advising families in how to go about an intervention and providing support for recovery as part of a broader net. In some cases, counselors may specialize in working with couples where one or both have a dependency issue.
- Carceral status - A side effect of the War on Drugs has been to load up the criminal justice system with patients experiencing substance use disorders. This population has a unique set of challenges and requires specific treatment techniques to reach. The National Institute on Drug Abuse estimates that 65 percent of the American prison population are actively struggling with a substance use disorder. Almost 15 percent of deaths among former prisoners are opioid related. At the same time, they lack the stability and support systems that come automatically to other patients. Counselors in this field work both in prisons and with parole programs to try to change that equation.
Using Your Substance Abuse Counseling Degree To Specialize in Specific Treatment Techniques
In other cases, counselors specialize by certain techniques.
Some find the delicate touch and expertise in running group therapy sessions where everyone feels heard and supported. Others might focus more on one-on-one therapy sessions, making breakthroughs in direct counseling in the office. Some are focused on outreach, going out to find patients who may never get a referral or pick up the phone, but still need the kind of help a SUD counselor can deliver.
Certain treatment techniques are more effective with certain patient populations, so a choice in one might lead to a natural alignment of both.
There are also various kinds of psychotherapeutic approaches that counselors might choose to specialize in. Cognitive behavioral therapy, contingency management, and matrix model treatment are all examples of techniques a particular therapist might choose to specialize in.
In both cases—whether patient population or treatment technique focus— your choice of degree will be important to make sure you get the right education for those specializations.
Just qualifying for licensure is good enough for the state. But when it comes time to go out and get a job with treatment organizations, you’ll want to show them a degree that backs up the kind of work they expect you to perform.
Addictions Counselor Degrees Lead to Positions Helping People With Every Kind of Substance Use Disorder
No matter what level of credential or what kind of population or therapy you might specialize in, the destination for almost all graduates of SUD counseling degree programs is the same: helping individuals, groups, and communities through the process of recovery.
Addiction counseling degrees lead to positions at organizations such as:
- Private counseling and therapy practices
- State correctional systems
- Nonprofit outreach organizations
- State human services agencies
- Hospitals and healthcare systems
- Residential treatment facilities and halfway houses
The kind of work they do in all those roles revolves around the tools that your degree will hand you:
- Running rehabilitation and recovery halfway houses
- Engaging in outreach and interventions with vulnerable populations
- Consulting and implementing prevention and awareness projects around substance use disorders
- Organizing and leading group therapy and support sessions
- Counseling family members of patients
- Assessing and treatment planning for patients
- Making referrals for other human services that patients may need to enable their recovery
There’s also plenty of paperwork, including case notes and communication, which you will find much easier with a strong college background in English, writing, and even business coursework.
The Level of Degree You Hold Will Affect Your Credential Level and Job Opportunities
The level of credential you qualify for will impact all of your choices for employment as a substance use disorder counselor.
While you will have the same kind of options to choose from among different specialities and different kinds of counseling organizations, your role in those jobs will be dictated by what your license allows.
SAMHSA, the Substance Abuse and Mental Health Services Administration, offers a model licensing ladder that more or less outlines what you’ll find available in most states. They break it down into five levels:
- SUD Technician - Works under direct supervision, supporting the work of counselors and assisting patients during treatment. Requires only a high school diploma.
- Associate SUD Counselor - Provides services under supervision as an assistant to a full SUD counselor. May be a provisional or temporary license on the way to full SUD counseling. Typically requires an associate degree.
- SUD Counselor - Can treat patients with more autonomy, but still operating under clinical supervision. Typically requires a bachelor’s degree.
- Clinical SUD Counselor - Able to diagnose, develop treatment plans, and treat patients at a high level, but still under general supervision as they either pursue fully independent licensure. Typically requires a master’s degree.
- Independent Clinical SUD Treatment Counselor/Supervisor - Has fully independent clinical practice authority, and may be able to provide supervision to other SUD counselors. Almost always requires a master’s degree.
While not formally a part of the SAMHSA model, almost every state also licenses peer recovery counselors, who are individuals who have been touched in some way by substance use disorder, or experienced it directly themselves. Knowing the realities of substance use disorders, they are in a unique position to offer valuable assistance to other patients.
So you can see how your level of degree will impact what kind of services you are licensed to provide. That, in turn, has an effect on the kind of day-to-day duties and tasks you perform as an addiction counselor.
Substance Use Disorder Counselor Credentialing: The Difference Between Licensing and Certification and How Your Degree Fits Into the Picture
As part of maintaining standards for safe and effective counseling, and granting the authority to practice to professionals who meet those standards, each state sets requirements for training and practical experience.
But states take different paths to verifying those requirements and giving you the authority to work with patients.
In some cases, a state government agency is directly responsible for checking your qualifications and issuing a license.
In others, however, the state authority is delegated out to an independent professional board. That board offers a certification, not a license, even though it gives you the same authority to practice.
Both of those are different than a national professional certification, which is a separate and more stringent validation of your qualifications that is used more to build your career than as a status of authority… although some states also accept national certifications as qualifications for licensure.
Some states have both certification and licensing paths, with licensure typically being the higher-level credential. For example, you’ll often find credential titles similar to these:
- Certified Substance Use Disorder Counselor
- Licensed Advanced Substance Use Disorder Counselor
Lastly, it’s worth noting, all of these credentials differ from a college certificate in substance abuse counseling, which refers simply to a short-course educational training program that can be part of meeting the education requirement for state credentials, but by by itself doesn’t grant practice authority.
Substance Abuse Counselor Schools Need to Be Recognized by Your State Credentialing Authority
The key to getting a license at the level you aim for is ensuring that the coursework your degree offers is officially recognized by the state agency or certification board that you plan to become licensed with.
Each state sets their own criteria for required educational content and hours for SUD counselor licensing at each level. While most of those criteria are basically similar from state-to-state, it’s the responsibility of each agency that offers licenses to decide whether a particular school meets their standards or not.
So most of those agencies or independent boards will directly approve specific programs in their state or area which offer a degree that will be accepted. In other cases, they may rely on national accreditation for that approval.
The National Addiction Studies Accreditation Commission, affiliated with NAADAC, the Association for Addiction Professionals, is the only national agency that specializes in addiction counseling accreditation. Fewer than 40 programs nationwide have submitted to and qualified for this accreditation. That’s out of several hundred programs around the country that offer programs that very often meet state standards already. As such, NAADAC is typically seen as a second level of quality recognition, but not the exclusive test for programs to meet state requirements.
Some states also look to programs that are accredited by CACREP, the Council for Accreditation of Counseling and Related Educational Programs. CACREP handles clinical mental health counseling programs, but plenty of those have a focus in substance use disorders.
Ultimately, it all comes down to the credentialing agency in your state to decide.You can almost always appeal directly to the agency to see if they will recognize your education even if the school is not listed. In most cases, as long as it complies with the overall standards, it will be accepted.
A Look at the Coursework and Experiential Learning That’s Part of an Addictions Counselor Degree Program
Because most degree programs lead to licensure and conform to state educational requirements, they have a lot in common when it comes to the subjects you will see in class.
The topics covered include:
- Understanding the psychological and physiological mechanisms of addiction, and cultural factors that lead to substance use
- The pharmacology of substances that are commonly abused
- Techniques for assessing and evaluating substance use disorders
- Understanding the American Society for Addiction Medicine clinical guidelines
- The role of therapy placements, recovery care, and discharge conditions in SUD treatment
- The implications of cultural diversity on treatment and evaluation
- Treatment planning and referrals to other human services specialties, including coordination and case management
- Individual and group counseling techniques
- Confidentiality and professional ethics in substance abuse treatment
With higher level degrees, you’ll get more of the scientific and social background behind all of these aspects of counseling. While an associate degree or certificate may only have time to get into the specific skills of assessment and treatment, bachelor’s and master’s programs will also put you through classes in developmental and abnormal psychology, biology, and social studies that help you get a deeper grasp on the how and why of treatment.
You also get the opportunity to branch out further through elective classes. You might dive into adolescent substance use disorder and treatment, or take classes to build skills in telehealth or SUD treatment for specific ethnic groups.
Particularly in bachelor’s and associate degree programs, you’ll also get a strong dose of standard liberal arts coursework. Everything from general sciences to history to arts are part of these classes.
Although it might not be directly related to offering excellence in addiction therapy, these classes help develop your empathy, your communication skills, and your critical-thinking and problem-solving abilities. It’s a valuable part of what an American college education has to offer, and prepares you to be a more effective agent in the fight against substance use disorders.
Out in the Real World, Experiential Training Puts Your Classroom Studies To Practical Use
Because experiential education and direct practice hours are both important for learning and licensing, most degrees and even many certificates come with in-person practicum or internship placements.
These are opportunities to get out into the community and work with actual patients under the supervision of active SUD professionals.
A practicum is typically a shorter, more closely supervised placement that is basically a class that comes with some hands-on practice. It’s tightly integrated to the curriculum and your instructor plays an important role in the process.
An internship is often a longer and more independent kind of experience. You will be supervised primarily by licensed counselors and work in a real job at a treatment facility or outreach agency. These offer more freedom to get your hands dirty on the job, learning skills as an important part of a counseling organization.
Particularly for longer degrees, you’ll typically get a chance to rotate through a number of practicum or internship opportunities to expose you to various kinds of SUD counseling. They help you make contacts in your area as well as develop an idea of what you might want to specialize in as a counselor.
Considering an Online Substance Abuse Counseling Degree
Increasingly important to many students is whether or not a school delivers their SUD counselor education online.
Online studies are a big hit even after the COVID-19 pandemic receded. They might be the perfect choice for your own addiction studies.
Substance abuse counselor online degree programs open up your options for schools around the state or the country. You’re not restricted to picking only colleges within driving distance, or picking up and moving at high costs and difficulty. Instead, you can choose the right program for your needs no matter where you are.
Substance abuse counselor degrees at every level are offered online.
Substance abuse counselor online classes allow you to shift your schoolwork to times that are convenient. Most online degrees are taught asynchronously—you don’t have to be watching a lecture at the same time the professor streams it. Instead, wait until the kids are in bed, or catch up on a weekend morning. It doesn’t make any difference in your grades, but it can make a huge difference to your lifestyle and career to study at your own pace.
Online programs help you save money by keeping you close to home. By freeing up your time and keeping you from having to relocate, you can make the most effective financial decisions for your situation. And you aren’t hemmed in by the limit of how far you’re willing or able to commute.
Of course, any kind of practice-oriented profession like substance abuse counseling is going to require a certain amount of in-person work. That means that internship and practicum hours are still filled on-site in places where you can work in direct contact with patients and other counselors. The good news is that schools that deliver addiction counselor programs online are experts in making arrangement for you to put in those hours at local SUD treatment facilities or organizations.
A Career in Substance Abuse Counseling May Lead You Through Multiple Degrees
Because of the licensing ladder and ongoing continuing education requirements needed to keep those credentials, it’s not at all unusual for people in substance use disorder counseling to go from associate to bachelor’s to master’s degrees and beyond.
It’s a natural pattern that you’ll probably be drawn to once you start working in the field. Everyone always wants new tools and more knowledge to take on the devastating problems they encounter in the field. It doesn’t hurt that more advanced degrees lead to higher levels of licensing that can lead to higher salaries, either.
No matter where you choose to start or stop your addiction counseling education, you’ll come away with the skills needed to make a difference… to local families, your community, and to the country.