What Drives Staffing Levels for Substance-Use Disorder (SUD) Services in New York State?

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November 29, 2021

Luke Nasta
Patricia Strach

Executive Summary

Unintentional overdose deaths from drug use have risen dramatically over the past two decades, fueled initially by prescription opioids. In the past year alone, the United States recorded nearly 100,000 drug overdose deaths, an increase of 30 percent compared to 2019. Yet, the United States does not have the substance-use disorder (SUD) workforce to address the problem. Over the past decade, a handful of studies have explored the number of professionals required to address this public health crisis at the national level and found shortages.

To better understand the state of the SUD workforce in New York State, we surveyed Alcoholism and Substance Abuse Providers of New York State (ASAP), the Coalition of Medication-Assisted Treatment Providers and Advocates of New York State (COMPA), and the New York State Office of Addiction Supports and Services (OASAS) licensed counseling service providers’ administrators and their direct services staff (counselors) to determine what the workforce looks like in New York State. The findings show that the current workforce is too small to meet the services demand brought about by the opioid-fueled drug overdose epidemic. Key findings of the study include:

  • Staff turnover rates are consistent with national estimates of turnover in the health care and social assistance fields. Administrators report that 44 percent of their counseling staff and 38 percent of support staff turn over every one to three years.
  • SUD professionals work in the field for extended periods of time. Almost half (47 percent) have worked in SUD services for more than seven years. Twenty-seven percent of counselors reported having worked one to three years in SUD services; 15 percent, three to five years; and 12 percent, five to seven years.
  • Nearly all (93 percent) of counselors list “helping others” as something they like about their jobs and a majority enjoy that their job is challenging (51 percent) and collaborative (55 percent). Further, of the job attributes we inquired about, work/life balance was the only attribute that a majority (58 percent) found frustrating.
  • An overwhelming majority of counselors surveyed (80 percent) would pursue higher education if they received tuition reimbursement and slightly more (82 percent) would strive to achieve a higher degree if it would lead to greater compensation. This signals a strong willingness for SUD counselors to improve their skill set and stay with their employer if barriers to education were lowered or incentives increased.
  • Notably, 64 percent of administrators reported the need for more counselors and 59 percent specifically identified the need for trauma specialists. Counselors identified additional counselors (65 percent) and trauma specialists (72 percent) as the types of staff most needed. More than 40 percent identified that there is a need for both vocational/educational and housing specialists.

Read the full report here.