Substance Abuse Social Work Guide - 2024

Social Worker License

by Social Worker License Staff

Updated: June 16th, 2022

If you’re reading this guide, chances are that you are thinking about a career in the “helping professions.” As a rule, these careers are the ones which work with people and try to improve their lives and range from medicine and dentistry to social work and teaching. People who work in these jobs get satisfaction from seeing someone better off as a result of the work they do-or at minimum, seeing someone stay healthy with their help.

One of these helping professions is social work. Most people first hear of social work in the context of schools or their state child protection agency. While those areas of social work are much older, these days there are social workers who help people with substance abuse and mental health issues. In this guide, we’ll look at the substance abuse career track, including what it is and overall job opportunities.

What Does a Substance Abuse Social Worker Do?

Briefly, a substance abuse social worker helps support people with substance abuse issues. In this context, substance abuse can include alcohol, street drugs, marijuana, and prescription drugs. Help can include a variety of assistance, from getting someone into appropriate housing, counseling, and other interventions. Let’s look at this rewarding career in detail.

First, what is substance abuse?

Let’s get this part out of the way first. Many people can use drugs, marijuana, or alcohol without becoming addicted to them. When medical professionals talk about “substance abuse,” they refer to an inability of a patient to control their substance use. And, as the National Institutes of Health (NIH) points out, substance abuse disorder is a mental health condition. It can range from mild to severe, and generally requires treatment.

Along with an inability to control substance use, an important part of substance abuse is that there is a level of impairment in the patient’s everyday life. For instance, an alcoholic might have trouble being on time for work, or they might drive while drunk. As a result, the patient may get fired from their job, arrested, or both. Later on, this person can lose their home because they can’t pay rent or get kicked out by an upset partner.

People with substance abuse disorders frequently struggle with other mental issues, too

Although substance abuse disorder is already a mental disorder, people who have this disorder frequently have a different mental health issue, too. According to multiple studies and clinical experience, about half of people with a substance abuse disorder have additional mental health problems. For example, a lot of people with anxiety or depression “self-medicate” with alcohol because it helps them socialize or distracts from their bad feelings. 

In general, any kind of mental health disorder can become associated with substance abuse problems. However, there’s an even stronger correlation between severe mental illness (SMI) and substance abuse disorders. Federally, SMI means a mental health condition that causes significant impairment in the patient’s life. While anxiety and depression can rise to the level of SMI, most people think of more “severe” conditions like schizophrenia, bipolar disorder, and PTSD. We don’t know if one causes the other, just that they commonly occur together. 

Substance abuse social workers frequently treat both conditions.

In the United States and most of its jurisdictions, substance abuse social workers are referred to as “mental health and substance abuse” social workers. There are a few reasons behind the technical description. First, as we mentioned above, substance abuse is technically a mental disorder, and many people have both mental health and substance misuse problems. Also, the strong correlation between trauma, substance abuse, and general mental health problems means that there are a lot of overlapping issues that social workers can help with.

A generation ago, mental health treatment and substance abuse treatment were done separately. And while this still happens to the extent that some facilities can only deal with substances, or some practitioners are unaware of a substance abuse problem, the holistic approach of treating both at once is more common. In other words, current clinical practice supports treating substance abuse disorder in the context of other challenges the patient faces.

What populations do substance abuse social workers help?

Anyone with a substance abuse problem, and, in some cases, their families. Substance abuse disorders can affect people of any sex, gender identity, race, ethnicity, religion, level of education, socio economic class, or age. In society, we often think of substance abusers as people who have nothing and live in hotels or on the street. However, this isn’t necessarily true. For instance, teenagers often live at home, and “functional alcoholics” frequently hold down a job or participate in household activities. 

Likewise, a substance abuse social worker can help the families of people struggling with substance abuse. If the addicted family member successfully goes into recovery, it often helps to repair many of the relationships that were harmed by the addiction. Similarly, a substance abuse social worker can help the family work through the family dynamics, such as enabling the addict, that are barriers to recovery.

What issues does a substance abuse social worker address?

As a substance abuse social worker, you might deal with a wide range of problems for your clients. Besides the family dynamics, people with addictions have many relational and economic challenges to work through. Chief among these is any co-occurring mental disorders.  In addition, people with addictions often need help with the details of daily living. Dealing with past trauma and co-occurring mental illness is often just part of the struggle for sobriety.

For this reason, a substance abuse social worker can help with:

  • Obtaining substance abuse treatment for clients. This can be by calling around to find a rehab bed, getting them a spot in an outpatient program, or locating a medication assisted treatment (MAT) program.
  • Helping a client obtain health insurance, Medicaid, or charity care to cover the cost of treatment.
  • Facilitate peer support, such as 12-step groups.
  • Finding housing when the patient is ready for discharge from treatment, or as an adjunct to getting outpatient care.
  • Arranging for other professional services or job training so they can get their lives back on track.

In other words, a substance abuse social worker treats and helps the whole person. They don’t simply help the person get off of drugs or alcohol. Rather, they ensure that this person has the tools to cope with everyday life and maintain their sobriety.

What are common traits of substance abuse social workers?

Social work is one of the “helping professions,” and for this reason the typical social worker is a compassionate person who enjoys making a positive difference in the lives of others. However, although good intentions are one of the biggest reasons people consider social work as a career, this isn’t the only trait they need. Rather, there are other personal characteristics that are critical for success.


We already mentioned this, but compassion is one of the most important traits of a social worker. To be successful, a social worker needs to be able to see the person for who they are, understand their struggles, and look past their problems to see potential.

A high level of communication and listening skills

Most social workers help people who are at a low point in their lives. And in the case of people with substance abuse and mental illness, the client may also have trouble thinking clearly. This means that as a social worker, you would need to listen carefully to what someone has to say. What’s an important trait for most social workers is even more important for the substance abuse field.

Similarly, you need to have great communication skills. Not only do you need to tell the client what you recommend, but you also must often convince insurance companies or facility administrators what your client needs. Plus, counseling and group sessions require clear, deliberate communication to be effective.

Good interpersonal skills

Likewise, a substance abuse social worker needs to relate well to other people. There are group dynamics in settings like group therapy and support groups, teamwork with colleagues or outside service providers, and even a need to try and mediate between clients and their families. Also, you need to model healthy relationships and interpersonal interactions for clients. Sometimes clients never learned these things in the first place, and other clients need to re-learn healthy social skills.

An ability to stay organized

Substance abuse social workers tend to have a lot of work to do. This includes a large number of clients, administrative tasks, individual counseling sessions, case management, group sessions, and more. Depending on your company or organization, you may have staff meetings and other chores, too. If you aren’t very well organized, it’s easy to lose track of what needs to be done, and when. Forgetting to do something in a timely manner can negatively affect your clients or your organization.

Excellent problem-solving skills

As we mentioned above, substance abuse social workers’ clients often have problems that go beyond substance abuse, including mental health concerns, a lack of housing, or food insecurity. Because social workers try and address the range of problems someone is facing, it’s important that social workers quickly determine what needs to be done in order to help their client. For instance, finding someone housing in a tough rental market can be a challenge, as can getting someone on food stamps without an address.

Of course, in some situations a separate social worker might help with some of the non-mental health related challenges a client faces. For instance, you might work together with someone who lives in supported housing to get a client back on track with their sobriety-often, it’s an issue of different skillsets and coordination between organizations.

What do future social workers learn in their courses?

Besides developing the competencies we talked about in the last section, students in a bachelor’s program (BSW) will learn the following skills. Later, they’ll apply these skills to their social work career with clients.

  • Human behavior: How do people normally behave in society, and how can this be adversely affected by addictions, poverty, or other challenges? For a substance abuse social worker, this would mean that they can assess what a client’s substance and mental health-related deficits are. In addition, it can help identify the extent to which other problems, like poverty, influence a client’s struggles.
  • Social welfare policy and practice: This involves knowing what people need to thrive, and how to obtain those supports for someone. For someone who is economically deprived, this could mean helping them get a housing voucher or food stamps. People with mental health challenges can find treatment through a social worker.
  • Basic psychology: A social worker needs to know if someone may be dealing with a mental disorder, or if they simply need economic support. This helps them decide which resources a client needs.
  • Research skills: In this case, finding out what services will best meet the needs of a client. Also, determining best practices when necessary.

Here’s the thing: in most states, social workers with just a BSW are limited in what they can do. They might need supervision from someone with a Master’s degree (MSW) or be consigned to assistant status. And, in nearly every state you’ll need a license for any kind of clinical work.

Substance abuse social workers, generally speaking, work in a clinical context to some extent. For this reason, they’ll need a state license. To get a license, they’ll typically need an MSW and to pass a test. Here’s what you’d learn to get an MSW:

  • More advanced research capabilities. These will mostly help when you look at different treatment options for a client, or if you want to do research.
  • Clinical skills. The biggest difference between a master’s and bachelor’s social workers is the ability to perform assessment and counseling. In other words, MSWs are often clinical social workers.
  • Increased specialization. You can specialize in substance abuse at the BSW level, but only on a limited scale. With a MSW, social workers become experts at their particular field.

As you can see, most people who want to be substance abuse social workers will want an MSW. Often, you can get into an MSW program with any bachelor’s degree, but you’ll graduate faster with a BSW (“advanced standing”). Either way, most programs have schedules that let you work full time while also studying for your degree.

How does a substance abuse social worker operate within public policy?

There’s no question that substance abuse has a serious stigma attached to it, which is one reason why the Department of Housing and Urban Development (HUD) launched a program that helps people in recovery get housing and keep it. This is an improvement on Housing First, which aims to get people off the streets before treating their addictions and mental disorders. However, studies show that substance abusers with housing still struggle with recovery, unless they receive further services.

Here’s the thing: a “regular” social worker will help that person get housing. However, to treat the addiction itself, you need a substance abuse social worker. In this way, social workers help to further public policy by getting people off the streets, then dealing with the problems that caused someone to become homeless in the first place.

Career growth and stability for mental health and substance abuse social workers

If this career sounds like one you’re interested in pursuing, you probably want to know what your job prospects are. After all, getting an MSW involves a lot of time and money. While compassion and a desire to improve client’s lives is an important reason to go into the field, you also need to pay the rent. With that in mind, here’s what we know about career growth and stability.

Substance abuse social workers are in demand

According to the Bureau of Labor Statistics (BLS), jobs in social work are projected to grow 5.5% from 2018 to 2028. This is faster than the average across all industries, meaning that social workers are in demand. Each year, there should be around 78,300 job openings, which reflect job growth, retirements, and career changes alike. In total, there are about 17,600 social workers as of 2020, with 124,000 of these working in the mental health and substance abuse field.

What does this demonstrate? Simply put, there’s a lot of demand for social workers. While substance abuse and mental health social workers are a smaller proportion of social workers than the ones who work with children and families or healthcare settings, there are still a lot of jobs available.

The opioid crisis increased the demand for this social work specialty

In recent years, the United States has struggled with an opioid addiction crisis, involving both heroin and prescription opioids. According to NIDA, one reason for this is the overprescribing of painkillers that has happened since the Nineties. And for many of these patients, a prescription is the pathway to addiction. Furthermore, many of these patients move on to heroin because of its increased availability and cheaper price.

To address the opioid crisis, the Federal government developed new programs that make it easier for people to get treatment. They also have programs to help improve treatment options for chronic pain, and to determine best practices in drug treatment. All of these efforts help increase employment opportunities for substance abuse social workers.

Substance abuse social workers earn a solid salary

Nationwide, the median salary for social workers is $64,360 (Bureau of Labor Statistics - 2022), and slightly less for those in the substance abuse specialty. By contrast, the median salary for all professions in the United States is around $45,000. This means that social workers make a little bit more than the average nationwide.

Besides the decent wage, social workers often get good employment benefits. In particular, most government employers offer good-quality health insurance, time off, and other perks. Even though some social workers need to work at off hours to meet with clients, the benefits and job satisfaction are an excellent tradeoff.

Substance abuse social workers have a rewarding career helping people to get off of drugs and alcohol, then stay in recovery. They also help clients take advantage of community resources to get and retain jobs, housing, and other essentials. Better yet, social workers can earn a solid salary, especially with a Masters in Social Work (MSW).