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Addiction Counseling Degrees

By Ashley Boyce, an allied health world staff writer
Published: February, 27 2010

What kind of degree is needed to work as a substance abuse counselor?

A substance abuse counseling degree can be earned at the associate’s degree level. These can usually be completed in two to three years including the time it takes to satisfy requirements for internship hours. This means 90 total credits, 45 of which are general undergraduate requirements, while the other 45 are specific to the chemical dependency profession. These substance abuse counseling degrees are available through most community colleges and many online schools.

What degree levels can a substance abuse counselor aspire to?

Substance abuse counselor education is not only for those interested in knowing how to become a substance abuse counselor. Many people who have gone on to earn bachelor’s, master’s, or even doctorate level addiction counseling degrees hold the CDP credential and draw from this unique education in their daily work. It is not uncommon for medical doctors to hold this credential as it expands their scope of practice and ability to counsel patients on issues related to drug and alcohol use.

Master’s and doctorate level psychologists often earn the CDP credential. This allows them to become more specialized in their practice and better aware of the process and effects of chemical addiction, which exists as one of the biggest social problems in America today. Juvenile delinquency is almost always associated with some level of substance abuse, making the CDP credential very applicable to the field of child and adolescent psychology.

What are the prerequisites for entering substance abuse counseling degree programs?

This is a very inclusive and accessible profession. With only a high school diploma or equivalent GED, you can enroll in a substance abuse counseling degree program.

How is the Harm Reduction Model taught in substance abuse counseling degree programs?

The ultimate goal of all drug and alcohol treatment is to get individuals to the point where they can fully abstain from the use of any chemical substance. A harm reduction model is often followed when it is recognized that an addiction is so severe and has been so long-term that immediate abstinence- going cold turkey- isn’t a realistic expectation.

Methadone prescriptions are offered as a form of harm reduction, usually with the expectation that the addicted individual will eventually be able to detox from the methadone and live a life free of any chemical agents.

As addiction counseling degree programs will explore a very painful subject. For people who are elderly or extremely advanced in their addiction, sadly there may not be a realistic hope for a full recovery through abstinence. This is known to be one of the more difficult things about substance abuse counselor careers. This is often based on the fact that these people have become so infirm as a result of age or physical neglect due to their lifestyle, perhaps already suffering from a list of severe ailments, that withdrawal would be so physically traumatic that it could literally kill them. Under these extreme circumstances the CDP, whose care the addict is in, may opt for harm reduction through monitored use of a drug or alcohol rather than a traditional treatment regimen. Harm reduction can mean allowing an alcoholic to continue drinking or allowing a drug addict to continue using under circumstances that will reduce the harmful behaviors so often associated with this lifestyle. Harm reduction is also used as a means by which to get elderly or mentally ill drug addicts or alcoholics off the streets where their health and safety is at greater risk, and where they can cause problems for the rest of the community. The city of Seattle has actually developed a program paid for with tax dollars that provides housing and assisted living for elderly, mentally ill, and severely addicted portions of the homeless population in which their alcohol and drug consumption is condoned, but closely monitored. These publicly funded harm reduction programs are created in response to public sentiment regarding these mentally ill and severely addicted homeless people drinking and becoming intoxicated in public where they can become a nuisance.

Substance abuse counseling degree programs introduce students to the controversial harm reduction method of needle exchange. Needle exchange programs have been set up as a method by which to reduce the harm of drug use. This is done in an effort to prevent the sharing of intravenous needles among drug users that is largely responsible for the transmission of blood borne viruses like HIV or Hepatitis C within the community of users. Using clean needles also reduces the occurrence of infection and abscess that are the result of using dirty needles.

What other medical professionals do chemical dependency counselors work with?

Treatment facilities are almost always run by one onsite medical director who holds an MD in addition to a substance abuse counseling degree. Medical directors operate under a Drug Enforcement Agency (DEA) license that allows them to prescribe drugs just like a clinical or hospital MD or pharmacist would. The medical director has the final word on all methadone dosage levels and is ultimately responsible for the prescription and distribution of pharmaceutical controlled substances from the clinic. If a patient is entering the methadone program or seems to need an adjustment in dosage, a dose evaluation is performed by either the onsite medical director or a contracted MD who visits the facility. Some clinics also require their patients to have yearly physicals during which time contracted MDs also visit the facility. Sydney explained, “Doctors oversee the entire program, so they’re the ones that make the decision as to whether a person stays or goes. The medical director’s name is on the prescription, it’s her name on the bottle so she is ultimately responsible.”

How do chemical dependency counselors support law enforcement?

Sydney Love told us, “Typically the first week of the month when everybody gets their disability check, that’s when you see a lot of activity around here. Dealers will drive right up. In the park on third right across from the courthouse you’ll see a group of homeless lined up to buy crack and by the time the police show up the dealer has sold out and everybody has moved on to go get high.” Sydney doesn’t hide her frustration with the police and anger with the dealers who prey on the homeless, mentally ill, and drug addicted who she describes as, “the most vulnerable segment of society”.

“The little coffee house up the street provides a great view of the park. At that time of morning you don’t see kids out there with their parents. The only people out there are seeking, selling, or using.” she offered matter-of-factly. Her morning observation is a way of staying informed of what her clients are up to, and also allows her to learn who the local drug dealers and lookouts are which she says, “is just a good thing to be aware of.” She went on to say, “After working downtown for years, I’m not scared of anybody.”

Mornings spent watching drug activity and taking notes of which of the clinic’s clients are involved, also provides her a glimpse into the lives of these addicts. This has helped her develop a perspective that isn’t entirely removed from the addict’s reality and has contributed to her becoming something much more than just an outsider offering advice. Although this is one of the most important and potentially dangerous parts of her day, her paid workday won’t start for another hour.

What’s involved in “busting” patients who either sell their methadone or are caught doing drugs while in treatment?

There is a responsibility CDPs have to maintaining the integrity of their programs, although they can’t be distracted from their core duties by trying to enforce the law outside of their practice. However, those interested in knowing how to become a substance abuse counselor will still find it interesting to learn that a CDPs’ level of intervention in the use and sale of drugs is typically limited to the people they recognize from their clinics or programs. “If it’s one of my direct clients I see out there, I’ll bust them right then and there. I’ll call them out right there in front of everybody if I see them smoking crack or selling their methadone. They have to be serious about getting clean to stay in the program.” Sydney said.

She went on to explain, “You’d be amazed at how often I get offered drugs in the morning on my way to work. It never ceases to amaze me how our clients try to sell me their methadone doses. If I don’t know who the person is, I’ll ask to see the bottle like I’m interested in buying it and simply take note of their name which is printed right on the label. These people are so altered in their using, and because of this they’re not very sly about it.”

When it is discovered that a client is violating the rules of the program by using drugs, selling their methadone, or failing to conduct themselves in a manner respectful of the residents of the neighborhood in which the clinic is located, they will be subject to suspension or dismissal from the program. If a client is seen using or selling drugs the established protocol is to write up an incident report that will be discussed with the onsite medical director at the weekly staff meeting. Reprimand or dismissal options are considered based on the severity of the offense, the client’s level of mental competency, and the client’s behavioral history. The sale of methadone is the most severe transgression and is grounds for immediate dismissal for a full year without an opportunity to appeal. The use of drugs is less severe and often causes the CDPs to question the effectiveness of their treatment so as to consider a more effective approach. Suspension is most often for 21 days and can be appealed by the client for less severe offenses. Twenty-one days may seem light, but for a heroin addict taking methadone to avoid the pain of withdrawal, this is a serious punishment.