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Vital Signs: Taking the Pulse of the Addiction Treatment Profession

ATTC Network Workforce Study

In response to the emerging shortages of qualified addiction treatment and recovery services professionals, SAMHSA/CSAT instructed the ATTC National Office to lead the ATTC Network in the development and implementation of a national addiction treatment workforce data collection effort. 

Data was collected from two main sources:

1. A random sample of clinical directors or a designated direct care supervisor from facilities listed in the I-SATS database. 

2. A national sample of key thought leaders, identified by CSAT in conjunction with the ATTC network, in the substance use disorders treatment field. 

To download the full report on this study please click here.

A summary of the national findings is desribed below and is available to download as an excutive summary by clicking here.

A recorded presentation of the findings is accessible through the ATTC Network's Vimeo page by clicking here.



What are the basic demographics of the workforce?

  • Clinical directors in a nationally representative sample of facilities included in the I-SATS are predominantly white, middle-aged women with no military affiliation. These clinical directors are educated professionals who began their career in the SUD treatment field and have, on average, 17 years of experience in the field. About one third identify as being in recovery from a SUD.
  • Direct care staff members supervised by the clinical director respondents are also mostly white women with no military affiliation. Direct care staff members tend to be younger, on average, than clinical directors and have less years of experience at their current places of employment. Direct care staff members are also educated professionals. The highest degree status of direct care staff that was most commonly reported was a Master’s degree. Furthermore, the majority of direct care staff is currently licensed/certified or is seeking licensure/certification. Slightly less than one third of direct care staff are in recovery from SUDs as estimated by their clinical directors.
  • Almost one third of clinical directors are only somewhat proficient in web-based technologies, and almost half of SUD facilities do not have an electronic health record system in place.

What are the common strategies and methodologies to prepare, retain, and maintain the workforce?

  • SUD treatment facilities most commonly offer professional development for staff through new employee orientation, ongoing training, and direct supervision. When facilities do not provide for staff training and continuing education, the most commonly reported reason was a lack of funds. Nevertheless, the majority of survey respondents reported that staff at their facility had been trained in both culturally responsive and gender responsive SUD treatment. These findings were substantiated by interviews with clinical directors who reported that limited funding can often hinder a facility’s ability to provide ongoing education.
  • Recruitment continues to be a significant issue for many SUD treatment facilities. According to survey respondents, facilities primarily use web-based classified advertisements to recruit new staff and almost half of facilities have difficulty filling open positions, mostly due to an insufficient number of applicants who meet minimum qualifications. Through interviews, clinical directors emphasized the positive effects that developing relationships with colleges and universities can have on recruiting qualified professionals.
  • Retention also continues to be an ongoing challenge for SUD treatment facilities. According to survey respondents, the average staff turnover rate is 18.5%. Some of the most successful retention strategies employed by treatment facilities include the provision of healthcare benefits, implementation of a supportive culture, and access to ongoing training. Satisfaction with salary level, which is often cited as a factor in employee retention, varied among clinical directors. Half of respondents reported satisfaction with their income while half reported being unsatisfied.

What are the anticipated workforce development needs in the next five years?

  • More SUD treatment professionals will be needed in the next five years. While there is limited data to track the projected growth, retraction, and composition of the SUD workforce over the next five years, it is anticipated that the implementation of the Affordable Care Act in 2014 will result in a significant increase in the need for professionals who are able to care for individuals with SUDs in a variety of managed healthcare settings.
  • Applicants for open positions in SUD treatment facilities need to be better qualified. Clinical directors reported that their facilities face significant challenges in filling open positions due to a lack of qualified applicants.
  • The workforce needs to be diversified. The current workforce is predominantly white, female, and over the age of 45. Younger professionals from diverse racial/ethnic backgrounds who are able to work in integrated settings will be needed.
  • In addition, six mega-trends will affect the SUD treatment workforce in the next five years, as follows:
    1. Macro-level changes to healthcare and treatment delivery;
    2. A push for enhanced pre-service training, professional development, and uniform credentialing;
    3. Increased use of evidence-based and recovery-oriented methods of SUD treatment targeted for a changing client population and emerging drugs of abuse;
    4. Workforce recruitment and retention efforts;
    5. The recognition of substance use disorders as a valid health issue;
    6. Implementation and use of health information technology.


For more information, contact Olivia Ryan, Program Manager – Research, ATTC National Office,




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