In 2023, nearly 25% of the US population aged 12 or older used illicit drugs, and over 17% met the criteria for a substance use disorder (SUD), with synthetic opioids and excessive alcohol use driving a sharp rise in drug-related deaths. Despite the growing need for SUD treatment, significant access gaps remain—especially for individuals from marginalized communities, rural areas, and socioeconomically disadvantaged populations. Addiction counselors can help address behavioral health and SUD workforce shortages. However, there is currently no standardized definition or title for an addiction counselor, which leads to variability across states.

This article identifies state-level credentials for high school through bachelor’s-level addiction counselors, defines training and supervision requirements, and describes the proportion of states that permit addiction counselors and other behavioral health professionals to be reimbursed for substance use treatment and service delivery.