Substance Abuse Counselors Relapse: Can They Keep The Patient’s Best Interest?

counselor's support

More than 100,000 individuals who work as substance abuse counselors have some kind of personal connection to the problem which makes them perfect for the position. While most of them have family or friends who were addicts, 50 percent of the counselors, administrators, social workers, therapists, and others who help addicts achieve sobriety are recovering addicts themselves.

While personal connection to the client means that these professionals are dedicated and passionate, there is also a downside. It’s no secret that alcoholics and addicts even those who enjoyed sobriety for some time, relapse.

Most substance abuse programs as well as licensing boards require applicants to have at least two-year significant free time. When they relapse, they lose their license because they violate the condition of their licensure.

What happens if a substance abuse counselor relapse?

Some employers may be reticent about rehiring those who have relapsed; their biggest concern is the safety of the client, particularly those who are in an early stage of recovery. The problem lies in the fact that when people relapse, they may begin to cross boundaries, and it is doubtful those counselors who are in the throes of their own addiction can keep the patient’s best interest foremost in their priorities.

Chuck Rice, an attorney and instructor at a nationally recognized graduate school of addiction studies, said that “The counselor would just be gone.”  While relapse of substance abuse professional may be dangerous to patients, the biggest threat is actually to the person who relapses. Many counselors and clinicians are difficult to work with because they are in serious denial.

Then again, the greatest challenge for a counselor who relapse is financial, so they hide their addiction for fear of losing their license and their job so their use escalates. By the time co-workers and friends recognize what’s going on, the person  has already experienced a full-blown crisis.

Reasons behind the relapse and fall out

Many counselors and clinicians complain that it is easy for them to blur the lines between job demands and personal recovery. They get used to being the one with the experience, the credibility, and the answer, so it is not difficult to confuse their work when they attend meetings for their own recovery.  Burn out becomes a major issue.

The challenges facing an individual who decides to make a career in substance abuse is that it is difficult for counselors to attend 12 steps meetings because they may ultimately find themselves sitting beside a past or current client. What would they say to a client in the room when they become a member of a recovery group?

Experts strongly recommend that these substance abuse counselors should have a support program outside the job. The irony of it all is that no safety nets or support exist for professionals who work in the field. Most professional and healthcare organizations have monitoring system to help members deal with addiction issues. Monitoring is needed for substance abuse professional. NAADAC was underused because people don’t want to be identified for fear of losing their job. However, without a formal system, NSAADAC can only deal with the relapse informally. A national system agreeable to the addiction world is needed to assist people in recovery.

California failed to screen substance abuse counselors

The state of California failed to meet such a requirement. The California State Office of Oversight and Outcomes ordered an investigation for 36,000 substance abuse counselors. The State Senate investigative arm announced Monday that it found almost two dozen substance abuse counselors presently working in California who are registered sex offenders. The Department of Alcohol and Drug Programs do not keep track of the counselors’ criminal history or arrest records. The report says that these counselors are still dangerous even after their time and rehab have been completed.

California and Pennsylvania are among the nation’s 15 most populous states and are the only two states that do not have a system to weed out criminal records of  applicants. Other states require counselors to report their background and check their fingerprints against criminal records.

A bill by Sen. Mark DeSaulnier, D-Concord requiring background checks and licensing died in the Legislature in 2010. The California State Office of Oversight and Outcomes recommended that state lawmakers try again.


If a national monitoring system is not created, these professionals who work to help others keep a clean life will go without the support system they need. Professionals must help make the system work as the recovery field continues to grow to ensure that the foot soldiers in our battle against substance abuse will remain straight and narrow.


Written by: Janet Grace Ortigas

10 Responses to "Substance Abuse Counselors Relapse: Can They Keep The Patient’s Best Interest?"

  1. Amy   April 25, 2014 at 3:56 pm

    No. Any addict can answer that. You put everyone and everything in jeopardy when you’re in hard addiction. Sobriety is to hard to get and way too precious to gamble with.

  2. Amy   April 25, 2014 at 3:53 pm

    I have been in and out of rehabs, residential and iop. I’ve been in and out of so many programs it’s scary and more so sad. I have had a lot of different counselors through the years. I have had good ones who had never used drugs and bad ones that had been through drug addiction. But as a rule I think recovering addicts make better counselors. I have finally gotten clean and turning my life around. My Dr and my counselor have played a major role in my recovery. I think I would make better counselor now after being in treatment so much for so many years then any counselor ever could with out living through drug addiction and the recovery process. I have heard every story, every excuse known to man. If I didn’t use it I have heard it. So it’s a difficult question. I do think the best counselors are the ones who have lived it.

  3. Danielle BSW and AA member   April 1, 2014 at 3:49 pm

    Where are you getting the stat “50 percent of the social workers…who help addicts achieve sobriety were once addicts themselves” ?

  4. Sarah Hess   May 22, 2013 at 3:33 pm

    As a recovering addict and a counselor as far as relapsing goes its not the end of the world is that not what we tell our clients. The thing to do is acknowledge the relapse for what it is and continue to move forward. I feel that as counselors the first thing we need to do is handle any unresolved issues we have in our own lives before we can take on another persons issues, this is one of the things they teach us in school. I was told how can you expect to help some one if you are having problems yourself. It can be a very difficult situation when dealing with addicts on a day to day basis and you as a counselor are having urges and cravings. So if a counselor relapses i feel they should stop seeing clients, get the help they need and pick up where they left off before the relapse process began.

  5. Sarah Hess   May 22, 2013 at 3:01 pm

    I agree with you Kevin as far as being at a AA or NA meeting and seeing one of my clients, i feel it not only improves the credibility of the counselor with their clients it also can enhance the counselor/client relationship. i feel self disclosure to clients is very important, it can help put the client at ease especially for new members to group settings as well as individual counseling sessions So in my opinion seeing a client at a 12-step meeting can be very beneficial to both client and counselor.

  6. James Johnson Jr   May 21, 2013 at 11:57 am

    This is very relevant subject and I have what I hope is not a unique observation. “The Profession” is always quite verbal about “it’s a disease…” “It’s a disease…” Well if it’s a disease in the case of counselor relapse we don’t treat it like a disease. They are often ostracized and immediately fire, lose their license, their livelihood. How is that treating it like a disease?
    I have plenty of examples: If a psychiatric nurse is hospitalized for suicidal ideation or even an attempt they do not lose their jobs or license. Would a diabetes professional lose their right to practice if they ended up in the hospital because they did not take care of themselves?
    The profession often seems hypocritical and antiquated, still stuck in “AA” thinking when it comes to abstinence.
    Don’t get me wrong if they are visibly impaired I know they cannot see patients but they should be treated as anyone else. That is unless we are going to abandon the idea that addiction is a disease.
    Addiction is the only health condition that lends itself to legislation about the practitioners health condition (please correct me if I missed something).
    We should think about it.

    • Kevin Norton, MSW, RCSWI   May 21, 2013 at 7:43 pm

      Very insightful observation(s) James. Before making a more thorough reply, I am going to take your advice and THINK ABOUT IT some more. Your comments are extremely thoughtful and go right to the heart of this topic. Thanks, you’ve given me a lot to think about!

    • Kevin Norton, MSW, RCSWI   May 22, 2013 at 10:47 am

      Ok James, I took some time to ponder over your insightful and well-articulated points, and have found myself disappointed with my conclusions. Sadly, the social implications of your premise extend far beyond the scope of “counselor relapse.” If the current paradigm declares addiction to be a disease, why would this designation not apply to addiction therapists? And, from a broader perspective, is social perception (and prejudice) of persons who suffer from addiction and related co-occurring disorders in line with the current paradigm? The question, of course, is rhetorical. The stigma of addiction remains stronger and more pervasive than ever. While AA (and NA) remains one of the most valuable resources for helping great numbers of individuals achieve and maintain sobriety, its zero-tolerance principles have come into conflict with modern interventions which incorporate harm-reduction and substitution models of therapy.
      Political correctness, whether masking deep-rooted and underlying atitudes toward addiction, racism, socialism and gender equality, just to name a few, keeps us unable to have serious discussions which include alternative and creative options for dealing with some of our most insidious maladies. My experience is that addiction professionals (especially those who have experienced addiction personally and are in recovery themselves), in general, exist in public perception down alongside our clients toward the bottom of the food chain, regardless of how many lives we improve or literally help save.

  7. Jose Martinez   May 20, 2013 at 2:24 pm

    I as a counselor continue to go to 12 step meetings only I go to online meetings. I also do not have a problem in self disclosing to clients of course there are limits to how much and what I will disclose. I disclose enough so that clients know that I have been where they are at and i have been where they may end up.I know if I have a “slip” that there is something that i have not worked on enough or stopped working on, if I were to “relapse’ I have no choice but to stop counseling because I would be living a lie and at some point I would do more harm to my clients then good and if I am not helping then I am hurting and they have gone to enough pain and suffering that I should add to it.

  8. Kevin Norton, MSW, RCSWI   May 20, 2013 at 11:02 am

    As a member of the “50 percent of the counselors, administrators, social workers, therapists, and others who help addicts achieve sobriety are recovering addicts themselves” group, I do not personally find the following scenario from the article a problem: “The challenges facing an individual who decides to make a career in substance abuse is that it is difficult for counselors to attend 12 steps meetings because they may ultimately find themselves sitting beside a past or current client. What would they say to a client in the room when they become a member of a recovery group?” When clients, past or current, wind up in the same AA meeting with me, I have found the experience to enhance and have a positive effect on the treatment process and therapeutic relationship. Clients see me as authentic, and unashamed of my status as a recovering alcoholic, lending more credence to our therapeutic interactions, and providing for them a positive role model. They see me as a “real person” as opposed to merely a counselor who often must speak in abstract terms about the disease of addiction. Additionally, my interaction with them at 12-step meetings allows me to more completely monitor their progress in a non-professional setting. I see no conflict; I see the potential for my increased effectiveness as a counselor.


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