Substance Misuse Worker

The Job and What's Involved

People who misuse drugs, alcohol and other harmful substances often require professional support to overcome their dependency. An essential part of the UK's healthcare, social care and criminal justice teams, substance misuse specialists work in a variety of roles, supporting both adults and young people. They may specialise in:

- Drug and alcohol testing
- Assessing the needs of individual clients
- Care planning and rehabilitation referral
- Education, advice, guidance and support
- Counselling and other psychological interventions
- Medical treatment and closely overseeing rehabilitation.

The duties of substance misuse workers can vary widely. For example:

Drop-in centre workers provide more immediate refuge, advice and on-going support. Some offer a needle exchange facility. They may also support clients with housing issues or welfare benefit claims.

Police custody referral workers explain the implications to offenders who test positive for drugs and other substances when arrested.

Nurses and doctors working in specialist clinics assess patient needs and their current health, make prescription recommendations and, if appropriate, refer them to other support facilities, including residential rehabilitation clinics.

Counsellors in rehabilitation units monitor client treatment and deliver group and one-to-one sessions, helping clients address physiological dependency.

Outreach workers visit substance users in rural, city and town locations, sometimes patrolling city streets or accompanying police. They may address immediate needs, such as finding temporary housing for homeless clients.

Youth workers provide a combination of education and emotional support to young people, who may be using substances themselves or are children of drug and alcohol using parents.

Substance misuse workers can also be employed within prison drug teams and community probation venues, such as hostels and housing associations. There is potential for all workers to be exposed to aggressive and uncooperative client behaviour.

Substance misuse professionals can work varied hours. Some work standard hours Monday to Friday. Others can work more irregular hours, including evenings and weekends. It is possible to work part time and on a job share basis. Volunteer positions are common.

Many jobs are community based. Some may be based in clinics, outreach venues, prisons and community sites. The work can involve travelling to various venues within a district, possibly visiting substance users in their homes. Some clients may be homeless or in temporary accommodation.

Starting salaries for substance misuse workers may be around £15,000 a year.

Getting Started with this Career Choice

There are between 20,000 and 30,000 people employed in the substance misuse field. Jobs exist with a variety of employers throughout the UK, including:

  • Prisons.
  • Voluntary drug and alcohol support organisations.
  • Charities that protect vulnerable people.
  • NHS trusts, hospitals, GP practices and specialist clinics.
  • Treatment units, including private and healthcare rehabilitation centres.
  • Housing agencies.
  • Local authority children's services departments.
  • Connexions partnerships.

Many transfer into this field from a variety of other professions including nursing, teaching, youth work, prison or probation services. Some substance misuse roles are restricted to particular professional groups. Only medical professionals are allowed to prescribe medication.

Some counselling and social care roles may require applicants to have the relevant professional qualifications, although it is possible for substance misuse workers to provide intervention support. Although many positions are open to candidates with no set qualifications or experience, a background in health, criminal justice or social care is a clear advantage.

All posts are usually subject to a Criminal Record Bureau check or Disclosure Scotland. Additional security checks may be required.

Jobs may be advertised in publications such as Drink and Drug News and websites such as Other vacancy sources include local authority and NHS trust websites, as well as national and regional newspapers.

Education and Training

Entry requirements vary between employers. Very few employers consider recruiting people under the age of 21 into unsupervised support roles.

Some employers look for candidates with experience of working with vulnerable people, youth work or as a volunteer. Studying counselling or an NVQ/SVQ in Health and Social Care (available at Levels 2, 3 and 4) may help applications, although candidates need to source a suitable work placement to gain a qualification.

One route into the substance misuse field for those over 18 is the Advanced Apprenticeship in Community Justice (Drug and Alcohol Pathway). Currently available only in England and Wales, it takes two years to complete and involves studying towards nationally recognised vocational qualifications. Apprentices must be employed for the full two years in a suitable setting.

Apprenticeships and Advanced Apprenticeships provide structured training with an employer. As an apprentice you must be paid at least £95 per week; you may well be paid more. A recent survey found that the average wage for apprentices was £170 a week. Your pay will depend on the sector in which you work, your age, the area where you live and the stage at which you have arrived in the Apprenticeship.

Entry to Employment (e2e) can help to prepare those who are not yet ready for an Apprenticeship. In addition, Young Apprenticeships may be available for 14- to 16-year-olds. More information is available from a Connexions personal adviser or at

There are different arrangements for Apprenticeships in Scotland, Wales and Northern Ireland.

For further information visit My World of Work, Careers Wales; and for Northern Ireland contact

Entrants wishing to work as a substance misuse worker in specialist roles may need job specific experience and the relevant professional qualifications. See Counsellor, Nurse, Social Worker and Youth and Community Worker for more information.

A Few More Exams You Might Need

Most employers offer a comprehensive induction programme. New entrants are usually closely supervised. Some organisations operate mentoring programmes.

Employers usually encourage further development, offering access to training to enhance, develop and maintain knowledge and skills. Aside from job specific professional qualifications, there are opportunities to complete a range of relevant vocational qualifications in the substance misuse field.

Relevant courses include:

  • NVQ/SVQ at Levels 2, 3 and 4 in Health and Social Care
    Award in working with substance misuse.
  • NVQ/SVQ at Level 3 and 4 Community Justice: Work with Offending Behaviour.
  • Open University/FDAP Professional Award for Drug and Alcohol Practitioners.
  • Open University/FDAP Professional Development Awards.
  • Open University/FDAP Professional Award for Managers of Drug and Alcohol Practitioners.

Continuing Professional Development is essential for maintaining skills and advancement.

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Skills and Personal Qualities Needed

A substance misuse worker should have:

  • Excellent communication and observation skills.
  • The ability to develop positive relationships with clients from all backgrounds.
  • Belief in each clients' ability to make positive changes.
  • Patience and empathy.
  • A non-judgemental manner.
  • A mature, well-balanced temperament.
  • The ability to assess and reduce risks to their personal safety and risks to other parties.
  • Discretion, maintaining professional boundaries.
  • Confidence to work independently and in a team environment.
  • Good report writing skills.
  • Good organisational skills to manage their workload.

Your Long Term Prospects

There are many opportunities in this area, as there has been a large increase in the number of substance misuse workers and a growth in local authority drug and alcohol action teams. Experienced substance misuse workers may be able to progress by moving into a supervisory or management role.

Some may choose to specialise further, for example working with young people or adults.

Get Further Information

Care Council for Wales (CCW),
South Gate House, Wood Street,
Cardiff CF10 1EW
Tel: 029 2022 6257

Federation of Drug & Alcohol Professionals (FDAP),
Unit 84, 95 Wilton Road,
London SW1V 1BZ
Tel: 0870 763 6139

National Treatment Agency
for Substance Misuse

Northern Ireland Social Care Council (NISCC),
7th Floor, Millennium House,
19-25 Great Victoria Street,
Belfast BT2 7AQ
Tel: 02890 417600

Scottish Social Services Council (SSSC),
Compass House, 11 Riverside Drive,
Dundee DD1 4NY
Tel: 0845 6030 891

Skills for Health, 2nd Floor,
Goldsmiths House, Broad Plain,
Bristol BS2 0JP
Health learning and skills advice line -
Tel: 08000 150 850

Skills for Justice,
9-11 Riverside Court,
Don Road, Sheffield S9 2TJ
Tel: 0114 261 1499

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