Changing Addicts’ Lives: Working in Substance Addiction Recovery

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Even before the arrival of the COVID-19 pandemic into our lives, and this “new normal” we’ve really yet to see, we were living in an age of rapid change. The “opioid epidemic” was rapidly becoming the “fentanyl epidemic,” with the nation experiencing rising substance use, an increase in drug overdoses, both fatal and suspected – these were rising even before the massive rise seen with the pandemic – increased mental health issues, a known precursor to drug or alcohol abuse, and more and more U.S. citizens in need of addiction treatment services than ever before.

Yet with all this happening in the field of substance addiction and its treatment, the recovery industry, like the rest of U.S. healthcare, has only really seen one single significant change in its overall approach – the growth and spread of telehealth services.

For these very reasons (and as bad as this sounds), the substance addiction treatment industry has never had such a promising and rosy outlook, but only in terms of the demand for qualified professionals and others to work in the real business of changing addicts’ lives.

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A Rosy Outlook: Expected Growth in the Addiction Recovery Industry

It’s not often you see the phrases “rosy outlook” and “substance addiction” used in the same sentence, but the industry’s outlook has never been so promising and full of anticipated growth when viewed from a strictly business angle. 

For example, according to the Bureau of Labor Statistics, the demand for counselors qualified in substance abuse and behavioral disorders is now estimated to increase by, at least, an already impressive 22% through to the year 2028. Additionally, the need for social workers, integral to the post-treatment progression of recovering addicts, is estimated to increase by a notable 11% within the same period.

Considering the seriously detrimental impact the pandemic has had on the U.S. jobs market during 2020, any industry boasting such impressive estimated growth is obviously good for the economy – and obviously bad for the mental and physical health of those affected by substance abuse – the users, and, just as importantly, their families and loved ones.

With regard to the immense rise of telehealth in just a year as a prominent method of healthcare delivery, it is clear this particular provision is already “the next big thing” in drug and alcohol treatment and recovery support. This will, in turn, open up a plethora of various online positions within the telehealth area of treatment and recovery services.

However, a word of warning who may believe this could be an easy industry to access: Virtually every senior, clinical or counselor position in the field of substance addiction treatment and recovery requires a Master’s degree in a relevant field.

That said, the rise of online recovery support apps has led to another new branch of addiction support – recovery coaches. Recovery coaches, at present, are not restricted by educational requirements, such as a Master’s or Bachelor’s degree.

What Do The Letters After an Addiction Professional’s Name Stand For?

Often, people will search online to see the kind of positions available in a particular sector, and the caliber of people who already occupy those roles. In any healthcare sector, many of those who actually do the “occupying” have letters after their name, which can stand for various academic degrees and professional certifications. Here are the most common:

  • Ph.D. (Doctor of Philosophy): Psychologists who have completed 5-7 years of education and training, including both psychological research and clinical rotations
  • PsyD (Doctor in Psychology): Psychologists who have completed 5-7 years of education and training; however, PsyD programs require fewer statistics and research requirements as Ph.D. programs
  • LCSW (Licensed Clinical Social Worker): Social workers who have completed a 2-year program in clinical social work, and have passed a state licensing exam to provide therapy
  • LMHC (Licensed Mental Health Counselors): Counselors who have completed a 2-year program, and have passed a state licensing exam to provide therapy

Prescription Medicines: Although both Ph.D. and PsyD-qualified psychologists are licensed professionals equally qualified to provide therapy, neither can prescribe medication. Only medical professionals with MD (Doctor of Medicine), eg. psychiatrists, or DO (Doctor of Osteopathic Medicine), can legally prescribe medication.

Professional Careers in Substance Addiction Recovery

The field of substance addiction recovery is an exceptionally worthwhile, yet personally challenging area to seek a career within. There are a wide variety of career paths and choices available in the sector, so an initial step would be to determine how you would best fit in an industry targeted at helping addicts and alcoholics overcome their substance addiction, and any other underlying disorder they may have.

You will first need to fully evaluate your current skill set (and to see where any gaps might exist in qualifications and previous experience) before making any choice. The various professional careers available to someone interested and motivated to work within the sector include:

1. The Counselor

Easily one of the most rewarding (and definitely the most common) professional positions in the field of substance addiction recovery is the addiction counselor (also known as substance abuse counselor, drug and alcohol counselor, and clinical therapist). Substance addiction counselors are mental health professionals who work with children, adolescents, and adults suffering from substance use disorders and other behavioral issues.

Addiction counselors are required to provide one-to-one counseling, resources and knowledge to people struggling with substance use disorders (SUDs). They help clients to adopt healthier behaviors that replace the misuse of drugs or alcohol and teach their clients effective coping mechanisms to deal with substance cravings and help them.

Addiction counselors are qualified to conduct various therapies, including:

  • Group & Individual Therapy
  • Cognitive-Behavioral Therapy (CBT)
  • Dialectical Behavior Therapy (DBT), and
  • Other services:
    • Relapse prevention strategies
    • Behavioral and medical interventions
    • Education

Specifically, and in addition to actual counseling and the above therapies, addiction counselors need to perform activities such as interviewing and assessing clients, maintaining client records, writing professional-client reports and evaluations, and collaborating with other professionals, eg. drug and alcohol rehabs, support services, etc. to assist in client treatment.

The majority of these positions require a Master’s degree, although a Bachelor’s degree may be sufficient as a bare minimum. As of May 2020, the average annual salary for a substance addiction counselor was $47,660, although those who work exclusively in private practice often earn much more.

2. The Psychiatrist

Mental health plays an exceptionally important part in an individual’s substance use and abuse; therefore, psychiatrists provide an important role in diagnosing mental health disorders and behavioral issues, often at the root of substance use disorders (SUDs).

These medical doctors require both a relevant medical degree (an MD or DO) and state licensing and are able to prescribe medications for treatment. Although it is entirely voluntary, most psychiatrists take an examination through the American Board of Psychiatry and Neurology (ABPN) to become a board-certified psychiatrist – this certification requires renewal every 10 years.

Often, psychiatrists will focus on a specific area of psychiatry, such as child psychiatry or addiction psychiatry. Psychiatrists shouldn’t be confused with psychologists, who study how the mind works and how brain functions influence behavior. 

According to the Bureau of Labor Statistics, the estimated average annual salary for psychiatrists in the United States is $220,380; however, the average for a psychiatrist who specializes in addiction is around $195,087 ($70,523 – $276,845).

Psychiatrists often use psychotherapy (or “talk therapy”) to help clients learn healthy coping strategies and develop positive ways of thinking. Additionally, many psychiatrists often become skilled in psychotherapy techniques, such as CBT, DBT, mindfulness-based techniques, and other modalities.

3. The Psychologist

Psychologists assess, diagnose, and treat people who have mental health disorders, and, like psychiatrists, they normally require a doctorate degree and state licensing. If a psychologist only holds a Ph.D. or a PsyD, they are not considered medical doctors, and so are unable to prescribe medications.

Psychologists work with clients to understand their behaviors, and are skilled in both conducting psychological evaluations, like personality tests, and assisting people to manage their mental health / behavioral issues through psychotherapy.

Educationally, psychologists will be trained in a number of specific areas, such as human behavior, development and personality, psychotherapy, and ethics. According to the Bureau of Labor Statistics, the average annual salary of psychologists is around $85,340, although this varies with specialty, location, and experience.

In terms of treatment provision, psychologists provide standard psychotherapy, as well as specific therapies such as CBT, DBT, psychodynamic therapy, and others. Like counselors, they can provide one-to-one counseling and group support sessions.

4. The Teletherapist (via Telehealth)

Following the rapid increase in telehealth (the online healthcare provision), more and more drug and alcohol rehabs and treatment centers are looking at expanding such services significantly. As many rural communities throughout the U.S. face a lack of recovery resources, teletherapy is helpful for those who are unable to find the help they need.

Teletherapists within the field of addiction can provide online counseling and resources to clients with substance abuse issues. Although this sector is fairly new and expanding rapidly, there are various roles available, such as psychologist, counseling, and recovery coaching. Depending on the role, educational requirements will apply, such as degree qualification, as well as the standard state licensing.

5. Substance Abuse Professionals with No Degree Requirement

Unlike the positions listed above, there are other avenues into the area of substance abuse that currently do not require a degree, eg. drug and alcohol outreach workers and recovery coaches.

The Recovery Coach

A relatively recent addition to substance addiction recovery care, recovery coaches can be a vital element of an addict’s post-treatment recovery, in terms of offering professional support, guidance, and resources. The responsibilities of a recovery coach can include:

  • Forming a plan of action with the recovering addict
  • Providing the client with accountability and support
  • Directing the client to the appropriate resources in their area
  • Helping the client to navigate the medical system
  • Helping the client to view their progress objectively
  • Assisting the client in harm reduction strategies for addictive behaviors

Initially, a recovery coach will need a high school diploma or GED certificate, as well as work or volunteer experience in the recovery support field. Furthermore, professional training courses and certifications are available to develop coaching skills, and many professional addiction training organizations, eg. NAADAC (Association for Addiction Professionals), offer formal certification in recovery coaching. In fact, many states recognize Certified Recovery Coach credentials from other states.

The Drug & Alcohol Outreach Worker

Drug and alcohol outreach workers (also known as substance misuse workers) help people to tackle and recover from their dependence on drugs and alcohol, involving helping clients to access services such as counseling, healthcare, and education.

This role can vary widely and could include visiting substance users and helping with immediate needs, eg. temporary accommodation, drop-in center work, counseling and rehabilitation, advocacy, and youth work. However, the main purpose of an outreach worker is to provide ongoing support for clients while they deal with their substance abuse issues.

Interestingly, many of these types of positions are posted on job sites with an additional requirement – applicants need to have been clean/sober for a certain length of time. This is because positions such as these are popular with recovering addicts who wish to give back to their communities.

The Administrator & Other Roles

  • The Administrator: Administrators can work within rehab center operations, eg. admissions, human resources, customer service, marketing, finance, and more.
  • The Dietician: Dieticians help create nutrition plans for rehab center clients, primarily to treat vitamin deficiencies and other conditions caused by substance abuse.
  • The Vocational Counselor: Vocational counselors provide employment advice and guidance, financial assistance, life coaching, job placement, and other roles that help recovering addicts lead more fulfilling lives after their addiction treatment has ended.

Sources:

  1. U.S. Bureau of Labor Statistics: Substance Abuse, Behavioral Disorder, and Mental Health Counselors (April 2021)
  2. Substance Abuse & Mental health Services Administration (SAMHSA): State Certification Guide (July 2015)
  3. American Board of Psychiatry & Neurology: Becoming Certified (September 2020)
  4. NAADAC (Association for Addiction Professionals): National Certified Peer Recovery Support Specialist (NCPRSS)

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WRITTEN BY GERARD BULLEN
APRIL 23, 2021

Gerard has been writing exclusively for the U.S. substance addiction treatment industry for many years, providing a range of medically-reviewed work, including white papers, long-form, and short-form content articles, and blog posts for accredited addiction treatment centers. A member of the American Medical Writers Association, Gerard’s specific focus is substance addiction (an area that has impacted Gerard’s personal life in several ways), and he is particularly drawn to the topics of professional, evidence-based treatment, new and alternative therapies, and enabling readers to find their own sustainable, long-term recovery. Gerard lives and works in Maryland, U.S., he’s happily married, and a proud father. His interests include hiking with the family, reading fiction (from the classics to virtually all of the current NYT bestseller list), American and British film classics, and his beloved dogs, Toby and Coco, both rescued from the local pound.

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