Every year on September 20, National Addiction Professionals Day provides an opportunity to recognize the professionals who work in addiction treatment, prevention, harm reduction, and recovery. Established in 1992, the observance highlights the contributions addiction professionals make throughout the behavioral health continuum of care. NAADAC describes these professionals as vital members of the health system whose work supports individuals, families, and communities affected by substance use and addiction.
For emerging mental health counselors, however, National Addiction Professionals Day should be more than an opportunity to recognize colleagues in another area of behavioral health. It is also an opportunity to consider how prepared we are to work alongside them. Mental health counseling and addiction treatment are sometimes discussed as though they are separate worlds. One clinician treats depression, anxiety, trauma, or relationship concerns, while someone else handles "the substance use." Real clients rarely organize their lives according to our professional specialties.
Substance use may intersect with trauma, anxiety, depression, grief, relationships, chronic pain, employment, family systems, housing, legal concerns, and physical health. For emerging therapists, developing at least foundational competence in substance use disorders and learning how to collaborate effectively with addiction professionals are therefore important parts of becoming a well-rounded mental health counselor.
Substance Use Will Walk Into Your Counseling Office
You do not have to work in an addiction treatment center to encounter substance use. A client seeking treatment for anxiety may also use alcohol every evening to manage distress. Someone presenting with depression may be using cannabis throughout the day. A client with trauma symptoms may use substances to avoid intrusive memories or emotional activation. Another client may be in recovery while seeking counseling for relationships, grief, identity, or another mental health concern.
This is one reason emerging counselors should resist thinking of substance use as a specialty topic that only matters if they plan to become addiction counselors. The overlap between mental health and substance use is substantial. According to the Substance Abuse and Mental Health Services Administration's 2025 National Survey on Drug Use and Health, approximately 18.5 million U.S. adults experienced both any mental illness and a substance use disorder during the previous year. Among these adults, about 42.6 percent received neither mental health nor substance use treatment. Among those who did receive at least one type of treatment, most received mental health treatment alone, while only 22.1 percent received both mental health and substance use treatment.
Those numbers should matter to emerging counselors because some of these individuals will enter mental health treatment first. We may be the professionals who have the opportunity to recognize that something else is happening.
Understanding Co-Occurring Disorders
SAMHSA defines co-occurring disorders as the coexistence of a mental health disorder and a substance use disorder. There is no single combination that constitutes a co-occurring disorder. A substance use disorder can occur alongside depression, anxiety disorders, post-traumatic stress disorder, bipolar disorder, schizophrenia, ADHD, or other mental health conditions.
The relationship between these concerns can also be complicated. SAMHSA notes that mental health problems may contribute to substance use, substances may produce or worsen mental health symptoms, and mental health and substance use disorders can share underlying vulnerabilities, including genetic factors and exposure to stress or trauma.
That complexity matters clinically.
If a client presents with anxiety, for example, we need to consider more than whether the symptoms meet criteria for an anxiety disorder. Substance use, intoxication, withdrawal, medications, medical conditions, trauma, and other factors may influence the presentation.
Likewise, it can be overly simplistic to assume that a client is merely "self-medicating." Substance use may serve several functions while also creating new problems of its own. Good clinical assessment requires curiosity about the entire person.
Mental Health Counselors Need to Become Comfortable Asking About Substance Use
For emerging therapists, asking clients about substance use can initially feel uncomfortable. There can be a temptation to ask a few intake questions, document "social alcohol use," and quickly return to the presenting concern. But meaningful assessment requires more than asking whether someone drinks or uses drugs.
What substances are being used? How frequently? In what quantities? In what situations? What function does the substance serve? Has use increased? Has the client attempted to reduce use? Has substance use affected relationships, employment, school, health, finances, or legal circumstances? Are there withdrawal concerns? Has anyone else expressed concern? How does the client understand their own relationship with the substance?
The purpose of these questions is not to catch clients doing something wrong. It is to understand their experience. A nonjudgmental approach becomes particularly important because stigma can make people reluctant to discuss substance use honestly. If clients believe disclosure will immediately result in judgment, labeling, or an ultimatum to stop using substances, they may simply stop telling us.
Collaboration Is Part of Competent Care
Recognizing a substance use concern does not mean every mental health counselor must independently provide specialized addiction treatment. It means we need to recognize the limits of our competence and know when collaboration, consultation, or referral is appropriate.
An addiction professional may bring specialized knowledge about withdrawal, levels of care, recovery supports, relapse prevention, harm reduction, medications for substance use disorders, treatment systems, and the behavioral patterns associated with addiction. A mental health counselor may simultaneously be addressing trauma, depression, anxiety, relationships, grief, or another co-occurring concern. When these professionals communicate appropriately and coordinate treatment, the client does not have to navigate two disconnected treatment worlds.
SAMHSA recommends integrated approaches to co-occurring mental health and substance use disorders. Its guidance describes integrated treatment as coordinating mental health and substance use interventions so that clients receive individualized services addressing both areas rather than having one concern treated while the other is ignored. SAMHSA identifies coordinated, co-located, and fully integrated models of care and reports that integrated treatment can improve outcomes and quality of life.
A recently published SAMHSA resource on integrated behavioral and physical health similarly emphasizes interdisciplinary teams, clear communication systems, and care coordination across providers. For an emerging therapist, collaboration is therefore not an admission that you do not know enough. It is often evidence that you understand enough to recognize when another professional belongs at the table.
The Importance of the "No Wrong Door" Philosophy
One of the most useful concepts for emerging counselors comes from SAMHSA's "no wrong door" approach. The basic principle is that an individual should be able to enter the behavioral health system through either mental health or substance use treatment and still have both areas appropriately identified and addressed. Someone entering mental health treatment should be screened for substance use disorders, and someone entering substance use treatment should be screened for mental health disorders.
Think about what this means from the client's perspective. A person experiencing depression and problematic alcohol use should not have to determine which problem is the "real" problem before receiving help. They should not be repeatedly redirected between systems while each provider says the other concern must be treated first. The person came for help. Our systems should be capable of responding to the person who actually arrived rather than the perfectly categorized client we might prefer to treat.
Learn From Addiction Professionals
Emerging therapists often focus heavily on learning from other mental health counselors. That makes sense, but it can unintentionally narrow professional development. Addiction professionals have much to teach the broader counseling community. They work extensively with motivation and ambivalence. They understand that change is rarely linear. They regularly encounter relapse, shame, family conflict, stigma, and complicated relationships between behavior and coping. They often work within interdisciplinary systems involving medical professionals, recovery communities, peer specialists, case managers, criminal justice systems, and families.
These are not lessons relevant only to addiction treatment. They are lessons about human behavior and change. An emerging counselor who learns from addiction professionals may become better equipped to sit with ambivalence instead of fighting it, understand continued use without reducing it to failure, recognize stages of readiness for change, and explore what a behavior is accomplishing before attempting to remove it.
SAMHSA's guidance for co-occurring disorders specifically highlights stage-based treatment and motivational approaches as important components of integrated care.
You Do Not Have to Become an Addiction Specialist, but You Cannot Ignore Addiction
There is an important distinction between foundational competence and specialized competence. Not every emerging mental health counselor will become an addiction professional. You may eventually specialize in trauma, couples counseling, children and adolescents, grief, eating disorders, or another area of practice. That does not eliminate the need to understand substance use. Substance use intersects with too many areas of mental health practice for counselors to simply decide that it belongs to someone else's profession.
You should understand the basic diagnostic characteristics of substance use disorders. You should know how to conduct appropriate screening and assessment within your competence. You should understand how substances can influence mental health symptoms. You should recognize when withdrawal or other medical concerns require a different level of care. You should understand the basics of harm reduction, recovery, relapse, and medications used in substance use treatment. Most importantly, you should know when you need an addiction professional involved.
Professional competence does not mean knowing everything. Sometimes competence means knowing who does.
Build Your Collaborative Network Before You Need It
Do not wait until you have a client in crisis to begin searching for addiction resources. During graduate school, practicum, internship, and the early years of professional practice, begin learning about the addiction treatment system in your community. Identify outpatient programs, residential programs, withdrawal management services, opioid treatment programs, recovery organizations, peer-support resources, and professionals with specialized addiction credentials. Talk with addiction professionals. Ask about their work. Attend trainings outside your primary area of interest. Learn how referrals actually work rather than simply knowing the name of a treatment center.
Understanding the continuum of addiction services will make you more useful when a client needs something beyond what you can provide. It will also help you avoid the dreaded clinical referral: "I think you need more specialized treatment. Here's a phone number I found five minutes ago."
We can do better than that.
A National Addiction Professionals Day Challenge for Emerging Therapists
This National Addiction Professionals Day, I want to challenge emerging counselors to do something beyond simply acknowledging the day on social media. Identify one addiction professional, treatment program, or recovery organization in your community and learn about what they actually do. Find out which populations they serve. Learn what levels of care they provide. Ask what makes an appropriate referral. Explore what services they offer for individuals with co-occurring disorders. If appropriate, introduce yourself and begin building a professional connection. Then take an honest look at your own developing competence.
How comfortable are you assessing substance use? Could you recognize the signs of a substance use disorder within a complicated mental health presentation? Do you understand harm reduction? Could you explain the difference between physical dependence and a substance use disorder? Do you know when withdrawal could become medically dangerous? Do you understand the role of medications in addiction treatment? You do not need to master all of this tomorrow. You do need to recognize that it belongs somewhere in your development as a mental health professional.
Closing Thoughts
National Addiction Professionals Day is an opportunity to recognize professionals doing extraordinarily important work. Since 1992, the observance has highlighted those working across addiction treatment, prevention, harm reduction, and recovery.
For emerging mental health counselors, it can also serve as a reminder that behavioral health care works best when we stop building artificial walls between mental health and substance use. Our clients do not arrive divided into specialties. They arrive as people.
They may bring anxiety and alcohol use. Trauma and opioid use. Depression and cannabis use. Recovery and grief. Substance use and relationship problems. Sometimes they bring all of these at once. You do not have to become an expert in every area they bring through the door. But you should become the kind of counselor who recognizes what you do not know, understands when another professional's expertise is needed, and values collaboration enough to invite that professional into the client's continuum of care.
So, on National Addiction Professionals Day, celebrate the addiction professionals in your community.
Then get to know them.
You will almost certainly need each other.
References
NAADAC, the Association for Addiction Professionals. (n.d.). National Addiction Professionals Day. National Addiction Professionals Day
Substance Abuse and Mental Health Services Administration. (2020). Substance use disorder treatment for people with co-occurring disorders (Treatment Improvement Protocol 42). SAMHSA TIP 42
Substance Abuse and Mental Health Services Administration. (2025). Screening and treatment of co-occurring disorders. SAMHSA Co-Occurring Disorders Resources
Substance Abuse and Mental Health Services Administration. (2026). Key substance use and mental health indicators in the United States: Results from the 2025 National Survey on Drug Use and Health. 2025 National Survey on Drug Use and Health
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