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How to Become a Substance Use Social Worker

June 22, 2021

Substance use problems in the U.S. have grown significantly in the last two decades as the nation has struggled with the opioid crisis. As a result, the need for professionals trained to address substance use disorders has also increased.

A review of the scope of the drug and alcohol problem in the U.S. illustrates the critical role of social workers who treat addiction:

  • In 2018, 20.3 million people in the U.S. age 12 or older had a substance use disorder, according to the National Center for Drug Abuse Statistics. Nearly 15 million had an alcohol use disorder, and 2 million had an opioid use disorder (including prescription pain reliever and/or heroin misuse).
  • Accidental drug overdose was the leading cause of death among persons under the age of 45.
  • In 2018, 67,367 drug overdose deaths occurred in the U.S., and more than 700,000 have died since 2000.

Conditions related to the COVID-19 pandemic have only exacerbated substance use problems. In the state of Virginia, for example, overdose deaths from fentanyl, heroin, cocaine, prescription opioids, and other drugs rose 39% during the first half of 2020 compared to the same period in 2019, according to the Virginia Department of Health. Experts have attributed the uptick to pandemic-related factors including social isolation and job losses.

Many clinical social workers encounter clients who use substances and provide counseling and support, but substance use social workers specialize in the prevention of substance misuse and in helping individuals and families recover from addiction.

What Do Substance Use Social Workers Do?

Social workers specializing in substance use and addiction perform case management, family counseling, community outreach and education, and individual and group therapy. They also advocate for policies that support the effective and compassionate treatment of people who suffer from substance use disorders.

The broad training in the factors that affect community health makes them uniquely qualified to address the needs of people with substance use problems. Understanding the ways that culture, community environments and support systems, public policy, and family dynamics affect an individual’s physical and emotional well-being informs their assessments.

They also bring an understanding of the connection between substance use and mental illness. Surveys have shown that approximately half of individuals who experience a substance use disorder in their lifetime also experience a mental illness, according to the National Institute on Drug Abuse.

A more detailed look at the types of duties substance use social workers perform illustrates the diversity of their responsibilities and expertise.

Identification and Assessment

Client assessments, which include evaluations of potential substance misuse issues, are a core competency of social workers. Many clients will not self-report issues, so social workers must be adept at spotting problems. Typical methods for assessing substance use disorders include direct observation and structured interviews. Social workers are also responsible for developing treatment plans and helping other professionals place clients in treatment programs.


Treatment responsibilities of substance use social workers include providing therapy, assisting with interventions, acting as care managers and conducting ongoing assessments that evaluate the effectiveness of treatment programs. They may provide counseling for individuals or groups.

Education and Outreach

Substance use social workers who focus on community education and outreach perform duties such as giving presentations at schools and community centers. Many also work with homeless populations, helping individuals with substance misuse issues, as well as basic needs, such as food and shelter.


Social workers have a responsibility to stay current on intervention research and the development and application of evidence-based practices. Some also participate in addiction treatment and intervention studies, which are most commonly conducted by universities and government agencies.

Substance Use Social Work Training and Career Paths

Social workers take different paths to becoming substance use and addiction specialists. Some progress through undergraduate and graduate programs with the intention of entering the field, while others have life experiences that inspire them to return to school to study the theories behind those experiences.

At a minimum, addiction counselors need a bachelor’s degree and certification in counseling. Undergraduate social work programs typically do not offer a concentration in working with substance use interventions, so aspiring substance use and addiction counselors often pursue a master’s degree to develop skills and knowledge specific to the role.

Graduate social work programs include coursework on substance use, but some students choose to do additional studies, pursuing certification in addiction counseling. Social workers who want to provide clinical care to people with substance use disorders can become licensed clinical social workers (LCSW), which requires a master’s degree in social work and at least two years of supervised clinical experience.

Substance use social workers are employed in a wide variety of settings:

  • Community centers
  • Drug treatment facilities
  • Government agencies
  • Homeless shelters
  • Hospitals
  • Mental health clinics
  • Outpatient care centers
  • Private practices

Effective substance use social workers blend classroom knowledge with skills and experience that they have built and applied in the field. Their academic training gives them a foundation in evidence-based practice, and they develop their personal approach to working with clients during fieldwork.

Job Outlook and Salary

The job outlook for addiction counselors and social workers in the U.S. is promising. The Bureau of Labor Statistics projects employment for substance use, behavioral disorder and mental health counselors will grow 25% between 2019 and 2029. More specifically, it projects the employment of substance use social workers to grow 17% over the same period.

Factors driving this demand include the high number of people seeking drug treatment, as well as reforms in drug policy that have resulted in more drug offenders being sent to treatment programs rather than to jail. The median annual salary for mental health and substance use social workers in the U.S. is $46,650, although salaries vary greatly depending on experience, employer type and geographic location.

What It Takes to Become a Substance Use Social Worker

Substance use social work can be emotionally taxing. Social workers see the most heartbreaking aspects of substance misuse and addiction, such as relapses and overdose deaths, and they help clients work through grief and loss during the recovery process. The work requires flexibility and the understanding that the recovery process often includes setbacks.

Social workers in the field describe the work as fast-paced and diverse. Substance use and addiction specialists interact with all cross sections of life and help clients with a wide variety of needs. While challenging, the work can also be deeply rewarding. Substance use social workers help clients achieve remarkable improvements in their health and transformative life changes, such as reinstatement of child custody.

Addressing the Addiction Crisis

The ongoing opioid crisis has coincided with growth in counseling and treatment options for substance misuse and addiction. Social work education programs are working diligently to increase curriculum options that raise awareness of and provide training for substance use prevention and treatment.

Current and prospective social workers who are interested in treating substance use disorders can start by earning a master’s degree in social work. The VCU School of Social Work’s Online Master of Social Work program provides both general and specialized training, preparing students to provide advanced services and serve in leadership positions. With an emphasis on clinical social work practice, the program features two field placements, including one in the student’s clinical area of specialization.

For students who share the school’s commitment to social justice, human rights, diversity, cultural competence and ethical practice, the VCU Online M.S.W. degree program provides an ideal opportunity to help individuals, families and communities recover from substance misuse and addiction and live healthier lives.