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American Addiction Centers National Rehabs Directory

Substance Abuse Counselors

In 2016, more than 22 million people suffered from a substance use disorder.1 That staggering number equates to 8.3% of the national population.1 Also in 2016, only 2.9 million of those people—a mere fraction of those that need help—went on to receive treatment for problems related to their use of alcohol or illicit drugs, according to the 2016 National Survey on Drug Use and Health.1

Looking at these numbers, the need for both accessible substance abuse treatment and drug abuse counselors becomes increasingly clear. Qualified counselors who can help people manage their addictions are an integral part of the substance abuse treatment industry, and of the American workforce in general.

What Are Substance Abuse Counselors?

Substance abuse counselors specialize in the treatment and recovery of individuals struggling with substance abuse and addiction. They work with people suffering from problems with many different types of drugs, ranging from cocaine to marijuana. Drug abuse counselors may work in places such as:

Drug abuse counselors are required in most states to have some sort of certification or licensure.2

What Does a Substance Counselor Do?

A drug abuse counselor works with the drug user in a therapeutic setting. His or her purpose is to help the patient understand their addiction and help them modify their thoughts, beliefs, and actions in order to progress into sobriety.2 Drug abuse counselors will screen a patient and assess their condition. What they learn will guide them in developing an individualized drug or alcohol treatment plan for the patient. They may also provide family and group counseling.2

The main goal of a drug abuse counselor is to help a recovering individual learn to get and stay sober. The work of a drug abuse counselor requires qualities such as compassion, patience, understanding and sensitivity. Counselors devote a great deal of time, energy and hope into their patients. They pride themselves in the recovery successes that their patients achieve.

Popular Therapy Types

Treatment for drug abuse is different for each patient and can include a combination of several types of therapy. Some of the more popular therapy types include:

Motivational interviewing (MI) is a type of therapy that creates an accepting partnership between the recovering individual and the counselor. The counselor expresses acceptance of the client and helps them to discover their desire to change on their own. Through MI, the individual can resolve their ambivalence about change and get personally invested in their recovery.3

Contingency management (CM) is a type of positive reinforcement counseling that encourages the patient to abstain from drug use and engage in healthy behaviors. When progress is made, the patient is rewarded for their efforts. When the patient regresses, rewards are withheld and punitive action may be taken. Incentive-based therapy has been proven to be effective in the treatment of drug and alcohol use disorders.4

Cognitive behavioral therapy (CBT) is a plan that leads patients to understand and avoid situations that are most likely to influence them to use drugs. The process teaches the user to recognize negative thoughts, beliefs, and emotions and how they impact their drug use. They also help patients recognize triggers and develop positive coping skills that exclude the use of drugs. It is a very common therapeutic approach for drug abusers. Studies by NIDA conclude that skills learned in cognitive behavioral therapy remain with patients after therapy has been completed.5

Family therapy is used to improve the functioning of a family unit, as well as address influences that may be pressed on the patient from family members. This approach involves the family of the recovering person by working with each family member alone and the family together as a unit. Family therapy is essential for the treatment of adolescents, who are typically living at home and dependent on family members. Teens who participate in multidimensional family therapy showed improvements in drug-related problems as well as in their overall behavior and mental health.6

What Else Do They Do? 

A counselor’s job doesn’t end when you or your loved one leaves their office. Drug abuse counselors also help arrange additional mental health treatment and healthcare that may be needed. They may consult with psychiatrists and psychologists if they suspect an underlying mental condition and then refer you to their services for care if needed.2

Some may recommend inpatient care at a substance abuse rehab center if they believe it is best for the patient. Counselors are trained to think beyond the counseling session and always make treatment decisions in the patient’s best interest.

How Does Substance Abuse Counseling Work?

When you first meet your substance abuse counselor, he or she will discuss your addiction with you as well as your past. The counselor will attempt to get to know more abuse your substance use (current and past), as well as factors that may have influenced and perpetuated your drug use. Your counselor will help you come to better understand your addiction and learn healthier coping skills.7 As your treatment progresses, your counselor will learn more about you and will be able to fine-tune your plan for recovery.

A drug abuse counselor will help you identify negative patterns and help you confront behavioral and emotional issues that may be hindering your progress.7 Some sessions will be easier than others, but with each session comes more progress.

American Addiction Centers maintains a strong partnership with a large group of health insurance companies at our addiction treatment facilities. Start the journey to recovery and find out instantly using the form below if your insurance provider may be able to cover all or part of the cost of rehab and associated therapies.

Substance Abuse Counseling Careers

Drug abuse treatment can be provided by a number of practitioner types. Each of these addiction treatment roles naturally requires varying levels of education and training. Roles can range from the non-credentialed recovery coach to social workers and clinical psychologists.2 Common to all of these is the fact that each requires some degree of specialized knowledge and fieldwork/drug abuse counseling expertise. Some career examples include:


  • Substance Abuse Counselor: One can embark upon this route post-high school education in a few states, but many states now require a bachelor’s degree at a minimum (many require a master’s), as well as licensure.8
  • Recovery Coach: The requirements for a recovery coach lie more in personal knowledge of addiction rather than degrees or licensing. Many RCs have struggled with addiction and are in recovery.2
  • RN (Registered Nurse): Requires a minimum of a 2-year associates degree (may require 4-year bachelor’s) + an RN license.9
  • Licensed Clinical Social Worker (LCSW): Requires at least 2 years beyond a bachelor level program + additional coursework in some cases.10
  • Addiction Psychologist (Masters, PhD, PsyD, others): Requires varying lengths of training and field work in addiction treatment. Private practice usually requires doctoral-level degrees (PhD or PsyD).11

NOTE: Rules and qualifications for counselors and psychologists vary widely by state.

How to Find Help for Drug or Alcohol Misuse

If you or a loved one is struggling with substance misuse, help is available and recovery is possible. Professional addiction treatment can start anyone battling a substance use problem on the path to a happier and healthier life. To learn more about rehab programs and treatment options, contact a caring admissions navigator with American Addiction Centers (AAC) for free at . You can also check your insurance coverage online now.

Addiction Treatment Levels of Care

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