# Substance Abuse and Behavioral Disorder Counselors

US SOC code 21-1011. Markdown version of https://futurehistory.earth/timeline/21-1011

Also called: Substance abuse counselor, SUD counselor, Substance use counselor, Substance use disorder counselor, Addictions counselor.

## In brief

BLS last counted US substance abuse and behavioral disorder counselors as their own occupation in May 2016: **91,040** jobs. Median pay was **$41,070** a year in May 2016. The earliest figure here is [an estimate](https://www.niaaa.nih.gov/our-work/history-niaaa) of **15,000** from 1970, not measured the same way as today's count. The last full technology era in this work: Buprenorphine office-based treatment, 2000 to 2016.

## What the sources say

### Official outlook

BLS's 2025-35 employment projections do not list this occupation on its own.

### AI exposure studies

- **28.9%** of this job's tasks are exposed to large language models. Not a forecast of job losses. [Eloundou and others, 2023](https://github.com/openai/GPTs-are-GPTs/blob/main/data/occ_level.csv)
- **0.033** estimated probability that the whole occupation could be computerised, over an unspecified number of years. Not a forecast of job losses. [Frey and Osborne, 2013](https://oms-www.files.svdcdn.com/production/downloads/academic/The_Future_of_Employment.pdf)

Data as of BLS OEWS May 2016.

## Substance Abuse and Behavioral Disorder Counselors employment and pay by year

- On record since: 1935
- Latest US employment: 91,040 (May 2016). Source: BLS OEWS May 2016 [4]
- Latest US median pay: $41,070 (May 2016). Source: BLS OEWS May 2016 [5]

### All 17 years of cited US data

| Year | US employment | Annual pay (median unless marked) | Source |
| --- | --- | --- | --- |
| 1970 | 15,000 (estimate) | n/a | Est., NIAAA [1] |
| 1990 | 70,000 (estimate) | n/a | Est., SAMHSA [2] |
| 2000 | 56,080 | n/a | BLS OEWS 2000 [3] |
| 2003 | 65,170 | $31,190 | BLS OEWS May 2003 [4] |
| 2004 | 68,880 | $32,130 | BLS OEWS May 2004 [4] |
| 2005 | 72,210 | $32,580 | BLS OEWS May 2005 [4] |
| 2006 | 75,940 | $34,040 | BLS OEWS May 2006 [4] |
| 2007 | 76,830 | $35,580 | BLS OEWS May 2007 [4] |
| 2008 | 79,180 | $37,030 | BLS OEWS May 2008 [4] |
| 2009 | 78,470 | $37,700 | BLS OEWS May 2009 [4] |
| 2010 | 77,940 | $38,120 | BLS OEWS May 2010 [4] |
| 2011 | 76,600 | $38,560 | BLS OEWS May 2011 [4] |
| 2012 | 80,130 | $38,520 | BLS OEWS May 2012 [4] |
| 2013 | 83,120 | $38,620 | BLS OEWS May 2013 [4] |
| 2014 | 85,180 | $39,270 | BLS OEWS May 2014 [4] |
| 2015 | 87,090 | $39,980 | BLS OEWS May 2015 [4] |
| 2016 | 91,040 | $41,070 | BLS OEWS May 2016 [4] |

## Sources (77)

### Employment series

1. [NIAAA — National Institute on Alcohol Abuse and Alcoholism (founding 1970, Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act)](https://www.niaaa.nih.gov/our-work/history-niaaa), National Institute on Alcohol Abuse and Alcoholism
2. [SAMHSA — Treatment Episode Data Set (TEDS) 1992-1995 Annual Report (substance abuse treatment admissions data; TEDS predecessor covers early 1990s treatment program activity)](https://www.samhsa.gov/data/data-we-collect/teds-treatment-episode-data-set/annual-report/1992-1995), Substance Abuse and Mental Health Services Administration
3. [BLS OES 2000 national estimates (flat file)](https://www.bls.gov/oes/special-requests/oes00nat.zip), Bureau of Labor Statistics
4. BLS OEWS, national cross-industry estimates (flat file), Bureau of Labor Statistics. Editions: [2003](https://www.bls.gov/oes/special-requests/oesm03nat.zip), [2004](https://www.bls.gov/oes/special-requests/oesm04nat.zip), [2005](https://www.bls.gov/oes/special-requests/oesm05nat.zip), [2006](https://www.bls.gov/oes/special-requests/oesm06nat.zip), [2007](https://www.bls.gov/oes/special-requests/oesm07nat.zip), [2008](https://www.bls.gov/oes/special-requests/oesm08nat.zip), [2009](https://www.bls.gov/oes/special-requests/oesm09nat.zip), [2010](https://www.bls.gov/oes/special-requests/oesm10nat.zip), [2011](https://www.bls.gov/oes/special-requests/oesm11nat.zip), [2012](https://www.bls.gov/oes/special-requests/oesm12nat.zip), [2013](https://www.bls.gov/oes/special-requests/oesm13nat.zip), [2014](https://www.bls.gov/oes/special-requests/oesm14nat.zip), [2015](https://www.bls.gov/oes/special-requests/oesm15nat.zip), [2016](https://www.bls.gov/oes/special-requests/oesm16nat.zip)

### Wage series

5. BLS OEWS, national cross-industry estimates (flat file), Bureau of Labor Statistics. Editions: [2003](https://www.bls.gov/oes/special-requests/oesm03nat.zip), [2004](https://www.bls.gov/oes/special-requests/oesm04nat.zip), [2005](https://www.bls.gov/oes/special-requests/oesm05nat.zip), [2006](https://www.bls.gov/oes/special-requests/oesm06nat.zip), [2007](https://www.bls.gov/oes/special-requests/oesm07nat.zip), [2008](https://www.bls.gov/oes/special-requests/oesm08nat.zip), [2009](https://www.bls.gov/oes/special-requests/oesm09nat.zip), [2010](https://www.bls.gov/oes/special-requests/oesm10nat.zip), [2011](https://www.bls.gov/oes/special-requests/oesm11nat.zip), [2012](https://www.bls.gov/oes/special-requests/oesm12nat.zip), [2013](https://www.bls.gov/oes/special-requests/oesm13nat.zip), [2014](https://www.bls.gov/oes/special-requests/oesm14nat.zip), [2015](https://www.bls.gov/oes/special-requests/oesm15nat.zip), [2016](https://www.bls.gov/oes/special-requests/oesm16nat.zip)

### Tool eras

6. [Wikipedia — Alcoholics Anonymous (founded 1935, Bill Wilson and Bob Smith; "Big Book" 1939; Twelve Steps)](https://en.wikipedia.org/wiki/Alcoholics_Anonymous), Wikipedia
7. [Wikipedia — The Twelve Steps (AA program; publication history; scope and limitations)](https://en.wikipedia.org/wiki/Twelve-step_program), Wikipedia
8. [NIAAA — History of NIAAA (National Institute on Alcohol Abuse and Alcoholism founding 1970)](https://www.niaaa.nih.gov/our-work/history-niaaa), National Institute on Alcohol Abuse and Alcoholism
9. [Wikipedia — Substance Abuse and Mental Health Services Administration (SAMHSA founding 1992; NIAAA + NIDA + NIMH consolidation)](https://en.wikipedia.org/wiki/Substance_Abuse_and_Mental_Health_Services_Administration), Wikipedia
10. [Wikipedia — National Institute on Drug Abuse (NIDA founding 1973; Drug Abuse Office and Treatment Act 1972)](https://en.wikipedia.org/wiki/National_Institute_on_Drug_Abuse), Wikipedia
11. [NAADAC — The Association for Addiction Professionals (history; NCAC credential; founding 1972)](https://www.naadac.org/about), NAADAC — The Association for Addiction Professionals
12. [Wikipedia — Addiction Counselor (CADC; LADC; state credentialing systems for addiction counselors)](https://en.wikipedia.org/wiki/Addiction_counselor), Wikipedia
13. [Wikipedia — Buprenorphine (DATA-2000; Suboxone approval 2002; office-based opioid treatment history)](https://en.wikipedia.org/wiki/Buprenorphine), Wikipedia
14. [SAMHSA — Buprenorphine: What is Buprenorphine? (first medication for opioid use disorder prescribable in physician offices; office-based opioid treatment)](https://www.samhsa.gov/substance-use/treatment/options/buprenorphine), Substance Abuse and Mental Health Services Administration
15. [Wikipedia — 21st Century Cures Act (signed December 13, 2016; $1B State Opioid Response grants; mental health provisions)](https://en.wikipedia.org/wiki/21st_Century_Cures_Act), Wikipedia
16. [Wikipedia — SUPPORT for Patients and Communities Act (2018; $8.9B authorized; buprenorphine prescribing expansion; CCBHC)](https://en.wikipedia.org/wiki/SUPPORT_for_Patients_and_Communities_Act), Wikipedia
17. [Wikipedia — Sober Grid (digital health company and mobile application for peer support in addiction recovery, founded 2015; geolocation-based sober peer network)](https://en.wikipedia.org/wiki/Sober_Grid), Wikipedia
18. [SAMHSA — 42 CFR Part 8 Final Rule: Expanding Access and Flexibility for Opioid Treatment Programs (2024 rule; telehealth including audio-visual screening for methadone; take-home dose expansion)](https://www.samhsa.gov/substance-use/treatment/opioid-treatment-program/42-cfr-part-8), Substance Abuse and Mental Health Services Administration
19. [Wikipedia — American Rescue Plan Act of 2021 (mental health and SUD funding; $30B+ behavioral health provisions)](https://en.wikipedia.org/wiki/American_Rescue_Plan_Act_of_2021), Wikipedia
20. [Bicycle Health — Telehealth opioid use disorder treatment (buprenorphine via video visit; counselor-prescriber team model)](https://www.bicyclehealth.com), Bicycle Health
21. [BLS Occupational Outlook Handbook — Substance Abuse, Behavioral Disorder, and Mental Health Counselors (2023-33 outlook: +18%, much faster than average)](https://www.bls.gov/ooh/community-and-social-service/substance-abuse-behavioral-disorder-and-mental-health-counselors.htm), Bureau of Labor Statistics

### Forecasts and exposure studies

22. [Frey & Osborne (2013), "The Future of Employment: How Susceptible Are Jobs to Computerisation?", Appendix (SOC 21-1011 Substance Abuse and Behavioral Disorder Counselors: probability 0.033, rank 114 of 702)](https://oms-www.files.svdcdn.com/production/downloads/academic/The_Future_of_Employment.pdf), Oxford Martin School, University of Oxford
23. [Eloundou, Manning, Mishkin & Rock (2023), "GPTs are GPTs", occupation-level exposure data occ\_level.csv (O\*NET-SOC 21-1011.00, human-rated β 0.289)](https://github.com/openai/GPTs-are-GPTs/blob/main/data/occ_level.csv), OpenAI

### Historical notes

24. [Wikipedia — Alcoholics Anonymous (June 10, 1935 founding date; Bill Wilson; Bob Smith)](https://en.wikipedia.org/wiki/Alcoholics_Anonymous), Wikipedia
25. [NIAAA — History (1970 Comprehensive Act; NIAAA founding; federal treatment funding)](https://www.niaaa.nih.gov/our-work/history-niaaa), National Institute on Alcohol Abuse and Alcoholism
26. [NAADAC — About (founded 1972; National Association of Alcoholism and Drug Abuse Counselors; professionalizing the workforce)](https://www.naadac.org/about), NAADAC — The Association for Addiction Professionals
27. [Wikipedia — OxyContin (launched 1996; Purdue Pharma marketing; prescription opioid epidemic origins)](https://en.wikipedia.org/wiki/OxyContin), Wikipedia
28. [Wikipedia — Buprenorphine (DATA-2000; office-based opioid treatment; Suboxone approval 2002)](https://en.wikipedia.org/wiki/Buprenorphine), Wikipedia
29. [Wikipedia — 21st Century Cures Act (signed December 13, 2016; $1B SOR grants; mental health and SUD provisions)](https://en.wikipedia.org/wiki/21st_Century_Cures_Act), Wikipedia
30. [CDC — Drug Overdose Deaths in the United States (provisional 2022 data; approximately 109,000 overdose deaths; fentanyl-driven surge)](https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm), Centers for Disease Control and Prevention
31. [SAMHSA — 42 CFR Part 8 Final Rule (2024; permanent regulatory changes for opioid treatment programs; telehealth and take-home methadone expansion)](https://www.samhsa.gov/substance-use/treatment/opioid-treatment-program/42-cfr-part-8), Substance Abuse and Mental Health Services Administration

### Predecessors & successors

32. [Wikipedia — Alcoholics Anonymous (sponsor-sponsee model; peer recovery support pre-professional era)](https://en.wikipedia.org/wiki/Alcoholics_Anonymous), Wikipedia
33. [NIAAA — History (state hospital alcoholism program workers; NIAAA training grants)](https://www.niaaa.nih.gov/our-work/history-niaaa), National Institute on Alcohol Abuse and Alcoholism

### Present-day analysis

- [O\*NET 30.3 — Substance Abuse, Behavioral Disorder, and Mental Health Counselors (21-1011.00): 483,500 employed; +19% projected growth 2024-2034; median annual wage $59,190; tasks, work activities, technology skills](https://www.onetonline.org/link/summary/21-1011.00), accessed 2026-05-24
- [BLS OOH 2024-2034 — Substance Abuse, Behavioral Disorder, and Mental Health Counselors: +19% growth; 48,300 new openings/year; driven by opioid crisis response, CCBHC expansion, criminal justice diversion programs](https://www.bls.gov/ooh/community-and-social-service/substance-abuse-behavioral-disorder-and-mental-health-counselors.htm), accessed 2026-05-24
- [SAMHSA NSDUH 2024 — 46M Americans had a SUD in the past year; ~10% received any SUD treatment; structural access gap is largest in SUD treatment among all behavioral health conditions](https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health/national-releases/2024), accessed 2026-06-21
- [SAMHSA TIP 35 — Enhancing Motivation for Change in SUD Treatment (updated 2019, reaffirmed 2023): motivational interviewing and therapeutic alliance are the primary predictors of SUD treatment retention and outcomes](https://library.samhsa.gov/product/tip-35-enhancing-motivation-change-substance-use-disorder-treatment/pep19-02-01-003), accessed 2026-05-24
- [Eleos Health — AI ambient clinical documentation; dedicated SUD treatment service line; 70% documentation time reduction; 90% provider stress reduction; 3-4x faster symptom reduction (RCT); SOC 2 Type II; deployed at Acadia Healthcare and LifeStance Health (press releases 2024-2025)](https://eleos.health/), accessed 2026-05-24
- [ASAM CONTINUUM — digital ASAM Criteria six-dimension level-of-care placement tool; computerized clinical decision support for SUD placement; deployed as required instrument by state behavioral health authorities (ASAM.org 2025)](https://www.asam.org/asam-criteria/asam-criteria-software/asam-continuum), accessed 2026-05-24
- [DynamiCare Health — digital contingency management platform; NIDA-funded RCT 2023: improved 30-day abstinence and treatment retention; deployed at state agencies, health plans, and SUD treatment programs (product pages 2025)](https://www.dynamicarehealth.com/), accessed 2026-05-24
- [Behaivior AI — behavioral health technology platform (Recovery™); pattern recognition AI for between-session relapse risk monitoring; IBM Watson AI XPRIZE top-10 winner; deployed by care providers, rehab centers, and telehealth organizations (product pages 2025)](https://www.behaivior.com/), accessed 2026-05-24
- [Pelago (formerly Quit Genius) — virtual SUD treatment platform; 15 peer-reviewed publications; alcohol: 62% use reduction in 30 days; opioids: 67% achieve 3-month opioid-free status; $11,829 annual medical cost savings per member (Aon analysis); deployed at hundreds of employers and health plans](https://www.pelagohealth.com/), accessed 2026-05-24
- [Lyssn — AI NLP platform for EBP fidelity scoring; 4.3M+ analyzed sessions; 17 years academic research; 60+ peer-reviewed publications; used by 100+ health and human services organizations; MI fidelity scoring for SUD counselor training and quality improvement (product pages 2025)](https://www.lyssn.io/), accessed 2026-05-24
- [42 CFR Part 2 — Confidentiality of Substance Use Disorder Patient Records; 2024 amendment effective Feb 2024; heightened SUD record confidentiality beyond HIPAA; applies to all AI tools processing SUD session audio or treatment records; counselor accountable for Part 2 compliance](https://www.ecfr.gov/current/title-42/chapter-I/subchapter-A/part-2), accessed 2026-05-24
- [NAADAC Code of Ethics (2021, current) — counselor accountability for client records, informed consent, and confidentiality; applies to AI-generated documentation in SUD treatment settings](https://www.naadac.org/code-of-ethics), accessed 2026-05-24
- [ACA — Technology-Related Resources for Counselors (2025): ethical use of AI, telehealth, and digital tools; therapeutic relationship, informed consent, and clinical judgment are exclusively human responsibilities; AI-generated notes require counselor attestation; licensing boards hold licensee accountable for all clinical records](https://www.counseling.org/resources/topics/professional-counseling/technology-related), accessed 2026-06-21
- [NEJM AI — "Large Language Models in Mental Health Care" (Mar 2025): LLM suicide risk predictions have failed multiple benchmark evaluations; clinical risk assessment requires licensed human judgment; directly applicable to SUD counselors managing elevated client suicide risk](https://ai.nejm.org/doi/10.1056/AIra2400480), accessed 2026-05-24
- [Journal of Substance Use and Addiction Treatment — "Digital Technologies in SUD Treatment: A Systematic Review" (2024): DynamiCare, Behaivior, and Pelago all require licensed clinician oversight; engagement highest when counselor actively co-manages digital SUD tools with the client](https://www.jsatjournal.com/), accessed 2026-05-24
- [SAMHSA "Strengthening the Behavioral Health Workforce" report: SUD treatment workforce shortage most acute among all behavioral health disciplines; AI and digital tools reduce per-counselor administrative burden and increase effective access capacity; framing is access-expanding, not workforce-substituting](https://www.samhsa.gov/data/report/strengthening-behavioral-health-workforce), accessed 2026-06-21
- [Eloundou et al. 2024 — GPTs are GPTs (Science): occupational LLM exposure framework; SUD counselors rated at low β-exposure due to face-to-face therapeutic core tasks; framework underestimates the documentation and between-session AI augmentation layer](https://arxiv.org/abs/2303.10130), accessed 2026-05-24
- [SAMHSA TIP 63 — Medications for Opioid Use Disorder: ASAM Criteria level-of-care placement is the national standard for MAT and SUD treatment; counselors conduct assessments and coordinate placement across the continuum of care](https://library.samhsa.gov/product/tip-63-medications-opioid-use-disorder/pep21-02-01-002), accessed 2026-06-21

How to read these figures: https://futurehistory.earth/methodology. Every figure links to its own source; gaps stay gaps.