Addiction Specialist Degrees, Certifications, and Qualifications
There are different specialists involved in helping individuals along their road to recovery from drug or alcohol addiction.
Addiction medicine refers to the physicians who have narrowed their focus, knowledge, and skills to specialize in the recognition and treatment of addiction and substance-related disorders.1
The physician, however, is only one part of a very comprehensive care team when it comes to the treatment of individuals with substance use disorders. They work collaboratively with psychologists, nurses and nurse practitioners, addiction counselors, clinical social workers, pharmacists, occupational therapists, and pastoral counselors, among others, to give individuals the most complete care possible.2
While the requirements vary by position, each includes specialized addiction training, certifications, and credentials to work in the complete care and treatment of individuals with addiction and other substance-related disorders.
Addiction medicine physicians provide prevention, screening, intervention, treatment, and recovery for addiction and substance-related disorders.1 Additionally, they can recognize and treat individuals who have co-occurring mental health disorders.1
The addiction medicine physician provides care by helping the individual with the substance use disorder, the individual who exhibits unhealthy substance use, and the family members and loved ones whose functioning and health are impacted by another’s substance misuse.3
Training, Certifications, and Requirements
Physicians (MDs or DOs) with the addiction medicine subspecialty must obtain the following:4
- A medical degree from an accredited institution (at the time of their graduation) in the United States. These include a school accredited by the Liaison Committee on Medical Education, a school of osteopathic medicine approved by the American Osteopathic Association, an accredited medical school in Canada, or from a medical school located outside the United States and Canada that the board OKs.
- Residency completion in a primary medical specialty such as family medicine, internal medicine, obstetrics and gynecology, surgery, or emergency medicine.
- Board certification from the American Board of Medical Specialists.
- A medical license to practice medicine in a state or territory.
Obviously, these physicians have additional training and experience in the field of addiction medicine, but last year, the process for them to obtain addiction medicine board certification changed. Through the American Board of Preventative Medicine (ABPM), up until the year 2025, physicians who complete a minimum number of hours in practice or participate in a non-Accreditation Council for Graduate Medical Education (ACGME)-accredited fellowship training will be considered for the addiction subspecialty exam.5 After 2025, physicians will have to complete an ACGME-accredited addiction medicine fellowship to be eligible to apply to take the exam.5
A physician can also receive subspecialty certification to be an addiction medicine specialist through the American Osteopathic Association (AOA). The requirements are similar. Individuals complete an ACGME or AOA fellowship and take an exam.6
There are two designations in the field of addiction medicine. There is the Fellow Designation of American Society of Addiction Medicine (FASAM) and the Distinguished Fellow of American Society of Addiction Medicine (DFASAM).7
The FASAM designation, which physicians can add after their names, means two years of consecutive society membership and current certification in addiction medicine from one of the recognized boards.7
Those individuals who have been singled out as a DFASAM have made significant contributions to the field of addiction medicine and demonstrate leadership and service, among other attributes.7
Addiction Nurses and Nurse Practitioners
Trained in general medicine and mental health, a substance abuse nurse specializes in the treatment of patients with substance use disorders. A substance abuse nurse provides direct patient care to those struggling with addiction and substance-related disorders. Their duties may include:8,9
- Work with doctors to create and integrate treatment plans.
- Assess and monitor the patient’s treatment.
- Conduct mental health screenings.
- Connect patients—and their family members—with mutual help groups and provide them with emotional support.
- Administer addiction medications and pain management services.
- Educate patients and their family members about the dangers of substance use and offer resources and information about treatment options.
- Help patients secure outpatient services.
Training, Certifications, and Requirements
To become a nurse who works in addiction treatment, an individual first needs to earn either an associate’s degree or bachelor of science degree in nursing.8 This is then followed by the required NCLEX-RN exam to obtain a registered nurse (RN) license.8
Although the RN license is the minimum requirement for practicing as an addiction nurse, some employers may require additional certifications, including a Certified Addictions Registered Nurse (CARN) or Advanced Practice Certified Addictions Registered Nurse (CARN-AP).8,10
Both the CARN and CARN-AP certifications require the individual to hold a current RN license, but there are differences.10
Requirements for CARN include:10
- Completing a minimum 2,000 hours of nursing practice in addiction within the last 3 years.
- Having 30 hours of continuing education credits.
Requirements for CARN-AP include:10
- Holding a master’s degree or higher in nursing.
- Having 45 hours of continuing education.
- Getting 500 (minimum) supervised hours in addictions and 1,500 hours of nursing experience with substance use disorders as an Advanced Practice Nurse (APN) within the last 3 years of practice as a substance abuse nurse.
With both certification levels, nurses may work in a variety of roles, including (but not limited to):11
- Staff member.
- Private practice.
Addiction counselors, substance abuse counselors, and alcohol and drug counselors might go by different titles, but generally, job responsibilities depend on education level and experience. Duties may include:12
- Screening patients.
- Helping with intake procedures.
- Assessing and evaluating patients.
- Referring patients for treatment or other services.
- Collaborating on a treatment plan.
- Counseling individuals and/or groups.
- Providing crisis intervention.
- Educating patients and their families.
- Functioning as a case manager.
Training, Certifications, and Requirements
The term counselor is an umbrella term used to describe many different substance abuse professionals, which may or may not require advanced education. Specific requirements differ by state, but the National Certification Commission for Addiction Professionals (NCC AP) offers three voluntary credentials: National Certified Addiction Counselor, Level I (NCAC I), National Certified Addiction Counselor, Level II (NCAC II), and Master Addiction Counselor (MAC).13 Each credential has different requirements.
The requirements for NCAC I include:14
- A GED, high school diploma, or higher
- A current state-issued credential or license as an addiction counselor or professional counselor.
- A minimum of 3 years or 6,000 hours supervised experience as a substance abuse counselor.
- A minimum of 270 hours of education and training specifically in addiction or related counseling subject matter.
- A passing score on the NCAC I exam.
The requirements for NCAC II are identical to NCAC I with a few exceptions, which include:15
- A bachelor’s degree or higher in substance abuse, addiction, or related counseling field such as marriage and family therapy or mental health.
- A minimum of 450 hours of education and training in addiction and substance use.
- A passing score on the NCAC II exam.
The requirements for MAC are identical to NCAC I and II with a few exceptions, including:16
- A master’s degree or higher in substance use disorders or related counseling subject matter.
- A minimum of 500 hours of education and training in substance use disorders.
- A passing score on the MAC exam.
The International Certification & Reciprocity Consortium (IC&RC) provides a framework for local boards to offer credentials, which are administered by county, state, region, or military boards so requirements vary.17
These credentials include:17
- Alcohol and Drug Counselor (ADC). This is the most widely recognized, entry-level credential.
- Advanced Alcohol and Drug Counselor (AADC). This advanced certification is for professionals who offer addiction services in an array of settings and hold a master’s degree or higher in a behavioral health field.
- Clinical Supervisor (CS). A certification intended for experienced professionals who want to coach, teach, mentor, and evaluate other addiction professionals.
- Prevention Specialist (PS). Prevention specialists make sure programs live up to their commitment to encourage well-being and public safety.
- Peer Recovery (PR). Peer recovery allows individuals with a history of mental illness and/or addiction to provide quality recovery support services to others.
The Certified Addiction Specialist (CAS) certification is provided by the American Academy of Health Care Providers in the Addictive Disorders. Currently, certified members exist in 48 states in the United States and in 7 countries. While this clinical certification consists of more than addiction counselors (medical doctors, psychologists, social workers, nurses, and psychiatrists can also receive the CAS certification), it demonstrates that the individual possesses experience providing treatment under the guidance of a qualified clinical supervisor and has specialized training in the field.18
Beyond this, addiction counselor designations and licenses differ by state. Licensure examples include Licensed Addiction Counselor Candidate (LACC), Licensed Professional Counselor (LPC), and Licensed Clinical Alcohol & Drug Abuse Counselor (LCADAC).19
Other Addiction Professionals and Certifications
Besides the doctors, nurses, and counselors, there are others who contribute to and provide care and treatment to those with substance use disorder and co-occurring mental health conditions.
Some of these professions include:19
- Clinical Social Worker. Clinical social workers evaluate an individual’s mental health and utilize therapeutic techniques to help them.
- Psychiatric or Mental Health Nurse Practitioner. Psychiatric or mental health nurse practitioners can provide an assessment, diagnosis, and therapy for substance use disorders or mental health conditions.
- Psychiatric Pharmacist. Advanced-practice pharmacists, these individuals specialize in mental health care, can recommend medications, or prescribe them (if they’re able to in the state in which they practice).
- Family Nurse Practitioner (FNP). FNPs provide general medical services such as that of a primary care doctor.
- Pastoral Counselor. Clergy members trained to counsel and diagnose, pastoral counselors receive the equivalent of a doctorate in counseling with training in clinical pastoral education.