Substance abuse treatment is a discipline that should be recognized as professional.

While it’s almost common knowledge that there is a stigma associate with substance abuse and addiction, it had never occurred to me that this stigma could impact the substance abuse treatment field. However, an insightful response to the Substance Abuse & Addiction Perception Survey illuminated my thinking:

“Given the stigma attached to substance abuse, and the partial effect it has on clinician compensation, I believe that there is not enough of an incentive for people to choose a career in substance abuse treatment and recovery. This has led to a very high turnover in the substance abuse field, resulting in reduced number of treatment facilities. This, coupled with the reduction of reimbursements and number of beds has exacerbated the problem.”

Though the response doesn’t provide any evidence to support the relationship between the stigma and treatment provider pay scales, I can see that there is less value given to substance abuse counselors than to other licensed clinicians. For example, here in New Mexico, someone can be licensed as a Licensed Alcohol Drug & Abuse Counselor (LADAC) with an Associate’s Degree. Of course, that person would have to acquire 3,000 contact hours, but those can be done in time. The point is that all other licensed clinicians must have at least a Master’s degree. No one within state government has really been able to provide me with a rationale for this licensing discrepancy.

Perhaps a positive spin would be that the reason for this allowance of licensure at an Associate’s level is that, by allowing community colleges to train LADACs, there could conceivably be more resources to treat substance abuse. I would be ok with that rationale, except for the fact that it still doesn’t address the lack of incentive issue raised within the responder’s statement. Even if there are several LADACs matriculating with Associate’s degree, the pay is low and the work is hard. If reimbursements are also low, then there are just not enough financial resources to pay a wage that’s commensurate with the work performed.

While the problem of low compensation is well presented in the response, there isn’t a hint of a solution. But, I do think there’s at least a partial one: Train already licensed and established clinicians in substance abuse and Addiction treatment. Many clients with mental health concerns also present with at least one substance abuse issue; therefore, clinicians with established practices would be well-served to learn the mechanics of substance abuse addiction, and their treatment modalities.

The other thing to consider is that most who get into the addiction treatment field do so for other reasons than money. As a matter of fact, I have absolutely no delusions that I will ever be paid well for counseling/teaching. But I do it as much as is possible because fighting Addiction is my “good fight” and path and that motivates me more than amount of money could. Still, there are many limiting factors for those who seek to treat Addiction; we should all seek to remove the stigma from the treatment field: Treating Addiction is a discipline onto itself and should be recognized and compensated as such.


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