Substance Abuse Social Work Pays Well—But Please Don't Do It for the Money.

Nearly 50 years ago, President Richard Nixon coined the phrase "war on drugs." The nation has been fighting the battle ever since, and victory is nowhere in sight.

The most recent scourge is the opioid crisis. According to the Department of Health and Human Services (HHS), in 2017 11.4 million Americans misused opioid prescriptions, over 130 people a day died from opioid use, 887,000 Americans were heroin users, and over 2 million Americans had an opioid use disorder. Over $47 billion is spent annually in the United States to battle substance abuse, according to the Drug Policy Alliance. With the problem worsening, HHS has declared a public health emergency.

The war on drugs has always faced impossible hurdles. An intractable disease to treat, substance abuse often controls those in the cycle of substance abuse. That's because substance abuse disorders are brain-centered diseases that have physiological, neurobiological, and environmental components; as the National Institute of Health (NIH) explains, drug and alcohol abuse "hijacks your brain." Once a person develops a substance abuse disorder, both the neurobiological and emotional cravings of the disease make it difficult to break away.

There is much debate about how to treat substance abuse. Treatment facilities often employ multi-disciplinary teams of mental health professionals, including counselors who are former "users," now "clean." Rehabilitated counselors are valued because they can offer powerfully motivating insights into their own recovery.

But treatment centers must also have trained, licensed mental health professionals who can apply evidence-based treatments and provide substance abuse counseling. When it comes to treating those dealing with substance abuse, licensed social workers play a pivotal role.

If you're considering a career in social work, you may want to become a substance abuse social worker. Because treating those with substance abuse problems is specialized and expertise-dependent, salaries for social workers in this sector can be higher compared to other social work practice areas. Earnings depend on setting and employer.

How much do substance abuse social workers earn?

How much can you earn as a substance abuse social worker? According to Glassdoor, the average annual salary for a mental health and substance abuse social worker is $53,950. Salary.com lists a salary range of $46,110 to $58,630, while Payscale reports an average salary of $46,540.

The Bureau of Labor Statistics reports that the highest-paying industries for substance abuse social workers (along with the percent of all substance abuse social workers employed in the industry) are:

• Insurance carriers: $65,830 (0.2 percent of all substance abuse social workers)
• Colleges, universities, and professional schools: $59,670 (0.6 percent)
• Specialty hospitals: $59,500 (0.2 percent)
• General medical and surgical hospitals: $58,390 (5 percent)
• Mental health service providers: $56,990 (6 percent)

The top five states for substance abuse social worker salaries are:

• New Jersey: $79,130
• District of Columbia: $69,690
• Hawaii: $67,930
• Connecticut: $63,290
• New York: $62,130

The top metropolitan areas for substance abuse social worker salaries are:

• Trenton, NJ: $84,990
• Vallejo-Fairfield, CA: $81,350
• Napa, CA: $79,310
• San Luis Obispo, CA: $76,030
• Ventura, CA: $73,720

Who should become a substance abuse social worker?

Substance abusers are difficult clients, and not all social workers have the patience and endurance to work with them. They have personality traits that can make their treatment exceptionally challenging. Because they attempt to hide their habit, are in denial about their problems, and deal with strong cravings, they are often dishonest and manipulative. To both loved ones and therapists, those who suffer from substance abuse disorders offer a steady stream of rationales for why they don't have a problem.

As part of their deception, substance abusers may appear accepting of help, presenting a facade of recovery even as they continue to use. Further, they may be involved in criminal activity. Social workers who choose to work with this population should understand that deception and resistance to treatment are characteristic of the disease.

But there are compelling reasons to enter this field. For one, there is the opioid epidemic in the United States, which shows no sign of abating; there's no lack of patients requiring treatment in this field. Second, substance abuse treatment often involves cognitive behavioral therapy, presenting a great opportunity for social workers interested in a strong clinical experience. Finally, many social workers enjoy the challenge of trying to help this troubled population. Treatment is difficult and relapse common, but even one success can be highly rewarding.

Where are substance abuse social workers employed?

According to the Bureau of Labor Statistics, just over 20 percent of substance abuse social workers practice in outpatient care centers (average salary: $47,430). Another 15 percent work in individual and family services practices (average salary: $47,250), roughly the same proportion who work for local government agencies (the number of government employees rises if you include those working in schools and hospitals; average salary: $54,590). About 10 percent find occupations in residential facilities (average salary: $39,510), about the same proportion that work in psychiatric and substance abuse hospitals (average salary: $53,360).

The highest-paying employers in the field, unfortunately, hire relatively few substance abuse social workers: insurance carriers (average salary: $65,830), colleges and universities (average salary: $459,670), and specialty hospitals (average salary: $59,500) together employ just over 1 percent of substance abuse social workers. Other relatively high-paying employers include general medical and surgical hospitals (5 percent; average salary: $58,390) and mental health practitioners (6 percent; average salary: $56,990).

What degree will you need to practice substance abuse social work?

The process of becoming a social worker starts with earning a bachelor's degree in social work (BSW) or master's degree in social work (MSW) from an institution accredited by the Council for Social Work Education (CSWE). A master's in social work will provide the training to facilitate greater career opportunities that can be both more professionally fulfilling and higher paying. According to the CSWE website, MSWs earn salaries about $13,000 higher than those earned by BSWs.

Most substance abuse social worker positions require the MSW and additionally require licensure as a Licensed Clinical Social Worker (LCSW) or Licensed Master Social Worker (LMSW). While some states allow for BSW licensure, the majority require an MSW from a _CSWE-accredited school_ in order to be eligible for social work licensure. You would be well served to familiarize yourself with state licensure requirements by degree held.

The NASW offers specialized credentialing for social workers working with those impacted by alcohol, tobacco and other drugs (ATOD). Per the NASW, this credential advances the expertise of social workers in substance abuse by providing them with in-depth knowledge of ATOD in "epidemiology; etiology; physiology and pharmacology; treatment; U.S. policy and history regarding ATOD; populations affected; health issues; legal and ethical issues; and education/prevention." Applicants must hold a master's, be currently licensed, and demonstrate two plus years of post-MSW work in the field of substance abuse to be eligible for this credential.

Looking ahead: what are the prospects for substance abuse social workers?

Many social workers are drawn to the field of substance abuse out of the desire to help others. But another strong draw could be a healthy job outlook and industry trends.

Perhaps the biggest impact on this field is the Affordable Care Act (ACA). Mental health and substance abuse now have federal parity protection, which directly affects coverage for 62 million Americans. Insurance providers must now cover some mental and substance abuse services, including rehabilitative treatment programs. It makes sense that demand for substance abuse social workers — and the clinical, evidence-based expertise they provide — will rise as more people learn about, and take advantage of, this benefit.

There are currently 14,000 substance abuse treatment facilities in the United States, a figure that has remained relatively stable over the last 15 years. It is a fair bet that our nation's substance abuse problem, and its need for social workers to treat it, aren't going away any time soon.

Is substance abuse social work for you?

Substance abuse social work is a challenging and often-frustrating field, for sure. We all know the high-profile cases of substance abusers who could not recover: Amy Winehouse, Chris Farley, Heath Ledger, Kurt Cobain. Some of your patients will be just as intractable, but without the fame or money. However, if you have the fortitude to work with and understand substance abuse disorders, a career in substance abuse social work can be financially and emotionally rewarding.

Questions or feedback? Email editor@noodle.com