Number of people diagnosed with addictive personality increasing faster than counselors to treat

Shortage Of Addiction Counselors Further Strained By Opioid Epidemic

Burnout and low pay can make it tough to retain counselors in the field of addiction services. "You take on your clients' pain," explains one former counselor.

Gary Waters/Ikon Images/Corbis

As the drug-related death toll rises in the United States, communities are trying to open more treatment beds. But an ongoing labor shortage among drug treatment staff is slowing those efforts.

Each year, roughly one of every four substance-abuse clinicians nationally chooses to leave the job, according to recent research. And that’s not just turnover — leaving one job for another in the same field. As an Institute of Medicine report documented in 2006, there’s been a shortage of addiction workers for decades. And the demand is only increasing; the Affordable Care Act and other federal laws have given millions more people insurance to help them pay for those services. If only there were enough counselors to treat them.

Amelie Gooding runs Phoenix House in Keene, N.H., and says she’s been short a full-time counselor for a year and a half.

“Everybody thinks, ‘Oh, there aren’t enough beds!’ ” Gooding says. “But there’s not enough treatment staff to open more beds.”

Because she’s understaffed, Gooding has to leave three of her 18 residential beds empty, and she cut her outpatient groups down to 50 percent capacity.

So where have all the counselors gone?

“For me, it got to be too heavy,” says former counselor Melissa Chickering, who used to work for Gooding at the Phoenix House and still lives in the area.

Clinical directors would give their right arm to hire someone with Chickering’s long resume, Gooding says. She has a master’s degree in social work and 10 years of experience. Instead, the valued counselor now spends her days teaching courses in psychology and health sciences at local New Hampshire colleges.

The problem with addiction treatment, Chickering says, is you take on your clients’ pain. Plus, she says, she found the lack of funding and coordination from the state criminal.

She remembers a particularly bad time when she was running an addiction program for teenagers.

“I had open beds,” she says. “But a girl came in and was on the waiting list — she just didn’t have the right funding.” Because of the rules, Chickering had to reserve empty beds for clients who had a different kind of health insurance than the girl in front of her had.

“So she died while she was sitting on the waiting list,” Chickering remembers. “And I went home that night, and I was like, ‘I had an open bed!’ How do you sit with that and be OK the next day?”

The problem isn’t just burnout, other addiction counselors say, though the job entails many late nights and loads of paperwork. The biggest problem, they say, is the low pay — addiction counselors earn an average of about $40,000 a year, according to the Bureau of Labor Statistics.

Anne Herron leads workforce development for the federal Substance Abuse and Mental Health Administration — the agency that oversees services for the treatment of substance abuse. Federal officials are well-aware of the counseling shortage and are working on it, Herron says. Her agency is reaching out to high schools and colleges, developing training curricula.

Those initiatives are a start, she says, adding, “We would like to see more.”

Becky Vaughn, an executive with the National Council for Behavioral Health, an industry group for state associations of addiction services, says she would like the federal government to reimburse tuition for people who are taking courses in addiction treatment.

In the meantime, the directors of a few clinics in New Hampshire say that the expanded coverage for addiction services that has come with Obamacare is already boosting counselor salaries. Staff will come, these employers say, if the clinics have the money to pay them.

3 Responses

  1. Yes I feel sorry for those who are addicted to heroin, alcohol and opiates but this article never said anything about legally prescribed medications. It really spoke of the under funded and inadequately staffed Phoenix House treatment center and how they are failing. Addiction is a disease too and just like us, the chronic pain sufferers, they can’t be denied treatment either.
    The biggest problem with drug addicts is that they are treated as criminals automatically. If they get caught using they don’t get help, they get charged for possession of a controlled substance. They then go to court and get sentenced or they get used by law enforcement agencies as bait to catch bigger fish. Next either after serving a short sentence or helping law enforcement, they are let right back out on the streets to start the vicious circle all over again and score more drugs and eventually they will OD. Who should we blame for these deaths?

    Then the story talked about the young lady who wanted help and couldn’t get it because of lack of insurance coverage and she died. How many people die every year because of piss poor insurance coverage or lack of any insurance at all? Seems to me like the problems are not the drugs, the real problem is the system!

    Looking back a while and I kind of remember an article about overdose deaths in the US compared to other countries. This article stated that the US OD death percentage per population was much higher than the other countries on the list. Thinking about it now those other countries who we were compared to had government sponsored health care. That means that every person in those countries had health care. It also means that doctors, nurses, pharmacists and counselors always get paid. No one is ever turned away if they need medical assistance and no one is ever discriminated against for certain medical issues. Sounds great doesn’t it?

  2. One would think Phoenix House would stop trying to make this appear a bigger crisis than it is. If they cannot hire enough staff, competition will step in.

    • Actuallu it seems they use the Rahm Emanual book of crisis management…..”Never let a good crisis go to waste”

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