Drug and alcohol abuse are not going away. In fact, this public health scourge is only getting worse as we struggle through the midst of the Opioid epidemic, which has brought narcotic addiction to even the most rural areas. To add to the problem, many turned or are turning to alcohol to help them cope with anxieties related to recent quarantines and the ongoing COVID-19 crisis. Sadly, these problems are not likely to go away any time soon. To combat addiction, substance abuse counselors are hearing the call.

For those who wish to become substance abuse counselors, there are more and more opportunities to train and become licensed. States are licensing professionals with two-year degrees all the way through to those with a doctoral diploma. Thus, for those who wish to answer the call to help heal the millions trapped in the morass of addiction, keep reading and learn how to become a substance abuse counselor.

What do Substance Abuse Counselors Do?

Substance abuse counselors are mental health professionals that help addicts, including alcoholics, recover from their seemingly hopeless state. To achieve this goal, they employ a variety of tactics to help their patients explore and heal the causes and conditions surrounding their addiction. These include talk therapies like cognitive behavioral therapy but also experiential methods such as wilderness and equine therapy.

Cognitive Behavioral Therapy (CBT) is a tried and true method that looks like what we might expect from a counselor. Patients explore their feelings and experiences with a counselor in a quiet office setting. The CBT methodology helps addicts learn to deal with the stresses of life without drugs and alcohol. The therapist hopes to help their client restructure their thoughts in order to amend maladaptive behaviors. This work is effective in helping addicts avoid relapse and discover new joys in life.

Wilderness therapy has been around for a while but is still considered somewhat of an alternative therapy. However, it has proven effective for many addicts, especially younger patients. In this healing process, a group of addicts hit the trail for a long trek guided by therapists. Along the way, therapists help their patients become part of the group, work as a team, and gain a sense of self-worth apart from drugs. Since addiction is so often a disease of inactivity, depression, and isolation, the exposure to nature, sunlight, and interdependence can be a strong medicine.

Equine therapy is another so-called alternative therapy. In this process, the therapist takes a back seat to a horse and the patient interacts one-on-one with that majestic animal. Since horses are extremely sympathetic, they reflect the patient's emotions, thus allowing the patients an opportunity to identify and connect with how they are really feeling. There are a variety of other therapeutic activities equine therapists employ with patients including horse riding, grooming, and more.

Who Do Substance Abuse Counselors Work With?

Substance abuse counselors work with people of all ages and walks of life. Some specialize in adolescent addicts or specific adult populations including those from certain spiritual traditions. Others may prefer to work with a specific gender, or even transgendered people. There is also a huge demand for substance abuse counselors to work with houseless people and prisoners, including juvenile offenders.

Substance abuse counselors can thus find work in a range of different environments. They might spend their days in a corrections facility, a homeless shelter, or even in private practice. Most will find work with a rehabilitation center that may have a hospital-type setting, though some have a college campus or a spa-like environment.

Counselors can thus seek out the population and setting that suits them best. This range of choices includes treatment philosophies, religious affiliation, and more. Since there are so many valid approaches to substance abuse therapy, counselors can focus on their favorite methodology while in school and then forge a career that fosters their passion. Furthermore, since addiction therapy can take place in a wide range of settings, including outdoor activities, counselors can apply their recreation to their profession.

Helpful Skills to Have

  • Patience:
    Counselors need to have deep patience with their clients. Sobriety does not happen overnight, and patients may not immediately, if ever, embrace the process. Further, if a counselor expresses impatience, their patient may become discouraged.
  • Listening:
    This is key. Patients may have difficulty expressing themselves or may have never found someone who would listen to them. Counselors who can practice active listening build trust and thus are able to help their clients all the more.
  • Communication:
    Interpersonal communication is perhaps the bulk of the counseling profession. Counselors need to be able to communicate themselves clearly and succinctly, listen acutely, and seek absolute understanding.
  • Confidence:
    When a counselor is confident, they can transmit that to their patients and thus facilitate more learning and healing.
  • Empathy:
    The ability to feel what a patient is going through can be a tremendous asset in the quest to heal addiction. Since addiction is often a disease of isolation, addicts need to see others connecting with them on an emotional level.
  • Experience:
    Counselors who have themselves gotten sober are frequently the favorite of patients. However, even non-addict or alcoholic counselors can build experience with addiction purely through helping clients achieve sobriety.
  • Strong Boundaries:
    Counseling can be a deeply personal business. Sometimes patients seek to manipulate counselors and it's not unheard of for counselors to get too close to their patients. Thus, counselors need to constantly check that they are maintaining professional boundaries.
  • Education and Training:
    There is no substitute for a strong academic background and even on-the-job training. Every licensed counselor is required to have a comprehensive education.

Steps to Become a Substance Abuse Counselor

Research Your State’s Requirements

Every state has its own requirements for substance abuse counselors. Some states only require a high school diploma and a certificate for an entry-level counseling license. Other states may require a bachelor’s degree or more. Furthermore, there are often requirements for budding counselors to complete a period of supervised training.

It's vital that counselors explore the licensure requirements in their state. Since some states have multiple levels for their counselors, it's important to investigate the parameters for each. Some may wish to enter the field with a lower licensure level before they commit to graduate school or more.

For those who are curious about entering the field, most substance abuse programs will be able to provide guidance. Prospective students should ask what the program does to help its graduates qualify for licensure, including any special examination preparation.

Complete Educational and Work Experience Requirements

In order to become an addiction counselor, it's vital to start with an education. Every state structures its licensure process differently. Some offer multiple license types, each of which has their own educational requirements. Furthermore, there are some programs that are dedicated only to substance abuse counseling while there are others that have a broader scope.

Most substance abuse counseling degrees prepare graduates to work in drug and alcohol rehabilitation programs. However, depending on the degree, and subsequent licensure, counselors may be limited in the scope of their practice. For instance, most counselors with only an associate or bachelor’s degree will likely not be able to provide one-on-on counseling. Furthermore, they are unlikely to be able to operate a private practice.

To work in private practice, most states require that counselors have a minimum of a master’s degree in psychological counseling. It’s also possible to work as a counselor with a Master of Social Work. MSW holders are quite common in the field and they are found working with addicts in both the private and public sectors. All aspiring counselors must pass an exam and work for a period of time under direct supervision from a licensed counselor.

As for work requirements, state licensing boards generally require a supervised period under a licensed counselor. During this time, the supervisor will need to observe the license candidate performing certain duties in accordance with the license they seek. Each state has its own requirements and possibly multiple licensure levels, so counselors should be sure to investigate those requirements so their transition to a fully licensed professional is smooth and easy.

Background Check

Counselors must be able to win the public trust, and they should be deserving of that trust. Thus, every counselor will need to pass a background test. That is, people come to them in a very vulnerable state. They are in need of very personal work and they need to work with trustworthy professionals. Patients and clients may even need to divulge very personal information that may include matters of a financial or even criminal nature. For this reason, states seek to protect people by ensuring that their licensees have thus far proven trustworthy.

Since many substance abuse counselors have themselves been involved with addiction, it is not uncommon for them to have a criminal background. While this may be a hindrance, if the license candidate can show that they have become rehabilitated, the board may allow their licensure. Future counselors should consult with their academic advisor or a state licensing body if they fear rejection on the basis of their background check.

Continuing Education

Continuing education is a reality for most licensed professionals and substance abuse counselors are no exception. While each state will have its individual requirements for continuing education units (CEUs), the general rule is that every professional should complete 20 hours of CEUs per year.

Counselors who are members of independent certifying bodies will often have many CEU opportunities throughout the year. These can be online classes, webinars, or in-person lectures. It’s vital that every CEU be recorded according to the state's requirements. Note that some counselors earn CEUs by publishing articles or leading their own professional workshops.

Available Degrees

Associate Degrees

Two-year degree programs for substance abuse counselors are a terrific option for non-degreed people who seek a career in counseling. While the programs are structured to take only two years, some students need more time, which programs often accommodate, though you should check if there is a time frame in which you must graduate before signing up for a program.

There are a number of degree options including the Associate of Arts, Associate of Applied Sciences, and an Associate of Science. Though each will provide an entry to the profession, the AAS degree may slightly inhibit future degree work. That is not always the case, but students should investigate if they feel they may later want a more advanced degree.

Bachelor’s Degrees

A Bachelor’s degree in substance abuse counseling is likely to merit the same licensure level as is available to a worker with an associate degree. However, each state does vary. Regardless, a Bachelor of Arts or a Bachelor of Science in Substance Abuse Counseling will not merit a license for private counseling practice.

Typically, a bachelor's degree is structured to take four years to complete. However, some may complete their degree a bit sooner if they forgo summer breaks. These degrees have a wide range of cost, but when students remain in-state at a public college or university, the cost should be somewhere around $30,000.

Master’s Degrees

For graduate school, students have two general options: a degree in counseling psychology or a Master of Social Work. Both degrees will enable the holder to pursue private practice or pursue upper-level positions in a drug rehab facility. However, the MSW degree has a special benefit of providing an easier path to work for a state or federal agency.

Both degrees will take about two years to complete and will cost somewhere around $20,000 for an in-state university. Students may also want to investigate whether their program offers the possibility of a teaching assistantship, which can offset some of the cost. There are also several online graduate degree options for substance abuse counseling degrees, but those often will not offer a teaching assistantship.

What Certifications are Available?

Certifications are a great way for a counselor to distinguish themselves in the job market. They do not replace any state certification but once a counselor earns these credentials, they will have an even more distinguished resume. Completing a certification such as the NCC AP or the CADC will show to the profession that the holder has met certain high standards for knowledge and skill in the field. Since these are national certifications, they will help when a counselor moves to a new state and begins seeking a job. This is especially helpful if it's perceived that one's home state has lower licensure standards than the state you move to. A national certification helps to level the playing field.

Certification often goes hand-in-hand with membership in a professional association. These memberships open up the possibility of free, or at the very least affordable, CEU opportunities, national conferences, and even state-level events where fellow counselors meet for learning and fellowship.

Places of Employment

Substance abuse counselors are found in many diverse locations. They are most often thought to work in private practice, perhaps in a quiet office tucked into an office park, or in a drug rehabilitation center. Some may, in fact, split their time between those two settings. On the other hand, they may be found in settings such as a correctional facility, hospitals, schools, or even working remote from home or a call center.

Where counselors work is often up to them. This means that counselors can seek an environment that best suits their style and comfort level.


As an average figure, substance abuse counselors earn just under $40,000, according to Payscale.com. The hourly rate can be as low as $12/hr. or as high as $18/hr. Entry-level counselors tend to earn on the lower end of this average. Payscale reports that first-year counselors earn $36,000 per year and that figure rises to around $40,000 by mid-career. By late-career, substance abuse counselors earn close to $50,000 per year. Keep in mind that these figures don't factor in bonuses, profit-sharing, or any other sort of additional compensation. Furthermore, these figures may be weighted by the larger numbers of counselors who don't move up from their associate degree, nor do the figures account for those who engage in private practice.

Job/Career Outlook

Currently, the job market for substance abuse counselors is strong. The Opioid epidemic is running rampant and there is a high demand for counselors to help those afflicted by addiction to those drugs. The COVID-19 pandemic also seems to be impacting the way people use and abuse alcohol and drugs, which will likely have a lasting impact. This is a sad reality, but one that still demands passionate and dedicated counselors.

In fact, the U.S. Bureau of Labor Statistics shows that the market for substance abuse and other counselors is projected to increase by 22% in the years between 2018-28, thus resulting in employment for nearly 400,000 counselors nationwide. Since alcohol and drug abuse is not unique to any one place, there are jobs available in every state, though some states offer more opportunities than others.

The largest market for substance abuse counselors appears to be in California, which employs 32,000 counselors. Their outstanding state health plan surely contributes to so many people receiving the help they need. The next-highest concentration is in Pennsylvania, which employs 20,000 counselors. Interestingly, the highest-paying state for counselors is Utah, which only employs 3,200 counselors, but pays them an average of $67,000 per year. Meanwhile, the mean salary for California counselors is $55,000.