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Drug epidemic spotlights shortage of counselors

Chuck Biedka
| Sunday, March 20, 2016, 11:26 a.m.
Gateway Rehabillitation therapist Beth Shallenberger poses for a portrait  on Wednesday, March 16, 2016, at her office in Greensburg. Shallenberger said the addictions counselor shortage is felt locally because of the increased number of people using heroin and misuing pills.
Steph Chambers | Tribune-Review
Gateway Rehabillitation therapist Beth Shallenberger poses for a portrait on Wednesday, March 16, 2016, at her office in Greensburg. Shallenberger said the addictions counselor shortage is felt locally because of the increased number of people using heroin and misuing pills.
Louis Bator, an outpatient manager at Greenbriar Treatment Center in New Kensington, talks with a client on Tuesday, March 15, 2016.
Jason Bridge | Tribune-Review
Louis Bator, an outpatient manager at Greenbriar Treatment Center in New Kensington, talks with a client on Tuesday, March 15, 2016.

The office along Fourth Avenue in New Kensington looks much like many in the region, but what happens there can change — and even save — lives.

Louis Bator and Audrey Means meet there with people trying to stop using heroin, cocaine or alcohol.

Means, a Greenbriar Treatment Center addiction therapist, meets daily with clients. Bator, a counselor, manages four outpatient clinics, including one in New Kensington.

Their goal, said Means, is to help people become “stable in recovery and integrated into a productive lifestyle. People can definitely recover.”

But Means is one of only two therapists regularly working at the site and, although Greenbriar says the staffing is adequate, it hasn't changed in 10 years.

The number of certified addiction counselors has remained consistent in Pennsylvania for the past five years at about 2,300, said Pennsylvania Certification Board spokeswoman Terri Wray.

Compare that to the average of 314,000 Pennsylvanians who reported being dependent on or abusing illicit drugs every year, according to the federal Substance Abuse and Mental Health Administration. When viewed in light of state regulations that limit addiction counselors' caseloads to 35 patients each, only about a quarter of Pennsylvanians who could benefit from drug counseling could get it in any given year.

The increasing need for addiction counselors and therapists isn't new.

In a 2013 report to Congress, the Substance Abuse and Mental Health Administration warned of a counselor shortage “caused by high turnover rates, worker shortages, an aging workforce, stigma, and inadequate compensation.”

It's a problem perplexing health planners and doctors as rising overdose deaths continue to rock the country.

The report estimated that more than 6 million of the nation's drug addicts — about 80 percent — weren't getting counseling.

In 2014, the latest year for which data are available, heroin killed 400 people in Allegheny, Armstrong, Butler and Westmoreland counties.

Nationwide, about 47,000 people died from drug overdoses in 2014, outpacing the approximately 34,000 deaths annually from firearms, according to the federal Centers for Disease Control. Of the drug deaths, more than 10,000 were attributed to heroin.

Many not getting help

Dr. Neil A. Capretto, medical director for Gateway Rehabilitation, agrees the vast majority of drug addicts aren't getting the treatment they need, adding the counselor shortage is partially to blame.

“This is happening at a devastating time, especially with heroin and pills. Drug abuse deaths are way up,” Capretto said. “We still need people in internal medicine, and we need more counselors.”

Southwestern Pennsylvania Human Services Inc.'s behavioral health clinical director Cheryl Emala said staffing is a challenge.

“Our biggest struggle ... is finding counselors. We have a lot of clinical support, and all of our programs are growing,” Emala said. “Many clients have complex medical and mental health issues that need to be addressed so they don't relapse ... and that means longer treatment is often needed.”

But, unlike in other areas of the economy, increased demand for counselors doesn't translate into an increased supply.

Barriers for counselors

A recent survey by the Pennsylvania Department of Drug and Alcohol Programs (DDAP) found an alarming 33 percent annual turnover for addiction counselors in the state.

About 22 percent of current counselors said they will leave the field in five years unless things change, said Jason Snyder, a DDAP spokesman.

“There was frustration with the field's low pay and a requirement of payers — insurance companies — to do more paperwork,” Snyder said.

“These people got into the field to help clients,” he said. “There isn't enough compensation, and the more paperwork, the less clients can be served.”

Becky Vaughn of the National Council for Behavioral Health said addiction counselors regularly feel the shortage in their ranks and other pressures of the job.

“In many places, insurance companies are asking for a higher education level for counselors,” Vaughn said. “It's very difficult when they only earn $30,000 to $35,000 a year for them to go to graduate school.”

According to the Bureau of Labor Statistics, in 2014 substance abuse workers, including counselors, in Pennsylvania earned an average about $37,900.

Pay and paperwork aren't the only factors keeping the number of counselors down.

“There's a stigma about (drugs) ... so intense that it keeps some people away from treatment and others from counseling them,” adds Lynn Cooper, director of the 300-member Rehabilitation and Community Providers Association in Harrisburg.

Counseling benefits

In Greensburg, Gateway therapist Beth Shallenberger said the addictions counselor shortage is felt more because of the increasing number of people dying from drugs. Counselors are a critical link in saving lives, helping clients deal with their lives and stop their addiction.

“The intangible rewards are incredible,” said Shallenberger. For her, the best part of the job is to ”journey with people and watch them get better. They can get better. There is hope.”

“People in addictions counseling won't get rich, but they will get rewarded,” Capretto said.

And the benefits to society can be measured, according to Capretto.

“For every $1 spent on treating heroin addicts, society saves $12 in court, medical and other costs,” he said. “Despite how much society can save, finding addiction funding can still be a daunting task.”

Chuck Biedka is a Tribune-Review staff writer. Reach him at 724-226-4711 or at

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