Every month, more than ten percent of Americans twelve years of age and older use illicit drugs, says a 2016 CDC report. The substance abuse epidemic has been such a steady presence in this country that media outlets have mostly stopped covering it – unless there’s a new development or a lull in the news cycle. The only advantage to being so firmly established in this crisis is the wealth of knowledge, statistics and actionable evidence that social workers being trained in this area have access to.

Substance abuse social workers are a powerful weapon in the war on drugs on every “front” (prevention, treatment and follow-through). Since each case is unique, and since substance abuse social workers often work in tandem with substance abuse counselors, therapists and other professionals, the role of the substance abuse social worker is often poorly understood.

What Is a Substance Abuse Social Worker?

To best differentiate the role of a substance abuse social worker from the other professions in mention, it’s best to consider the “umbrella” of social work without the substance abuse angle for a moment. Social workers interact directly with clients or on behalf of organizations to:

      • Increase public access to important social services
      • Identify needy populations and develop approaches to serve them
      • Strengthen familial and societal support structures for individual clients
      • Mediate between clients and organizations (outreach, paperwork, etc.)
      • Campaign against discriminatory practices by organizations
      • Counsel clients in one-on-one settings

This list can vary based on context, and is by no means exhaustive, but these are at least a sample of the central tenets of social work. In the case of substance abuse, most of these duties translate directly. Substance abuse social workers increase their clients’ access to the services they need for recovery: counseling (though many social workers do the counseling themselves), financial support, detox center admittance, treatment programs, outpatient care, and much more.

This kind of social worker may work with crisis intervention groups to strengthen preventive initiatives and treatment protocols. Substance abuse social workers can also train others social workers, educators or counselors to skillfully apply their own interventions. They can work in conjunction with an inpatient facility care team, whether the patient was admitted for substance abuse or not. Depending on the social worker’s level of training and preferred area of employment, there are dozens and dozens of ways in which these professionals may be called upon.

In both the one-on-one scenario and from an organizational perspective, there are three basic steps that substance abuse social workers follow to address their clients’ needs: assessment, development of the care plan and follow-through.

Creating and Implementing Assessments

Not unlike medical staff at treatment and rehabilitation centers, the most important step in defining an appropriate set of treatment protocols is to assess the client’s (or population’s) substance abuse problem. Substance abuse social workers must think critically to develop assessment questions based on what they know – and don’t know – about the client or population.

      • How long has substance abuse been a problem?
      • How has it affected the client or population’s work functionality?
      • How has the abuse affected family and organizational support systems?
      • What motivates substance abuse in this individual or population? (Trauma, coping strategies, etc.)
      • Is substance abuse encouraged in the individual or population’s subculture/friend group?

Like before, this list is but a small sample of a real assessment in the field, which can vary greatly based on context. The premise, however, is the same: assess the client or population’s substance abuse behaviors and motivators to develop a targeted care plan. The care plan will consist of mutually agreed upon goals and milestones that are ideally developed with a client-centered mentality.

Developing Care Plans

The more autonomy a social worker has, the more control they will have over each client’s care plan. A substance abuse social worker who works in a standalone, outpatient facility, for example, will recommend whichever resources they can to comprehensively treat the client or patient’s substance abuse problem. This social worker can refer the client to addiction treatment centers of varying levels (inpatient, outpatient, consultation, etc.). It’s also common for a self-employed social worker to provide their own counseling and psychotherapy services.

When a substance abuse social worker is employed with an agency or other organization, like a rehab center, hospital or government wellness initiative, they often contribute to an existing treatment plan by recommending resources, counseling clients directly and developing assessments. On a broader scale, Master’s-level professionals especially can aid in research efforts. Correlative studies that examine the impact of certain socioeconomic markers on substance abuse tendencies, for example, are especially relevant to the substance abuse social worker’s efforts. However the substance abuse worker chooses to follow through with clients, it’s important to both reward progress and encourage further steps.

Following Through

Thanks to the state of American healthcare, increasing substance abuse rates (especially prescription opioids) and increasingly potent and prevalent pharmaceutical interventions, patients admitted to treatment centers and hospital centers tend to follow a certain rhythm. They are admitted, quickly stabilized, and discharged. Even if they have access to substance abuse counseling, it may be very short-lived because of the need for healthcare institutions to quickly process patients. It is now more imperative than ever for the substance abuse social worker, who often has a much smaller window of time than they would like, to follow-up with patients whenever possible.

Appropriate follow-up strategies can take several forms depending on the client and/or patient’s situation. If finding employment was one of the client’s goals, for example, the social worker may regularly contact new employers as a follow-up service, recommending strategies to manage any work-related issues that may surface as a result of the substance abuse problem. Substance abuse social workers can simply consult with clients on a regular basis

What Substance Abuse Social Workers Are Not

To avoid confusion, as substance abuse social workers are often mixed up with addiction counselors and therapists, understand that social workers generally have a broader scope of practice. They do counsel clients quite often, and they can even use the same methods (i.e., psychotherapy) as their above-mentioned counterparts, but they also act as advocates and educators. They are not only therapists, but all-around facilitators, which is why their responsibilities are sometimes hard to define. Substance abuse social workers can work for research groups, educational institutions, healthcare facilities and many other environments.

Since the role of the substance abuse social worker covers such a broad area, it’s more efficient to think of this position in terms of the clients’ needs instead of listing out specific job duties. From financial assistance to crisis intervention, if a substance abuse social worker doesn’t provide the service, they will likely be able to refer to someone who does.

Tim Kalantjankos

B.S. Sociology | University of Nebraska at Omaha

A.S. Physical Therapy | Clarkson College

September 2019

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