Substance Abuse Counseling - Counselor

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Substance abuse counseling is a specialty area within the counseling field. Substance abuse refers to the misuse of psychoactive substances including alcohol, prescription medication, marijuana, and illicit drugs. Not everyone who uses a substance will develop a substance use disorder. Substance use becomes a problem when the use leads to negative consequences, such as legal issues, relationship problems, or failure to keep up responsibilities. It is often not until a person faces consequences that they reach out for professional help for their substance abuse.

Alcohol Abuse Counseling

If you are concerned about your alcohol use, you can visit your primary care doctor or a substance abuse counselor. There are screening instruments available that can help identify adults with unhealthy alcohol use. Once unhealthy alcohol use is identified, providers do the following:

  • Provide feedback to the person about their unhealthy alcohol use
  • Discuss the person’s readiness to change their unhealthy alcohol use behaviors
  • Develop goals and an action plan
  • Schedule follow-up appointments

There are numerous counseling interventions that are effective at treating alcohol use disorder, including motivational interviewing and cognitive behavioral therapy. There are also several medications approved by the U.S. Food and Drug Administration to treat alcohol use disorder. These medications include disulfiram, naltrexone, acamprosate, and topiramate. Medications help reduce the likelihood the person will return to drinking alcohol.

The recommended treatment for alcohol use disorder is a combination of medication and counseling. Individuals who quit using alcohol could experience withdrawal symptoms, some of which can be extremely dangerous including seizures and even death. If you or a loved one is experiencing withdrawal symptoms from alcohol, seek medical attention immediately. 

Drug Abuse Counseling

While some people quit using drugs on their own, many still benefit from receiving help from counselors. The main drug abuse counseling interventions include cognitive behavioral therapy, motivational interviewing, motivational enhancement therapy, mindfulness-based therapy, and relapse prevention. There are also various medications to help treat opioid use disorder. The goal of drug abuse counseling is to help people change their behaviors, thoughts, and emotions surrounding drug use. Treatment should address each person’s unique needs and symptoms.

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Qualifications of Substance Abuse Counselors

If you or a loved one needs substance abuse counseling, it is important to know the different professional titles of professionals who you may encounter. Currently, there various standards in the United States regarding the training or credentials of substance abuse counselors. There are also different terms used from state to state to describe substance abuse counseling. This can cause confusion for individuals who are looking for substance abuse counseling.

Although the titles can be confusing, it is important to understand the qualifications of the professional from whom you seek substance abuse counseling. The qualifications of a substance abuse counselor determine the limits of their job duties and responsibilities. For example, a Licensed Professional Counselor is able to diagnose substance use disorders, but Certified Substance Abuse Counselors are not allowed to diagnose.

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Qualifications vary depending on level of education, years of experience in the field, certification or licensure, and supervised practice. This differentiates substance abuse counseling from other types of mental health counseling (e.g., 45% of states do not require a college degree to be a substance abuse counselor while 98% of states require a masters degree for mental health counseling). The following are common titles of substance abuse counselors:

  • Certified Substance Abuse Counselor
  • Licensed Substance Abuse Counselor
  • Alcohol and Drug Counselor
  • Certified Addiction Counselor

Certified Substance Abuse Counselor

Certified Substance Abuse Counselors (CSAC) are professionals who provide substance abuse counseling. This certification is granted by certification boards in various states. Each state has different requirements. For example, Virginia requires CSACs to have a minimum of a Bachelor’s degree , 240 hours of substance abuse training, and 160 hours of supervised experience. In contrast, North Carolina requires CSACs to have a minimum of a high school education, 270 hours of substance abuse training, and 6,000 hours of supervised experience. CSACs are not allowed to practice independently.  

Licensed Substance Abuse Counselor

Licensed Substance Abuse Counselors (LSAC) are professionals who are licensed to provide substance abuse counseling. This license is granted by licensing boards in various states. It is also known as Licensed Substance Abuse Treatment Practitioner (LSATP), Licensed Clinical Addictions Specialist (LCAS), and Licensed Clinical Alcohol and Drug Counselor (LCADC).

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The typical requirements to become a LSAC include a minimum of a master’s degree, years of supervised post-graduate substance abuse counseling experience, and a passing score on a written examination. LCASs are able to practice independently and are qualified to supervise other substance abuse counselors.

Alcohol and Drug Counselor

The Alcohol and Drug Counselor (ADC) credential is granted by the International Certification & Reciprocity Consortium (IC&RC). This credential is for entry-level providers of addiction counseling. To receive the certification, a counselor must pass an exam, demonstrating their knowledge and skills in the following areas of addiction counseling:

  • Screening, Assessment, and Engagement
  • Treatment Planning, Collaboration, and Referral
  • Counseling
  • Professional and Ethical Responsibilities

For more information on Alcohol and Drug Counselors, visit

National Certified Addiction Counselor

A National Certified Addiction Counselor is a voluntary national certification for alcohol and drug counselors. This certification is granted by the Association for Addiction Professionals (NAADAC). National Certified Addiction Counselors are distinguished as providers who specialize in the assessment and treatment of alcohol and drug abuse. For more information on NAADAC, visit