How to Become a Substance Misuse Nurse

The United States is in the midst of an opioid crisis and needs well-trained healthcare professionals. Learn how to become a substance misuse nurse.

portrait of Emily Gillespie-Lord
by Emily Gillespie-Lord

Published August 17, 2022

Reviewed by Brandy Gleason, MSN, MHA, BC-NC

Our Review Network

BestColleges is committed to delivering content that is objective and accurate. We have built a network of industry professionals across healthcare and education to review our content and ensure we are providing the best information to our readers.

With their first-hand industry experience, our reviewers provide an extra step in our editing process. These experts:

  • Suggest changes to inaccurate or misleading information.
  • Provide specific, corrective feedback.
  • Identify critical information that writers may have missed.

Our growing Review Network currently consists of professionals in fields like business, nursing, social work, and other subject-specific industries; professionals in higher education areas such as college counseling and financial aid; and anti-bias reviewers.

Reviewers typically work full time in their industry profession and review content for BestColleges as a side project. Our reviewers are members of the Red Ventures Education Freelance Review Network and are paid for their contributions.

See a full list of our Review Network contributors.

Edited by Taylor Gadsden
Share this Article
How to Become a Substance Misuse Nurse
Image Credit: bymuratdeniz / E+ / Getty Images

The United States is in the midst of a health crisis. According to the Center for Disease Control, more than 263,000 people have died due to prescription opioid overdose since 1999. Substance misuse treatment is a team effort between the patient and their health team. A substance misuse and addiction nurse must be patient, understanding, and able to help without placing any guilt or shame on their patients.

Nurses are responsible for monitoring patients and evaluating their progress throughout treatment. All nursing careers begin with nursing school, often followed by continuing education and specialty certifications. Substance misuse nurses make similar salaries to nurses in other areas of care. is an advertising-supported site. Featured or trusted partner programs and all school search, finder, or match results are for schools that compensate us. This compensation does not influence our school rankings, resource guides, or other editorially-independent information published on this site.

Ready to start your journey?

What Does a Substance Misuse Nurse Do?

A substance misuse nurse, sometimes called an addiction nurse, assists in the treatment of patients who suffer from addiction. This ranges from bedside care, administering medication, and emergency intervention to assisting in treatment plans and patient advocacy.

All nursing careers begin in nursing school. As a nurse furthers their education and earns higher degrees, their level of patient responsibility grows. For example, a registered nurse (RN) can administer medications, but a nurse practitioner (NP) can prescribe medications and create treatment plans for addiction recovery.

Substance Misuse Nurse Responsibilities

Substance Misuse Nurse Not for You? Check Out These Related Careers.

Nursing Careers Health Services Careers Healthcare Careers

What Are the Steps to Become a Substance Misuse Nurse?

To begin work in addiction nursing, you must first complete the basic education requirements, become licensed or registered, then land a job in a hospital or clinic. Some degree programs can be completed online.

Step 1: Earn an ADN or BSN

How do you become a licensed substance misuse nurse? While some nurses begin their careers by finishing a licensed practical nursing program (LPN), many others earn their associate degree in nursing (ADN) or a bachelor's degree in nursing (BSN). A career counselor can help you decide where to begin.

In most cases, there is no specialized degree to become a substance misuse nurse. Bachelor's degree programs do offer some specialty nursing courses. Master's degree in nursing programs may provide the opportunity to focus on a specialty. In all programs, nursing students study anatomy and physiology, as well as chemistry and other medicine-related courses. Students also learn soft skills that are important in a nursing career.

The average cost of an ADN and BSN is dependent on the program and the college or university. Yearly tuition at a public, two-year college cost an average of $3,501 in the 2020-21 academic year, according to the National Center for Education Statistics (NCES).

Step 2: Pass the NCLEX

How do you get an addiction nursing license? All ADNs and RNs must pass the National Council Licensure Examination (NCLEX) before they are allowed to practice and be considered licensed. The NCLEX is an exam that tests nursing students' knowledge to ensure they can practice safely. You have five hours to complete anywhere from 60 to 145 questions.

Tests in nursing school are knowledge-based, while the NCLEX is application-based. You will be tested on how well you can use what you learned in nursing school. Students can prepare for the NCLEX through practice exams.

Scoring for the NCLEX is based on the number of times you answer a question correctly while taking the difficulty of the question into account. The NCLEX testing system gives out more difficult questions when you answer correctly.

Step 3: Get a Job in a Substance Misuse Setting

Nurses can begin working in substance misuse immediately after graduating from nursing school and passing the NCLEX. A substance misuse nurse will learn general medicine, pain management, and mental health care.

Registered nurses made an average median salary of $77,600 as of May 2021, according to the Bureau of Labor Statistics. This is not taking any additional certifications into consideration.

Step 4: Apply for Certification

The Addiction Nursing Certification Board (ANCB) offers certification to RNs and advanced practice nurses (APRN) who work in substance misuse. Eligibility requirements include a minimum number of 2,000 hours working in addiction in any capacity, as well as 30 hours of continuing education (CE).

The exam fee for Certified Addiction Registered Nurse (CARN) is $300, while the Addiction Registered Nurse – Advanced Practice (CARN-AP) exam costs $400. Testing is offered year-round. Certifications are valid for four years.

Step 5: Consider Continuing Education or Specialization

Continuing education is required for most certifications in nursing. Substance misuse nursing is an evolving field. Nurses must stay up-to-date on harm reduction, trauma, and medication-assisted recovery.

A nurse with a BSN can earn their master's degree in nursing online, some of which are affordable and allow you to continue working while earning the degree.

Some nursing programs are beginning to offer addiction nursing as a specialty to their doctoral nursing programs.

What to Know Before Becoming a Substance Misuse Nurse

It is important to consider not only the education costs associated with becoming a substance misuse nurse, but also the time spent. How does the potential salary compare to the cost of your program? You need to make sure the nursing program you choose is worth the money and effort you put into it.


Accreditation is one of the most important things to look out for when choosing any college program. Many online programs are accredited, but not all are.

Without the proper accreditation, you will not be able to transfer your credits to any other program, and you may be barred from taking the NCLEX. A program that is not accredited will stop you from starting a career in substance misuse nursing altogether.


The cost of a BSN or MSN depends on the program and college. The average tuition for a bachelor's degree at an in-state public school was $9,349 in the 2020-21 academic year, according to the NCES.

Online and in-person programs often have different price tags as well. Make sure to include hidden costs when considering the true cost of the programs you explore. For example, the NCLEX costs $200 to take and certification for addiction nurses costs over $300. Also, consider any scholarships, tuition reimbursement opportunities, and federal grants.


Registered nurses made a median annual salary of $77,600 in May 2021, according to the BLS. RNs who hold a CARN can expect to earn more.

Nurses who earn a master's degree or doctorate to then work as a nurse practitioner (NP) make an average salary of $100,830 per year as of June 2022, according to Payscale. NPs who work in a specialty with extra certifications earn a higher pay in some instances.

According to the BLS , Hawaii and California and Hawaii pay registered nurses the most out of any other state.

Frequently Asked Questions About Becoming a Substance Misuse Nurse

What qualifications do you need to become a substance misuse nurse?

The only way to become a substance misuse nurse is to complete the required education to become an LPN or RN. The average LPN program takes one year to complete. An associate degree in nursing (ADN) takes two years to complete, making you qualified to be an RN. You can build off of this education to earn your BSN with an RN-BSN program.

Special certifications are recommended to help you be a well-informed nurse; continuing education is required to test for these certifications. More nursing programs are beginning to offer psychiatric mental health nurse practitioner certificates to their lists of available specialities. APRNs working in this specialty may care for those in substance misuse and addiction recovery.

What is the fastest way to become a substance misuse nurse?

The fastest path to working as an addiction nurse is to complete a one-year LPN program and pass the NCLEX-PN. LPNs work under the supervision of an RN and do not have the same responsibilities as higher levels of nursing.

LPN duties include IV and catheter insertion, monitoring vital signs, evaluating symptoms, and assisting patients in daily activities. While an LPN is only a licensed position and does not generally require a degree, you can use your LPN knowledge and training to become an RN.

Can I become a substance misuse nurse with an online degree?

As long as the program you choose is accredited, you can become a substance misuse nurse with an online degree. Accreditation is vital; if you do not attend an accredited nursing program, you will not be able to sit for the NCLEX exam. The NCLEX is needed in order for you to become licensed or registered to practice.

While the more practical aspects of a nursing program must be done in-person, a great deal of coursework can be completed on your home computer. Some programs allow students to complete work on their own schedule, offering nursing students a great deal of flexibility. Other programs have live streamed lectures.

How much money can I make as a substance misuse nurse?

The amount of money you make as a substance misuse and addiction nurse is dependent on your education level and where you work. A typical LPN earned a median salary of $48,070 as of May 2021 according to the BLS. RNs earned a median salary of $77,600 the same year.

Nurses with a BSN earn an average of $89,000 per year as of July 2022, according to Payscale. This does not include any pay bumps you can expect after completing continuing education and earning substance misuse and addiction certifications. is an advertising-supported site. Featured or trusted partner programs and all school search, finder, or match results are for schools that compensate us. This compensation does not influence our school rankings, resource guides, or other editorially-independent information published on this site.

Compare your school options.

View the most relevant school for your interests and compare them by tuition, programs, acceptance rate, and other factors important to find your college home.