Your Substance Use Disorder (SUD) Treatment Team: What Are Drug and Alcohol Counselors?

drug alcohol counselor with client
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If you receive a diagnosis for a substance use disorder (SUD) or an alcohol use disorder (AUD) and decide to seek treatment, you learn quickly you need to add several new words and phrases to your vocabulary. The same is true if a family member or loved one receives a diagnosis for SUD/AUD and you decide to help them find an appropriate treatment program with qualified drug and alcohol counselors.

We’re barely fifty words into this article and we’ve already use two phrases that may be new to you, aside from those two titles, drug counselor and alcohol counselor. The phrases we mean are probably not brand new since you and/or your loved on are past the diagnosis phase, but nevertheless, you now know treatment professionals are in the process of moving away from the word addiction, and instead use a phrase constructed like this:

[substance] + [use disorder] = clinical diagnosis

Therefore, when someone is diagnosed with what we used to call alcohol abuse or alcohol addiction or alcoholism, what they receive is a diagnosis for alcohol use disorder, and what we say when we refer to them is that they a person with an alcohol use disorder. The same is true for what we used to call drug addiction or drug abuse or substance abuse: we apply the same construction as above. For the disordered use of drugs in general, we say substance use disorder. When a clinician can specify a particular substance, they insert that in the diagnosis. For example:

[opioid] + [use disorder] = opioid use disorder (OUD)

In addition to that baseline adjustment, you’ll find phrases like integrated treatment and co-occurring disorders. To learn more about what those mean, please read these pages, which describe our approach to substance use disorders and mental health disorders:

What We Treat: Substance Use Disorders

What We Treat: Mental Health Disorders

Those are the first things you need to learn. Next, you’ll hear the phrase custom or individualized or tailored treatment plan. You hear that alongside the phrase treatment team. The former phrase describes the course of treatment the treatment center designs to meet your specific needs, while the latter describes the group of professionals who administer the treatment plan.

Your Treatment Team: Professionals Dedicated to Your Recovery

This article is about the people who make up a treatment team. We’ll review the titles/positions most commonly associated with a treatment team for people with SUD and focus on two titles/jobs in particular: drug counselors and alcohol counselors.

We’ll give an overview of all the potential members of an SUD treatment team in a moment. First, we want you to know the title drug and alcohol counselor is synonymous with these titles/positions:

  • Chemical dependency professional
  • Substance abuse counselor
  • Drug abuse counselor
  • Alcohol abuse counselor
  • Addiction counselor

There’s a small catch, though: requirements for those job titles vary from state to state. Someone called a counselor in one state may not have the same qualifications as someone with a similar title in another state. That’s why we’re fortunate to have an organization like the National Association for Addiction Professionals (NAADAC) that offers formalized training and certification beyond that required by individual states.

Before we describe the common members of a treatment team for evidence-based SUD treatment, we’ll briefly describe what drug and alcohol counselors do – and go into more detail below. A drug/alcohol counselor may perform the following tasks:

  • Conduct individual counseling sessions
  • Conduct group counseling sessions
  • Screen and assess incoming clients
  • Conduct treatment orientation
  • Evaluate treatment progress
  • Refer clients to psychiatric of medical care
  • Document treatment delivery and progress

When you or a loved one are in treatment a substance use disorder, your counselors are the clinicians you will mostly likely have the most contact with, on a daily basis. They facilitate group educational meetings, group process meetings, relapse prevention meetings, and either facilitate or introduce you to 12-step meeting or other types of peer support. In most cases, they also function as a liaison between you and other members of your treatment team.

Who’s On a Treatment Team?

The most important member of the treatment team is you.

Remember that: the success of your recovery depends on your commitment to the process and the belief that you can and will achieve lifelong, sustainable recovery.

Most well-regarded treatment centers that offer evidence-based treatment for substance use disorders and co-occurring disorders employ treatment teams with the following members:

  • Physicians/psychiatrists
  • Nurses
  • Psychologists
  • Social Workers
  • Counselors

However, simply earning the qualifications to earn those qualifications is not sufficient to become a specialist in the field of alcohol or substance use disorder treatment. For instance, an emergency room nurse is no automatically certified as an addiction specialist, and a neurosurgeon does not instantly receive certification to give specialized treatment for substance use disorder.

Each title above has to meet addition requirement to be on an SUD treatment team. Here’s a list of what each member of your treatment team has to do to become an addiction specialist.



Osteopathic Physicians



Social Workers


Those are the most common members of a clinical treatment team. You should find individuals with those titles at any fully licensed and compliant treatment center.

Now let’s take a closer look at the requirements for and duties of individuals who earn the title alcohol or drug counselors.

Alcohol and Drug Counselors: Detailed Requirements and Duties

The individuals with the title counselor at your treatment center most likely have one of the three certifications mentioned above: NCAC-I, NCAC-II, or MAC. Here are the requirements for those job titles, along with one we don’t mention above: peer support specialist. We provide them here so that when you participate in treatment, you know the people offering help and support know what they’re doing – because they’re trained by experienced professionals to do it.

NCAC Addiction Professional Certifications

National Certified Addiction Counselor Level I (NCAC I)

  • Requirements:
    • A GED, high school diploma, or higher
    • Up-to-date licensure as a substance use disorder/addiction counselor or professional counselor in the following areas:
      • Social worker
      • Mental health counselor
      • Marriage & family therapist
    • Minimum three years full-time or 6,000 hours of supervised experience as a SUD counselor:
      • Minimum 270 contact hours of education and training in SUD treatment or related counseling subjects
    • A passing score on one of the NCAC Level One exam

National Certified Addiction Counselor Level II (NCAC II)

  • Requirements:
    • A bachelor’s degree or higher in substance use disorders/addiction and/or related counseling subjects:
      • Social work
      • Mental health counseling
      • Marriage & family
      • Psychology
    • Up-to-date state licensure as a substance use disorder/addiction counselor or professional counselor
    • Minimum three years full-time or 6,000 hours of supervised experience as a SUD counselor
    • Minimum 450 contact hours of education and training in SUD treatment
    • A passing score on one of the following:
      • The National Certified Addiction Counselor Level Two Exam
      • eMAC exam through the National Board of Certified Counselors (NBCC)

Master Addiction Counselor (MAC)

  • Requirements:
    • A master’s degree or higher in substance use disorders/addiction and/or related counseling subjects:
      • Social work
      • Mental health counseling
      • Marriage & family
      • Psychology
    • Up-to-date state licensure as a substance use disorder/addiction counselor or professional counselor of the following type:
      • Medical doctor
      • Psychologist
      • Social work
      • Mental health
      • Marriage & family therapist
    • Minimum three years full-time or 6,000 hours of supervised experience as a SUD counselor
    • At least 500 contact hours of education and training in SUD
    • A passing score on one of the following exams:
      • Master Addiction Counselor (MAC) exam
      • eMAC exam through the National Board of Certified Counselors (NBCC).

National Certified Peer Recovery Support Specialist (NCPRSS)

  • Requirements:
    • High School diploma, GED or higher.
    • Minimum two years of personal recovery
    • Minimum 200 hours direct practice in a peer recovery support environment
    • 60 hours of peer-recovery contact and training
    • 48 hours of peer recovery training, which includes:
      • Documentation
      • Community/family education
      • Case management
      • Crisis management
      • Recovery-Oriented Systems of Care (ROSC)
      • Screening and intake

We’ll end this article by describing the typical duties of a drug or alcohol counselor, with slightly more detail than we offered above.

What Do Drug and Alcohol Counselors Do?

As we mention above, when you or a loved one enter treatment, you’ll likely spend the most face-time with the individuals at the treatment center with the title counselor.


Because they perform the following tasks every day:

Conduct Assessments

Most counselors are an integral part of the intake and assessment process, where they collect information that includes:

  • SUD severity and history
  • SUD treatment history
  • Presence of co-occurring mental health disorders
  • Motivations for seeking treatment and treatment goals
  • Personal needs

Create Treatment Plans

Along with you and the other members of your treatment team, counselors participate in developing your individual treatment plan. It’s essential for each plan to meet the specific needs of each patient, including treatment for co-occurring disorders, medication-assisted treatment, or complementary supports and/or lifestyle changes.

Facilitate Counseling Sessions

Counselors work one-on-one, in groups, or with families during the SUD treatment process. Counseling sessions can be on topics specific to the individual in on-on-one sessions, processing sessions in groups, or group sessions on a specific topic, such as communication, the science of addiction, or the role of social support groups in recovery.

Relapse Prevention

Counselors work with you or your loved on to create a realistic relapse prevention plan to put into use after structured treatment ends. With the help of a counselor, you learn how to identify the environmental and personal factors that lead to patterns of thought and emotion – called triggers – that increase your risk of relapse.

Aftercare Plans and Referrals

This is part of the relapse prevention role counselors play, but it’s bigger. An aftercare plan refers to everything you do to stay in recovery after formal treatment ends. That includes seeing your primary care physician and psychiatrist – hence the referrals – participating in 12-step support groups, sticking with your lifestyle changes, and applying all the recovery skills you learn during treatment. Your aftercare plan is your template for independent recovery, and your counselors help you decide not only what recovery might look like in your life, but also how to make long-term, sustainable recovery a reality in your life.


“If you don’t document it, it didn’t happen.”

Counselors write everything down. And if they don’t, they should. Keeping accurate records that reflect what actually happens during counseling sessions, treatment sessions, and individual and group therapy sessions is absolutely essential for monitoring treatment progress and evaluating the effectiveness of treatment plans. Documentation also allows for a seamless transition between levels of care within one treatment center, and facilitates any transition between different treatment centers.

Counselors: There for You

The most important requirement for an individual to succeed as a counselor is empathy. When you enter treatment and start participating in counseling sessions, you typically end up sharing things you never thought you’d share with another person. Sometimes you share these things in group sessions, and sometimes you share them in individual sessions. In either case, you’re not going to share unless you trust the counselor, believe they have your back, and have you best interests in mind. That relationship of trust is the core of your relationship with your counselor, and informs both your treatment progress and outlook. That’s why it’s important for you to research any treatment center you may consider for yourself or a loved one: if they’re open, honest, empathetic, and compassionate, then you may have found exactly the right treatment center for you.