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What Does an Alcohol and Drug Addiction Counselor Do?

Becoming a substance abuse counselor requires becoming therapeutic allies with their clients as they find out what works for their clients; one therapy may not work at all for one patient but be very beneficial for another. Counselors may also meet with their client’s families to help guide them in helping their loved one stay in recovery and be a more cohesive support.

Substance abuse counselors encourage their clients to stay in recovery and help the figure out how best to do that. And, because relapse is often a given in addiction, these counselors help their clients create a relapse prevention plan.

What Does an Alcohol and Drug Addiction Counselor Do?

To become a substance abuse counselor, the counselor must become therapeutic allies with their clients as they find out what works for their clients. One therapy may not work at all for one patient but be very beneficial for another. Counselors may also meet with their client’s families to help guide them in helping their loved one stay in recovery and be a more cohesive support.

Substance abuse counselors encourage their clients to stay in recovery and help the figure out how best to do that. And, because relapse is often a given in addiction, these counselors help their clients create a relapse prevention plan.

What Does an Alcohol and Drug Addiction Counselor Do?

Counselors become therapeutic allies with their clients as they find out what works for their clients; one therapy may not work at all for one patient but be very beneficial for another. Counselors may also meet with their client’s families to help guide them in helping their loved one stay in recovery and be a more cohesive support.

Substance abuse counselors encourage their clients to stay in recovery and help the figure out how best to do that. And, because relapse is often a given in addiction, these counselors help their clients create a relapse prevention plan.

Who Do they Work With?

A counselor can work with anyone and everyone who is affected by substance abuse. No matter their age or any other factor, they need the professional relationship and rapport these counselors are able to provide. Whether they are trying to stop using drugs or alcohol or if they are having issues avoiding relapse, they need assistance and guidance that can only come from a licensed professional.

Families of addicts may have struggled for years to get their loved ones to stop using, and they may know that whatever they’ve done in the past isn’t working. Counselors can also work with them, explaining the process of addiction, why their loved ones are struggling with dependence, and how they as family members can help them most effectively.

Counselors also work with fellow professionals as they look for the best therapeutic approaches for individual clients. They may develop working relationships with those outside support groups so that they always have somewhere to send their clients if they need more support or there is a type of therapeutic application that they are not versed in.

Why Do We Need Alcohol and Drug Addiction Counselors?

Addiction is a complex disease. It’s also a disease that develops from psychological issues and brain chemical issues on top of the problem of physiological addiction. As hard as an addict may try to stop using, those ongoing, underlying causes may have them retreating to their drug(s) of choice so that they can anesthetize their feelings and emotions. If they’re suffering from bipolar depression or schizophrenia, it’s easier to self-medicate rather than go to a professional for testing, diagnosis, and prescription of appropriate medications.

Counselors trained in substance abuse treatment know how to develop rapport with clients, they have cultural competence so they can work well with a variety of people, and they build effective communication skills so they can ask the difficult questions and get their clients to look at why they use.

And, because addiction is such a complex issue, it’s up to counselors to explain why trying to kick an addiction solo is such a bad idea. Their training (and personal experiences) give them the skills they need to work effectively with their clients. Some counselors gain education in this area because they have a history of substance abuse or they may have loved ones who have struggled with addiction issues.

What Issues Might Alcohol and Drug Addiction Counselors Deal With?

Because of the many issues counselors may face, they must have the skills to deal with just about anything that could come up in a session with a client. They should want to help others, be a good listener, have confidence, respect for other’s privacy, high-level communication skills, motivation, and even inspiration.

All of these skills and others can come in handy when you’re working with someone who is struggling with one or more addictions. As well as confronting the issues their clients are facing, counselors have to be able to handle their own. Burnout is a real issue for many types of counselors and, in a situation when your client is at very real danger for relapse, the stakes are understandably high.

Counselors may be required to meet with family members of their clients, help clients identify their triggers for abuse, create treatment goals and plans, refer their clients to support groups, lead individual and group therapy sessions, help their clients find jobs and write or update court reports.

Additionally, working with those who may attend a session drunk or otherwise under the influence of drugs may introduce risk into the job on top of the intense work and stress of dealing with those at the end of their ropes. Those under the influence of drugs or alcohol are not always stable and may be a physical danger on top of everything else. If the counselor has past addictions, they know what their clients are going through and may be able to make a strong connection so they can help them, but that brings its own danger to working with this demographic if the counselor has issues with relapse or even temptation because of the stress and presence of their own triggers.

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How to Become an Alcohol and Drug Addiction Counselor


Associate Degree

By beginning your college education at the associate level, you’ll be able to become a substance abuse counselor who is able to work with individuals and their families. You’ll complete intake interviews, conduct family counseling, manage cases, and keep records.

Before beginning all of this, you should know that you may still not be eligible to be a full-fledged substance abuse counselor with this degree. This is still a good start for your future career if you have decided that you want to enter this field. You might want to consider entering a 2-year program and then transferring to a 4-year program.

By choosing addiction counseling programs, you will potentially have a positive effect on the life of people who are struggling to defeat their addictions. By using your skills and education, you help them to figure out why they became addicted and how to get into recovery.


  • Addiction
  • Nicotine Cessation
  • Drug Use and Addiction
  • Criminality and Addiction

Bachelor’s Degree

With a bachelor’s degree in counseling, you’ll be able to help others to stop using drugs or alcohol as they work toward a healthy recovery. To be able to work as a substance abuse counselor, you need to have, at the minimum, a bachelor’s degree program in a related field.

For instance, you may be able to earn a BA in Psychology, a Bachelor of Social Work, or a bachelor’s degree program in substance abuse counseling programs. You aren’t limited to taking a counseling degree programs specifically; any of the above degrees are well-suited to helping you succeed in receiving a job offer from a substance abuse treatment facility, mental health center, or an inpatient substance abuse treatment center. Mental health and substance abuse social workers are expected to experience a 20.1% growth rate in job openings in the coming years.


  • Introduction to Substance Abuse Counseling
  • Alcoholism
  • Historical Perspectives in Substance Abuse Counseling
  • Basic Pharmacology
  • Stress Management in Clinical and Community Settings

Master’s Degree

If you earn a master's degree in counseling, you’ll have the preferred, often required educational background to accept a job offer as a counselor or run your own private practice. Your genuine desire to help guide people struggling with addictions will give you extra motivation to help them achieve sobriety.

After earning your master’s degree in counseling and passing your licensing tests, you may work in an inpatient rehab facility, outpatient facility, community health center, detox center, mental health treatment facility, hospital, in a private practice, or even an employee assistance program (EAP).

It’s possible to enter a profession as a substance abuse counselor through a master’s degree in mental health counseling. If you specialize in drug and alcohol counseling, you’ll have the skills you need to work with those people seeking your help.

After you earn a master’s degree in counseling, you’ll need to earn a license at the clinical level. This allows you to offer specialized services to people dealing with addiction. You can expect to spend several years on the front lines as you earn your licensure.


  • Understanding Prevention and Prevention Programs
  • Ethical Issues in Addictions Counseling
  • Approaches to Substance Use Disorders
  • Treatment Planning and Relapse Prevention

Doctorate Degree

With a doctorate in substance abuse counseling, you’ll be able to work directly with clients, teach new students about this mental health field, further the boundaries of psychological science, or conduct various types of research. Your research may reveal new tools and mental health counseling techniques that help clients who are in need of support, or they may deal with the physical toll and paths of addiction. A doctorate aimed at research also means you may not need to seek professional licensure.

In the degree programs, you’ll practice mental health counseling skills and techniques at a higher level and you’ll also receive evaluations from practitioners who have spent years in this field.

If you decide you want to expand your professional practice and carry out research, a doctorate in mental health counseling and psychological studies or addictions counseling gives you the room to take your profession and career into new directions.


  • Addiction Intervention
  • Advanced Counseling Skills & Techniques
  • Addictive Behaviors & Substance Abuse
  • Field Experience


Before you become a full counselor with a focus on addiction, you’ll need to satisfy several educational and experience requirements. These vary from state to state. You may work in a public facility, such as a community agency, or in private practice under the direction of an already licensed counselor in order to gain the needed experience.

This part of your required experience may come as the result of an internship or practicum where you’ll work under the guidance of a licensed substance abuse counselor who has been practicing for several years and they will support your request for licensure if you prove to be capable in the field.

In one state, your title will be Licensed Abuse Counselor. Your degree level, supervised experience, and training dictate what kind of certification you receive and, the lower your degree level, the more supervised experience you will need.

Another state offers three certification levels, from Licensed Substance Abuse Technician and Licensed Associate Substance Abuse Counselor up to Licensed Independent Substance Abuse Counselor. The last two require that you earn degrees from universities carrying regional accreditations.

As you can see, what is required and the type of license you will need to earn really does depend on where you live or plan to practice. Make sure to check with your state. You may do this through the state professional counselor licensure board, or it may be called the counselor and social worker board. No matter what it’s called, each state has an entity that deals with licensure for professional counselors.


Each state faces its own unique struggles with substance abuse and consequences experienced by individuals and communities who deal with this. Several states require certification study courses and exams customized to their residents’ needs.

In New Mexico, community college graduates with associate degrees are able to be licensed and work with addicts. Arizona is in a similar situation and this extends to the Navajo Indian reservation in the state as well.

However, there is a national certification exam for addiction counselors. This is the National Certification Commission for Addiction Professionals (NCCAP). A national certification course and exam helps to standardize the services and their quality offered to clients in some facilities and individual states require you to have this certification, even if the state does not. NCCAP has created benchmarks that professional substance abuse counselors are required to meet; the commission also monitors the abilities of every counselor treating addictions throughout the United States.


Licensure, as well as certification, assures that clients of substance abuse counselors, are receiving counseling that truly helps them to address, not only their addictions, but also the causes of their drug or alcohol dependence and the effects it has had on their life.

Licensure requires that substance abuse counselors take part in and complete supervised training hours, which must be completed before they apply for their state’s license to practice.

The hours counselors need relies heavily on the level of licensure the counselor is seeking, their level of education, and the jurisdiction in which they are working. The requirements range from 4,000 up to 10,000 hours. A counselor with their master’s degree may need no more than 1,000 clinical supervision hours.

Some states require counselors with bachelor’s degrees to treat clients while being supervised. Some licensing boards may request letters of recommendation, supervision logs from internships, and school transcripts.

Where Do Alcohol and Drug Addiction Counselors Work?

As a counselor, you may work in a variety of professional settings. Where you work may also be affected by the level of education you’ve attained. For instance, if you have earned either an associate degree or bachelor’s degree in substance abuse counseling, the human resources office for your employer may give you a title with the word “counselor” in it. Other offices won’t because you technically are not licensed.

You may work in a methadone clinic. Here, you will be a substance abuse counselor, working with the clients who take a regular dose of methadone in order to stay away from their addiction. A methadone clinic is regulated by the government and you must meet defined standards to work as a counselor here.

Treatment centers are another employment option. As a substance abuse counselor, you’ll have specific tasks to complete. Depending on your educational achievement, you may be responsible for individual or group therapy sessions.

School districts sometimes also employ substance abuse counselors. Here, you must hold a master’s degree to work with high risk children. You may work with children who are at risk of developing a drug dependence or have already had issues with drugs.

You may also work in a hospital providing substance abuse counseling services to patients who are in need of them; you might also work in a clinic, urgent care facility, or medical group in similar positions.


Depending on your education, certification, or licensure level, your average annual salary may begin around $39-40,000. While there is little difference between the annual salaries listed here, these are entry-level salaries. If you want to move up and have the chance to earn a higher salary, a high-level education will be necessary.

With certification, you may be given more advanced treatment opportunities, which include working with behavioral issues in individual clients along with addictions. You may work in group or individual settings, and you may also be responsible for writing and administering treatment plans for your clients.

In every level, you’ll act as a liaison between professionals outside the treatment facility and your clients inside the facility. These professionals can include education programs, hospitals, MDs, and psychotherapists.


Between 2019 and 2029, the level of job growth for mental health counselors, substance abuse counselors, and behavioral disorder counselors is expected to be around 25%. The Bureau of Labor Statistics shows that this is much faster than the average for other US occupations. Addictions, particularly to opiate drugs, are now an epidemic, which leads to people struggling with addictions seeking professional help in regaining control over their drug dependencies. This issue has substantially increased the demand for professionals with experience in this area.

Some states are beginning to require drug offenders to enter treatment and counseling services in lieu of spending time behind bars. Knowing that, if addicts are in active recovery, they are less likely to commit new crimes, this initiative makes sense. Thus, these court-ordered treatment services are now more and more in demand. It is also more cost-effective to treat drug offenders than it is to sentence them to prison.

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