Substance abuse counselor sees need for services grow

In her 20 years as a substance abuse counselor, Dot Duda treats major addictions – drugs, gambling, alcohol – and has seen it all, from the 14-year-old glue sniffer to the 70-something retiree who mixes alcohol and meds. And with the failing economy, Duda, who heads up the Prevention and Recovery Center at Mount Auburn Hospital, sees more and more people coming in after losing their job and turning to drugs or booze for relief. “We do not lack for patients, that’s for sure,” says Duda, who is a licensed mental health counselor as well as marriage and family counselor.

On a typical day, almost anyone can walk in the door, from a detox referral to an intoxicated man just off the street. “A former patient might tell someone in AA about the program, or it could be a family member seeking help with a loved one,” says Duda. “You’ve heard it said before, but it’s true: an alcoholic doesn’t necessarily mean someone who is homeless. They can be well-educated and have good jobs, but still have a drinking problem.”

Duda says her role as a therapist “to be a listening ear, and educate and guide clients.” After an initial intake appointment, treatment recommendations can range from support groups, medication evaluation, individual counseling or referrals to the inpatient psychiatric unit. “We have to use whatever techniques we know, since there is not one particular approach to treating all individuals,” says Duda.

Substance abuse costs the nation more than $84 billion a year, with alcohol and drug addiction taking a toll on worker productivity, healthcare expenditures and deadly accidents and crime. Employment of substance abuse counselors is expected to grow 34 percent, among the fastest growing careers.

Q: Give us an example of a patient who you’ve helped recently.
A: One young woman came to me who had a history of serious trauma as a child. She was addicted to heroin but is now working really hard at staying clean and is fighting to get her child back. She’s being treated for depression as well.

Q: What are rewards and frustrations of your job?
A: It’s great to work with folks and see the changes they can make to improve their life. On the other hand, it’s frustrating when people need detox and can’t get in to get help because they have no health insurance. Access to free beds is difficult and one of the most frustrating pieces for me.

Q: What qualifications do you need to be a substance abuse counselor?
A: Most jobs require a master’s degree in social work, although you can enter the field with only a bachelor’s degree. To become a licensed social worker, you need to pass an exam and have a certain number of hours of supervised clinical work.

Q: What are some misconceptions about your profession?
A: There are some people who still believe that overcoming addictions is about willpower, rather than a chronic disease. I compare it to being a diabetic and not sticking to a diet and still eating candy, sugar, or cake – things they know they shouldn’t be consuming. An addict is similar to this in many ways.

Q: Your job must be stressful. How do you deal with it?
A: I used to worry and be concerned about my patients. You wonder, ‘Did I do the right thing? Was there a better way to handle that?’ But after a while you need to walk out and learn to be a mother and wife and not bring your work home with you.