21 April 2026
California Needs More Substance Use Disorder Counselors: ASCEND is Helping Build the Workforce
Substance Use Disorder (SUD) counselors play an essential role In providing support and treatment to Individuals diagnosed with a substance use disorder. And we need more of them–especially in California, where it’s estimated there’s a gap of thousands of couselors to meet a growing demand.
Enter the Advancing Substance Use Disorder Counselor Education and Development (ASCEND) program. Sponsored by California Department of Health Care Services, this offering was developed by UC San Diego Division of Extended Studies, in partnership with the Assembly Bill 2473 Stakeholder Advisory Group, to meet the new education requirements established by California Assembly Bill 2473.
Substance use disorder counselors support 48.4 million Americans living with substance use disorders. Despite growing demand—and the $520 billion annual cost of substance use disorders—the workforce still struggles to keep pace.
According to the U.S. Bureau of Labor Statistics, the field is projected to see 48,300 job openings annually over the next decade — representing 17% growth, much faster than the average for all occupations. Despite this growing demand, barriers such as education costs have left the workforce pipeline struggling to keep pace.
In California, the need is especially urgent. An estimated 2.7 million Californians meet the criteria for substance use disorder, yet only about one in 10 receive treatment. With approximately 8% of California's population battling substance dependence, the state is estimated to need thousands of additional qualified counselors to meet the growing demand for care.
"Substance use disorder counselors work in a variety of settings, including county behavioral health agencies, hospitals, and jails and prisons," said Laura Fandino, chief academic officer and director of science and sustainability programs at UC San Diego Division of Extended Studies.
Prior to the passage of California Assembly Bill 2473, aspiring substance use disorder counselors were only required to complete a nine-hour orientation before beginning their required supervised work experience. While the 3,000 hours of supervised practice provided valuable on-the-job training, the limited classroom instruction left many newly registered substance use disorder counselors without consistent foundational education.
Under Assembly Bill 2473, registered counselors must now complete 80-hours of foundational education within the first six months of registration and continuing education to maintain their credential. These 80 hours cover 12 core competencies:
- Diagnostic and Statistical Manual of Mental Disorders and diagnostic criteria
- American Society of Addiction Medicine criteria and levels of care
- Cultural responsiveness
- Case management and care coordination
- Electronic health records
- Medication-assisted treatment
- Clinical documentation
- Co-occurring conditions
- Confidentiality
- Relevant law and ethics
- Professional boundaries
- Behavioral health service delivery
Through this new competency-driven, 80-hour substance use disorder counselor training requirement, California-based counselors will be better equipped to fully treat their clients. The 12 competencies will help substance use disorder counselors provide more holistic care by examining the entirety of a client's health record to determine the best treatment and provide quality behavioral health services. Substance use disorder treatment often occurs alongside other mental health conditions, physical health conditions, and behavioral health issues, so this new training will equip counselors to identify each client's situation and effectively provide substance use disorder care to support them during their recovery journey.
"It's truly amazing to be able to gain a useful set of tools to help people get sober and stay sober," said Kyle Medrano, a recent graduate of the ASCEND program who is entering the career field after 30 years in the bartending industry.
The Advancing Substance Use Disorder Counselor Education and Development (ASCEND) program is sponsored by California Department of Health Care Services and developed by UC San Diego Division of Extended Studies in partnership with the Assembly Bill 2473 Stakeholder Advisory Group to meet the new education requirements established by Assembly Bill 2473.
The free, online training provides California residents with the 80 hours of foundational education required to begin their supervised practice hours. Delivered through a flexible, self-paced format, ASCEND is designed to expand access to high-quality training while helping to strengthen California's behavioral health workforce.
Strengthening the substance use disorder counseling workforce is essential to addressing one of California's most pressing public health challenges. Programs like ASCEND help expand access to training, support new counselors entering the field, and ultimately improve the quality of care available to Californians.
Learn more about the ASCEND program and upcoming training opportunities at extendedstudies.ucsd.edu/ASCEND.