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Why Is There A Workforce Development Crisis?

In 2004, over 23 million Americans age 12 and older needed specialty treatment for alcohol or illicit drug problems. Of those in need only 10 percent received treatment at a specialty facility (NSDUH, 2005). There are a number of factors that contribute to low treatment participation rates. One of the most fundamental is the lack of an adequate human infrastructure to support current and future demands for treatment.
-- Strengthening Professional Identity: Challenges of the Addictions Treatment Workforce

Half of substance use disorder treatment professionals are female (51%), whereas 68% of the clients they serve are male.

The majority (85%) of treatment professionals are White, whereas only 56% of all clients are White.

Mulvey, K. Hubbard S., & Hayashi, S. (2003) “A National Study of the Substance Abuse Treatment Workforce.” Journal of Substance Abuse Treatment. 24: 51-57.

Our nation is facing a workforce development crisis in the addictions treatment field because of the many complicated and interconnected issues surrounding addictions treatment. Low wages, high turnover, a shortage of workers, insufficient professional development and stigma all currently contribute to this crisis. In addition, the workforce is being challenged with the demand for increased accountability, limited access to information technology and the need to rapidly incorporate scientific advances into the treatment process.17

A sound infrastructure must be in place to ensure the presence of a skilled workforce ready to meet the needs of those requiring alcohol or illicit drug treatment. Presently this strained and interconnected system is confronted with:

• Staff shortages
  The addictions treatment capacity is insufficient and therefore, inadequate to serve those in need. Compounding this issue is the retirement of addiction leaders.
   
• High Turnover
  Organizations are in a constant state of recruitment.
  
  
• Low salaries and minimal benefits
  Johnson, Knudsen & Roman (2002) reported that the average counselor salaries were low and only increased from $29,767 to $34,125 in the decade from 1992-2002, or about 2 percent a year.18 Low salaries are a barrier to recruitment.
  
  
• High Workloads 
  Staff shortages are contributing to the high workload.
  
  
• No uniform educational standards and no defined career paths
  Training programs preparing substance abuse prevention and treatment specialists lack uniform standards.19
   
• Stigma
  Addictions treatment struggles to be recognized as a field providing vital health care for a life-threatening chronic disorder. The negative perceptions attached to addictions are detrimental to the treatment organization’s recruitment and retention efforts.20
  
  
• Inadequate incentives
  There are few incentives offered to those considering entering the addictions treatment field.21
  
  
• Lack of resources and professional development opportunities
  More than 20 percent of early career members had little or no access to instructional materials or currently published literature.22
  
  
• Discrepancies between gender, age, and race of workforce compared to clients
  Differences between the practitioner and client may impact treatment outcomes.23
  
  
• Insufficient funding
  Providers often do not have the infrastructure to prioritize training, provide regular salary increases and make technology improvements, much less expand service provision and implement evidence-based practices.24
  
  
• Undefined Career paths
  Career paths that incorporate core competencies provide credibility to the field, and professional development and advancement opportunities. Career paths also support retention efforts and help individuals progress to leadership positions.25

By 2010, the demand for addiction professionals and licensed treatment staff with graduate-level degrees is projected to increase by 35 percent.26 Today’s workforce is faced with increasingly complex cases requiring a high degree of skill and professional training. Thirty years ago individuals provided counseling services with only minimal formal training. In contrast, credentialing bodies now exist in every state, and a college degree is the norm rather than the exception. Drug use patterns and subsequent treatment needs have substantially changed. Complex conditions such as co-occurring mental health and substance use disorders, co-morbid medical conditions, and criminal justice involvement, have placed exceptional demands on the workforce. These circumstances require a highly developed, multi-disciplinary approach involving several systems of care.27

Even as the workforce treatment system struggles, there are opportunities for significant reform. Click here to learn what ATTC Network’s role is in Workforce Development.