There are many workforce issues that we experience as treatment professionals working in the substance use disorder field. When we analyze these issues, I think it is important for us to understand the history of our profession. If we look back 50 years into this profession, the behavioral health field was nonexistent. During that time, we had mental health, alcoholism, and drug addiction. These were three separate distinct professions and never the twain did they meet. In the mental health arena we had psychiatrists, psychologists, and licensed social workers. All were providing care to those that suffered from chronic and persistent mental illness. In the “alcoholism” category we had recovering alcoholics, a 12 Step movement, and the beginning of what we now call treatment. Through this, the Minnesota Model emerged. In 1958, the Synanon organization was birthed by Charles Dietrich and used by recovering addicts. Fifty years ago we saw alcoholism and drug addiction as two separate and distinct problems, not one in the same. Thirty-five years ago, in the 1970s, the alcoholism and drug addiction professions began to see the need for certifications.
Each state was a little bit different during this time. There were minimal standards for people working with those that suffered from chemical dependency. The profession eventually created what is known as the “12 Core Functions.” Our workforce began internationally acknowledging a system that recognized licensed chemical dependency counselors.
In years gone by, there were many people in recovery who were compassionately and lovingly helping others suffering from alcoholism. Yet little education was needed. In order to have a license today, the educational level has been increased from those who barely finished high school or who were holding GEDs. In both professions we have come full circle to a place where we are now using peer support.
The way that we reference addiction and alcoholism has changed in our profession. Within the last 15 years we have begun to identify what is now seen as the “behavioral health field.” Our profession went from “alcoholism and drug addiction” to “chemical dependency,” from “chemical dependency” to “substance abuse” and from “substance abuse” to “substance use disorders.” Currently we are looking at both “substance use disorders” and “persistent mental illness” under an umbrella called behavioral health. We are seeing a melting pot of professional credentials: from LPCs to MFTs to CIPs to CADCs and LCDCs to psychologists, psychiatrists and physicians, all of whom have all types of certifications in addiction medicine. They are studying different topics, and they come together in what we nicely like to call multidisciplinary teams. From one provider to the next, these teams vary dramatically and there is a lack of consistency. There is no Yale, Harvard, or Stanford to educate those that consider themselves substance use disorder professionals.
I believe providing information about the history of this workforce helps in understanding why individuals enter this profession. Here are some reasons why individuals choose to work in the substance use disorder field. According to a previous study:
95% of people indicated that they were drawn to this field because of the challenging and interesting work
91% have a desire to work in a helping profession
78% were motivated by the substance use disorder problems that they saw in their community