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How to Become an Addiction or Substance Abuse Nurse

Kristen Hamlin
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Updated November 23, 2022
Find out what an addiction nurse does, the pathway to becoming one, and salary potential.
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certification52% growth from 2020-2030Certified Addiction Registered Nurse
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Drug addiction is one of the most significant public health issues facing the U.S. today. The Substance Abuse and Mental Health Services Administration reports that 21.4% of people over age 12 had used illicit drugs within the past year — and when alcohol and tobacco are included, that number jumps to over 58% within the past month. Not everyone who uses drugs or alcohol becomes addicted, but more than 40 million people have a substance use disorder.

Becoming an addiction nurse offers the chance to help those living with substance misuse disorders and their loved ones enjoy a happier, healthier future. From medical care in an inpatient unit to counseling in an outpatient treatment center, addiction nurses can play a critical role in providing help.

Use this guide for insights into how to get into this satisfying nursing specialty.

What Is an Addiction or Substance Abuse Nurse?

Addiction and substance abuse nurses apply their knowledge of mental health and medicine to provide care for patients dealing with addiction to drugs or alcohol. Working in hospitals, community health centers, and mental health and rehabilitation facilities, these nurses evaluate and monitor patients, assist with care plans, and provide support.

Addiction and substance abuse registered nurses (RNs) need experience in mental health. This includes taking electives in those areas.

For nurses wishing to make a difference in the lives of individuals living with substance misuse issues and their families, this can be an ideal career path.

Steps to Becoming an Addiction or Substance Abuse Nurse

Becoming an addiction or substance abuse nurse requires completing several basic steps. Specific requirements for the role may vary by state and employer, but the general education and work experience are the same no matter where you wish to work.

  1. 1

    Earn an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) Degree.

    The first step to becoming an addiction or substance abuse nurse is earning a nursing degree. Both the two-year ADN and four-year BSN degrees prepare nurses for this role.

    To become a certified addiction registered nurse – advanced practice (CARN-AP), you need a minimum of a master of science in nursing (MSN) degree. Nurses who have earned an ADN can enroll in an RN-to-BSN or RN-to-MSN program to earn an advanced degree.

    Mental health electives are important for prospective addiction nurses.

  2. 2

    Pass the National Council Licensure Examination (NCLEX) to Receive RN Licensure

    Passing the NCLEX for RNs is required for an RN license. The test requires nursing school graduates to apply their knowledge to different cases.

  3. 3

    Gain Experience in Mental Health and Rehabilitation Nursing

    RNs can gain experience in many different work settings, including hospitals, treatment centers, mental health clinics, and psychiatric hospitals. Although some employers prefer candidates with prior nursing experience, entry-level addiction and substance abuse nursing positions are open to those with a valid license and relevant training or coursework.

    New RNs can also gain experience in substance abuse and addiction treatment by volunteering. Nonprofit organizations often need trained nurses to help provide support, education, and other services.

  4. 4

    Consider Becoming a Certified Addiction Registered Nurse

    Although board certification is optional, many employers prefer — and some require — nurses to have the CARN credential. Issued by the Addictions Nursing Certifications Board (ANCB), nurses must have at least 2,000 hours of experience in addiction and substance abuse nursing and 30 hours of related continuing education for nurses to qualify for the exam.

    Becoming board certified can validate a nurse’s knowledge and experience in the field.

Addiction or Substance Abuse Nurse Education

A valid RN license is required to work as an addiction or substance abuse nurse. The fastest educational path to becoming an RN is an ADN degree, but many employers prefer nurses with bachelor’s degrees.

ADN Degree

An ADN is the minimum degree required for NCLEX and RN license eligibility. The two-year program is the fastest path to beginning a nursing career. Although some employers will hire experienced ADN nurses for substance use positions, many prefer applicants with a BSN degree.

Nurses with an ADN can enroll in an RN-to-BSN degree bridge program to expand their career options.

  1. 1

    Admission Requirements

    High school diploma or GED certificate with a minimum 2.0 GPA; SAT or ACT scores; personal essay; recommendation letters; resume or curriculum vitae (CV); relevant volunteer experience preferred

  2. 2

    Program Curriculum

    Foundations of nursing; health assessments; microbiology and immunology; medical-surgical nursing; nursing for specific populations

  3. 3

    Time to Complete

    Two years

  4. 4

    Skills Learned

    Assessing patients; taking vital signs; caring for wounds; starting intravenous lines; charting; administering medication; providing patient education

BSN Degree

A BSN is a four-year nursing degree that combines the fundamentals of nursing practice with critical thinking and leadership skills. These skills can prepare nurses for administrative and management positions.

For substance abuse nurses, a BSN includes electives in mental health and other related topics that prepare nurses to practice in this area. Many employers prefer to hire nurses with four-year degrees.

  1. 1

    Admission Requirements

    High school diploma or GED certificate with a minimum 2.75 GPA; SAT or ACT scores; personal essay; recommendation letters; resume or CV; relevant volunteer experience preferred

  2. 2

    Program Curriculum

    Pharmacology; anatomy; pathophysiology; leadership and management; research and statistics; nursing informatics; nursing ethics; psychology

  3. 3

    Time to Complete

    Four years

  4. 4

    Skills Learned

    Hands-on patient care; nursing “soft skills” for leadership and management positions like communication, decision-making, and critical thinking for nurses

Addiction or Substance Abuse Nurse Licensure and Certification

An RN license is required to practice as an addiction or substance abuse nurse. Nurses are licensed by their state of residence. An ADN or a BSN and passing score on the NCLEX-RN are the minimum requirements. Individual states may have other requirements for licensure, including a background check.

Nursing licenses must be renewed according to state requirements and may require completing continuing education requirements.

The ANCB offers two certifications for addiction nurses: CARN and CARN-AP. Although not mandatory, many employers prefer them. They can demonstrate competence in the practice of substance abuse nursing.

RNs with an ADN or a BSN, 2,000 hours of experience, and 30 hours of continuing education are eligible for the CARN.

Working as an Addiction or Substance Abuse Nurse

The variety of potential employers, from public hospitals to private treatment centers, means that addiction and substance abuse nurses can typically find a wide array of entry-level positions. The different types of job settings also mean that job responsibilities and earning potential for addiction nurses vary.

According to data from Payscale, addiction nurses earn an average annual salary of $86,000. The average hourly wage is $36.63 as of June 2022. Nurses with bachelor’s degrees and certification, in particular the CARN-AP designation, have the potential for higher salaries.

Frequently Asked Questions About Becoming an Addiction or Substance Abuse Nurse


question-mark-circleHow many years does it take to become an addiction or substance abuse nurse?

It takes 2-4 years to become an addiction or substance abuse nurse depending on the educational path. Qualifying for the CARN credential takes around one year of full-time work as an RN. To maintain certification, nurses must log 60 hours of credit through continuing education, coursework, or volunteer service.

CARN recertification is valid for four years.

question-mark-circleWhat education and training options are available for substance abuse or addiction nurses?

Addiction nurses can expand their skill sets and knowledge through continuing education and training courses offered by professional organizations like the International Nurses Society on Addictions, American Society of Addiction Medicine, and the Substance Abuse and Mental Health Services Administration.

question-mark-circleWhat scholarships are available for addiction or substance abuse nurses?

Nurses applying for certification can apply for scholarships from the ANCB to cover the cost of the exam. Scholarships are awarded based on a short essay and letters of recommendation.

question-mark-circleWhat career advancement opportunities are available for addiction or substance abuse nurses?

Substance abuse and addiction nurses with an MSN can seek certification as a CARN-AP, in addition to an initial nurse practitioner certification. The CARN-AP certification further demonstrates expertise in addiction nursing.


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