Substance Abuse Nurse Career Overview
What Is a Substance Abuse Nurse?
A substance abuse nurse cares for individuals in various settings who have substance use disorders (SUDs). A substance abuse nurse may also be referred to as an addiction nurse. For the purposes of this guide, the two terms will be used interchangeably.
The American Society of Addiction Medicine (ASAM) defines addiction as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”
How Long to Become?
2-4 Years
Job Outlook
6% increase from 2022 to 2032
Average Salary
$94,480
What Does a Substance Abuse Nurse Do?
Substance abuse nurses are typically registered nurses (RNs) and may also be advanced practice registered nurses (APRNs), such as nurse practitioners (NPs).
The substance abuse nurse’s credentials and state practice laws determine the scope of practice permitted. The setting in which care is provided also influences a substance abuse nurse’s duties.
Generally, the duties of a substance abuse nurse may include:
- Assessing and monitoring the patient’s status
- Documenting the patient’s medical history and symptoms in the patient’s record
- Creating and updating the patient’s plan of care
- Collaborating with the patient
- Administering medications and treatments
- Performing various procedures
- Operating and monitoring medical equipment
- Teaching patients
In Addiction Nursing Competencies: A Comprehensive Toolkit for the Addictions Nurse, the many specific duties of a substance abuse nurse can be found within the Assessment, Foundations, and Skills Checklist sections.
Such duties are described within the broad areas of:
- Safety
- Quality improvement
- Evidence-based practices
- Patient-centered care
- Professionalism
- Leadership
- Systems-based practices
- Informatics and technology
- Communication
- Teamwork and collaboration
For example, here’s a paraphrased list from the Skills Checklist section that provides a sampling of some of the duties of a substance abuse nurse:
- Performs substance use history collection
- Obtains urine specimens
- Addresses recurrent use
- Understands and educates about opioid overdose prevention and reversal — and intervenes appropriately, when needed
- Provides “safer consumption education”
- Provides “safer sex education” and conducts testing
- Understands how to appropriately de-escalate an agitated patient — and intervenes appropriately, when needed
- Conducts a “warm hand-off” between care settings
Additional skills on the list include the appropriate administration and monitoring of buprenorphine, naltrexone, and methadone — as well as managing patients who are in acute withdrawal and providing appropriate pain management for patients with SUDs.
Where Do Substance Abuse Nurses Work?
As the American Society of Addiction Nursing (ASAN) notes, substance abuse nurses may work in a variety of areas as they care for patients, clients, and members of the community. Such settings may include both inpatient and outpatient facilities, public health organizations, and academic institutions.
How Much Does a Substance Abuse Nurse Make Per Year?
According to salary data from the Bureau of Labor Statistics (BLS), the average annual wage for registered nurses is $94,480, with half of nurses earning more than that amount and half earning less. Wages of nurses in the lowest 10 percent average $63,720. Wages of nurses in the highest 10 percent average $132,680.
The BLS does not provide a pay breakdown according to specialty but does provide median annual wages for registered nurses according to general categories of work location. Since most substance abuse nurses care for patients in inpatient and outpatient facilities, public health organizations, and academic institutions, the following median annual salaries may apply:
- Psychiatric and Substance Abuse Hospitals: $94,440
- Outpatient Care Centers: $102,640
- Offices of Physicians: $83,110
- General Medical and Surgical Hospitals: $96,830
The salary of a substance abuse nurse is also influenced by factors such as education, experience, and geographical region of the country.
Annual Mean Wage of Registered Nurses, by State
- $69,030 - $80,760
- $81,390 - $86,210
- $87,220 - $94,670
- $94,830 - $137,690
Blank areas indicate data not available
How Do I Become a Substance Abuse Nurse?
The path to becoming a substance abuse nurse depends upon the credentials involved. Substance abuse nurses who are registered nurses must attend an accredited nursing program that leads to a Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN).
RNs must also be licensed in the state in which they work. Licensure can be obtained by passing the National Council Licensure Examination (NCLEX-RN) and meeting any additional requirements of the state’s board of nursing. The National Council of State Boards of Nursing (NCSBN) offers a resource to determine state-based nursing licensure requirements.
A substance abuse nurse can also obtain specialty certification by meeting eligibility requirements and taking one of two exams provided by the Addictions Nursing Certification Board (ANCB):
CARN – Candidates must:
- Hold a current license as an RN
- Have 30 hours of continuing education credits
- Provide evidence of 2,000 hours with experience related to addictions nursing within the last 3 years
CARN-AP — Candidates must:
- Hold a license as an RN
- Hold a master’s degree or higher in nursing
- Have 45 hours of continuing education
- Verify a minimum of 500 supervised hours in addictions and 1,500 hours of nursing experience in addiction as an Advanced Practice Nurse (APN) within the last 3 years practice in addictions
What Are the Benefits of Being a Substance Abuse Nurse?
Substance abuse nurses can enjoy many benefits, including the ability to work in a variety of settings and potentially earn a great wage.
But more importantly, substance abuse nurses can benefit from helping individuals overcome the grip of SUDs on their lives.
In January of 2023, the U.S. Department of Health and Human Services (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of its annual National Survey on Drug Use and Health (NSDUH), which “shows how people living in America reported about their experience with mental health conditions, substance use, and pursuit of treatment in 2021.”
“Every year since 1971, this survey has given us a window into our nation’s mental health and substance use challenges and 2021 was no different. As the findings make clear, millions of Americans young and old faced mental health and substance use challenges – sometimes both at once – during the second year of the pandemic,” said HHS Secretary Xavier Becerra in a statement announcing the results.
Since that time, an opioid epidemic has progressively gripped our nation.
Such dynamics demonstrate the need for substance abuse nurses, who can serve as beacons of hope for those who may feel hopeless about their situations. By providing compassionate care and expertise, substance abuse nurses can experience the benefits associated with helping others to help themselves.
Additional Resources About Becoming a Substance Abuse Nurse
To learn more about becoming a substance abuse nurse, check out these additional resources:
