Substance Abuse Counseling | Program Guide

Substance abuse counselors help individuals struggling with drug and alcohol abuse improve their emotional and mental wellbeing. These counselors work with patients and clients in a variety of settings, including hospitals, inpatient substance abuse clinics, and rehabilitation centers. To practice as a substance abuse counselor, you must hold a specialized counseling degree and meet a series of state-mandated licensing requirements.

Substance abuse counselors provide people in need with important services, and many individuals interested in mental health counseling find it a fulfilling and worthwhile career path. This guide provides information on education options and opportunities for prospective substance abuse counselors.

What is Substance Abuse Counseling?

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Inpatient care for substance abuse dates back to the early 1800s, when physicians used isolation therapy to keep patients struggling with addiction away from drugs and alcohol. Over time, treatment methods began to emphasize clinical therapy, addressing the underlying mental health issues associated with and contributing to addiction.

Throughout the 20th century, health professionals began to accept and recognize substance abuse as a legitimate mental health issue requiring specialized treatment. This development led to ongoing policy changes and adaptation. As laws and statutes began requiring insurance companies to cover behavioral health treatments, federal and state governments increased funding for behavioral health services like substance abuse treatment.

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Today, mental health practitioners and medical professionals take a comprehensive approach to substance abuse treatment, using counseling and medication to treat whole patients instead of individual issues. Substance abuse counseling emphasizes holistic treatment, considering the patient’s overall mental and physical health in addition to their substance abuse issues.

Substance abuse counseling uses integrated, therapeutic methods that often include new medications approved to treat issues such as alcoholism and opioid abuse. Recognized as a complex, multifaceted, and chronic illness, addiction calls for a nuanced and varied approach to treatment, with each patient requiring individualized counseling and medication plans.

Differences Between a Substance Abuse Counseling Program and a General Counseling or Therapy Program

Substance abuse counselors must hold at least a master’s degree in the field to obtain state licensure and practice publicly. In many states, substance abuse counselors earn the same license as general mental health counselors. However, there are some key differences between substance abuse counseling degrees and general counseling programs. Often, schools offer a substance abuse and addiction track or specialization within a general counseling program.

The curriculum for a substance abuse counseling degree emphasizes addiction’s impact on the individual’s mental health and relationships with others. Along with courses in general counseling theory and techniques, students explore topics in drug use and behavior, the factors contributing to addiction and substance abuse, and best counseling practices to treat substance abuse.

Master’s-level general counseling and substance abuse counseling degrees provide foundational knowledge in counseling practice and theory. Both degrees also require in-person practicum hours, allowing prospective counselors to work alongside licensed clinicians in the field.

Sample Coursework

There is often a great deal of course overlap between general counseling and substance abuse counseling programs. While the general counseling curriculum acts as a foundation, substance abuse counseling coursework explores specialized topics, examining issues and techniques specifically relevant to substance abuse treatment. Students pursuing a substance abuse counseling degree usually take a variety of general counseling courses, while general counseling students do not typically take classes in substance abuse counseling.

Substance abuse counseling students gain the specialized skills needed to help clients who struggle with addiction. The table below, though not comprehensive, offers some example courses candidates commonly take in each track.

General Counseling or Therapy Program

  • Counseling and psychotherapy theories
  • Techniques in counseling
  • Ethics in counseling
  • Multicultural counseling
  • Evaluation and assessment
  • Research and statistics
  • Group counseling

Substance Abuse Counseling Program

  • Pharmacology and substance abuse
  • Substance abuse treatment
  • Foundations in addiction
  • Addiction counseling theories
  • Psychology of addiction

What Can You Do With a Substance Abuse Counseling Degree?

Substance abuse counselors typically perform duties and responsibilities based on their work environment. For example, a substance abuse counselor working in a hospital might practice differently than one employed in an inpatient addiction treatment facility. Generally, these counselors work directly with patients who are currently dealing with or recently recovering from drug and alcohol addictions.

Substance abuse treatment professionals often implement one-on-one and group therapy alongside medical treatments to address the underlying mental and behavioral health issues that contribute to and exacerbate addiction and substance abuse.

What Does Substance Abuse Counseling Help With?

By addressing the root causes of addiction, substance abuse counseling helps patients identify and implement healthier coping mechanisms. Talk therapy and counseling provide outlets for those struggling with addiction to express their emotions, identify ongoing issues, and gain a better understanding of factors that trigger and enforce negative behaviors.

Where Do Substance Abuse Counselors Work?

Substance abuse counselors work in a variety of settings, including facilities that also employ general counselors and therapists. Below are some typical work environments for substance abuse counselors.

  • Outpatient substance abuse centers
  • General hospitals
  • Child and family services centers
  • Inpatient substance abuse clinics
  • Private practices

How Much Do Substance Abuse Counselors Make?

The figures in the following table represent substance abuse counselors’ average salaries according to experience level. Increased professional experience is typically associated with higher earnings. However, factors such as geographic location and industry may also influence salary potential.

Substance Abuse Counseling Degree Programs

A graduate’s career opportunities and potential level of practice depend largely on the type of substance abuse counseling program they complete. While master’s-level substance abuse counseling programs are common, few schools offer bachelor’s and Ph.D. programs in the field. However, general counseling, psychology, and sociology programs provide a great foundation for further addictions studies, and many include elective course options related to substance abuse counseling.

Online Substance Abuse Counseling Degree Programs

Many individuals seeking a flexible, accessible path to higher education choose to pursue a substance abuse counseling degree online. Often delivered asynchronously, with no on-campus course requirements, online programs allow busy students and working professionals to balance their studies with work and personal obligations. The online format is particularly beneficial for bachelor’s degree-holders, who can pursue a master’s and increase their employment opportunities while remaining employed.

Some distance education programs provide academic credit for life, military, and work experience. Many institutions feature generous transfer policies, which allow candidates with qualifying transfer credits to reduce their tuition costs and graduate early.

Factors to Consider When Selecting a Substance Abuse Counseling Program

Before you select a substance abuse counseling program, be sure to thoroughly research all of the available options. Factors like school accreditation, tuition rates, and online learning format can all play a part in your academic and professional success. Read on to explore some key variables in detail.


Accreditation is a voluntary quality control process used to verify a school’s academic rigor and quality. Colleges and universities receive either national or regional accreditation from independent regulatory accreditation agencies. These agencies must be recognized by the U.S. Department of Education or the Council for Higher Education Accreditation. Most states require counselors to hold a degree from an accredited school before seeking licensure.

Additionally, individual academic programs can earn programmatic accreditation through field-based agencies. Substance abuse counseling master’s programs frequently receive programmatic accreditation from the Council for Accreditation of Counseling and Related Educational Programs. Doctoral programs in counseling and related areas may hold accreditation from the American Psychological Association Commission on Accreditation.


For many students, program costs play a large part in the decision-making process. A variety of factors can influence program cost, including in-state versus out-of-state tuition, private versus public schools, and on-campus learning versus online courses. Each of these variables can impact tuition and fees, and it is important to keep each one in mind as you explore your options.

On-Campus vs. Online

Online substance abuse counseling programs often require distance learners to complete an in-person practicum or internship at a local facility. Some use a blended approach, combining online coursework with on-campus sessions. Be sure to consider your own learning style and your current work and life obligations before selecting a program.

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