The behavioral health care industry has long struggled to attract enough workers to keep up with the demand for services, especially in the substance use disorder (SUD) treatment realm. And the coronavirus has only made things worse, pushing the nation’s SUD crisis to new heights.
To meet the need for professionals, a growing number of colleges and universities are creating specialized academic concentrations and degrees in addiction studies. The programs could potentially bolster the SUD treatment workforce, better equipping the industry to win the critical battle against the SUD epidemic.
In 2017, there were just over 91,000 addiction treatment counselors nationwide, according to projections from the U.S. Health Resources and Services Administration (HRSA). However, in the same year, about 19.7 million Americans battled SUD, according to the National Survey on Drug Use and Health (NSDUH).
And HRSA only expects that supply-demand gap to widen in the years to come, projecting a 15% increase in demand for SUD counselors by 2030 and only a 3% increase in supply.
For an industry searching high and low for workers, the growing prevalence of addiction studies programs could prove to be an invaluable resource.
“We had a shortage [of addiction treatment workers] before COVID,” Cynthia Moreno Tuohy, the executive director of the Association for Addiction Professionals (NAADAC), told Behavioral Health Business. “It’s a tough field, and we’re requiring more and more education, but not giving people the opportunity to get that education.”
Higher education takes on SUD training
Traditionally, addiction treatment professionals have been lumped together with other behavioral health counselors, as they also frequently address patients’ underlying mental health issues.
As such, SUD concentrations and degrees should not be seen as a departure from the general academic branch of psychology. Instead, they are a recognition by higher education institutions that SUD has reached dire proportions, necessitating a more tailored academic focus to better prepare potential SUD professionals to address the problem.
“A lot of general master’s psychology programs don’t have an addictions track,” Maureen Keeshin, chair of the counseling psychology department at the Chicago School of Professional Psychology, told BHB. “They’re not addressing [it], and I think at the deeper level, we are having that opportunity.”
The Chicago School — which has six campuses nationwide, in addition to an online program — originally created an addiction studies concentration for its master’s counseling psychology degree back in 2003.
The program takes two years for full-time students to complete — or four to five years for part-time students. It focuses on assessment, intervention, prevention and treatment of SUDs and other addictions.
The addiction studies concentration has advanced accreditation from the Illinois Alcohol and Other Drug Abuse Professional Certification Association, allowing students — upon completing classes and an internship or practicum — to become eligible for Certified Drug and Alcohol Counselor (CDAC) status once they receive their degree.
Keeshin said the program addresses the Venn diagram-like association between SUD and other co-occurring behavioral health issues head-on.
“We really saw a need in the community and gaps to fill when it comes to people having expertise in both mental health and substance use [issues],” she said. “We know that there’s a lot of overlap between people who struggle with substance use disorders and mental health issues as well.”
Keeshin said graduates of the program can be found working for various employers such as hospitals, community mental health centers, residential treatment facilities and agencies like the Department of Children and Family Services (DCFS).
“Students are getting a full, comprehensive mental health training, and the addiction piece [accompanies it] in terms of focusing on a population that has a particularly high need now,” she said.
Like the Chicago School, Drexel University is making sure students are receiving more specialized addiction treatment training, though its program hasn’t been around as long.
“This program was in direct response to the opioid crisis and increased numbers of people overdosing and going into emergency rooms,” Ebony White, program director for Drexel’s online master’s in addiction counseling degree program, told BHB.
The program dates back to 2018 and is designed to provide students with skills to combat opioid use disorder (OUD), which is prominent in Drexel’s backyard in Philadelphia and across the Delaware River in southern New Jersey.
Drexel’s online addiction counselor master’s degree program is tailored specifically to working professionals in fields such as probation, parole, criminal justice, nursing, physician assistance and public health. It also gives students the training required in most states to sit for the Advanced Alcohol and Drug Counselor (AADC) or Master Addictions Counselor (MAC) certification exams.
While OUD was the primary driver behind Drexel’s program, it also arms students with the skills they need to combat other SUDs, including addiction to crack cocaine, which has long disproportionately affected urban neighborhoods that are home to large numbers of Black and Hispanic residents.
White described Drexel’s approach as one that helps students — and by extension, their present and future employers — to look at SUD issues through an “equity justice lens.”
“We’re not just looking at how the opioid crisis has affected middle and upper America, which is why it’s been seen as a pandemic,” White said, noting that crack cocaine possession has traditionally held more severe criminal penalties compared to other substances. “We’re also looking at how crack cocaine [has been] impacting communities … for years.”
She believes dedicated addiction degree programs like Drexel’s can also help address providers’ needs to be more skilled in the delivery of services.
“Psychology programs are more [based] around assessment, theoretical knowledge and evaluation,” White said. “They may have one or two courses that speak to addiction, but there’s not that intentional, consistent focus on addiction. When you’re getting an addiction counseling degree, [everything], even your internship or practicum … is centered around addiction.”
Drexel and the Chicago School aren’t the only institutions to introduce addiction treatment programs for students in recent years. According to Tuohy, over 400 colleges nationwide had addiction counseling degrees or tracks before the pandemic. However, she hypothesized that number may have decreased since then, as some states have slashed higher education funding in their budgets.
Given the rise of SUD nationwide, Tuohy believes now is the time for schools to scale up their programs, rather than cut them back.
“We’re going to need more programs, not less, if we’re going to raise up the addiction workforce,” she said. “That’s a big challenge.”
Challenges, opportunities for SUD education
NAADAC, which credentials the MAC certification exam, also has an addiction studies accreditation program. It established the program in conjunction with the International Coalition for Addiction Studies Education (INCASE), which sets standards institutions must meet based on over 120 competencies. Addiction studies students can apply college credits toward certification if their institution meets the accreditation standards.
“It is important … to reach out to the colleges to help them understand what the standards are and live by the standards, even if they don’t get accredited to do that,” Tuohy said.
Whether an institution has a rigorous SUD program or not, Tuohy said it’s important for instructors teaching SUD courses to have professional experience working in the field.
“That also is a weakness for some colleges, where they don’t hire people who have worked in the fields that have practical experience,” she said. “I always say research is great, but if it doesn’t mean anything on the street, it doesn’t mean anything [at all].”
Additionally, Tuohy said schools can sometimes miss the boat when it comes to sustaining the programs financially and helping students pursue degrees in the field.
“They don’t know all the resources that are out there,” she said. “Because they don’t know them, they don’t advertise. They need to get more aggressive … understanding … the different scholarships that are out there, and how can they recruit students through information about those scholarships.”
Beyond well-intentioned addiction studies education efforts, Tuohy believes that the onus is on the industry, at large, to ensure that future SUD workers will be compensated well enough to stay there in the long run.
“If you have a bachelor’s degree or a master’s degree, you should be making a salary to raise your family and not be on food stamps,” she said. “That’s a disgrace that we’re not paying attention to that. These are people who are literally saving lives.”