What Every CASAC, CAC, or CADC Needs to Know About the NAADAC 10-Step Ethical Decision-Making Model

Key words 6X: ethical decion making; NAADAC ethical descision making; CASAC, CAC, or CADC; substance use counselor

Let’s get real for a minute.

You can memorize the Code of Ethics from start to finish. You can write a damn dissertation on confidentiality and informed consent. But none of that matters when you’re sitting in your office, looking at a client who just handed you a mess you weren’t ready for. That’s when ethical decision making stops being a theory and becomes a blood-pressure-spiking, sweat-dripping, gut-check reality.

If you’ve been in the field long enough, you know what I’m talking about.

And if you’re newer to the work, buckle up because ethical dilemmas in this field aren’t rare. They’re regular.

Whether you’re a CASAC in a chaotic outpatient program, a CAC working inside a correctional facility, or a CADC navigating client care in rural recovery deserts, the NAADAC 10-step ethical decision-making model isn’t just a worksheet. It’s a lifeline.

Let’s walk through it—not like an ethics professor, but like a counselor who’s seen what happens when we don’t stop and think before we act.

Step 1: Identify

Start with what’s in front of you. What’s the actual concern? What’s the risk? Is it legal? Clinical? Moral? All three?

If you’re feeling uneasy, that’s your first signal.

Example: A client discloses they’re using fentanyl again, but they beg you not to tell probation. Your gut knows this isn’t just about privacy but safety. Time to zoom in.

Step 2: Apply

Pull out the NAADAC Code of Ethics. This is your foundation, not just a box to check.

Ask yourself: What standards apply here? Are there state laws that contradict your gut? What’s your agency’s policy?

If you don’t know where to look, stop pretending you do. Find out.

Ethical decision-making starts with owning what you don’t know.

Step 3: Determine

Is this situation big enough to need backup?

Don’t wait until you’re drowning. Talk to your clinical supervisor. Phone a colleague who’s been around the block. If it’s looking hairy, bring it in legally.

This step isn’t about passing the buck. It’s about protecting yourself and the client. You don’t get a trophy for going it alone.

Step 4: Generate

Now we brainstorm.

Make a list of laws, policies, and ethical principles that apply. Get honest about the scope of the issue. What could go right? What could go very, very wrong?

Start imagining the outcomes of different actions. Don’t filter yet—get it all on the table.

This is where ethical decision-making becomes proactive instead of reactive.

Step 5: Evaluate

Now that you’ve got your list, dig in.

What are the consequences of each possible decision? Who benefits? Who’s at risk? What kind of precedent does this set?

This is where you have to get out of your ego. Ethical decision-making isn’t about being the hero. It’s about doing the most responsible thing, even when uncomfortable.

Maybe you want to protect the client’s privacy, but reporting might be what protects their life. That’s the kind of tension you’re working with.

Step 6: Implement

Choose a path. Own it.

You’ve researched, consulted your people, and weighed the options. Now you act.

Whether you report, intervene, document, or set a boundary—it’s time to follow through.

This part gets real. Clients might get mad, and systems might push back. But this is why ethical decision-making matters. It’s not about being liked; it’s about being accountable.

Step 7: Document

This one saves your ass.

Write it all down. Every step. Every conversation. Every reference to the Code of Ethics or law. Why did you choose this path and not that one? Who did you speak to?

Documentation isn’t just paper. It’s protection. For you, for the client, for your agency.

I’ve seen people get shredded in court because they didn’t write it down. Don’t be that person.

Step 8: Analyze

Take a breath and look back.

Was the decision you made solid? Did it hold up under pressure? Were there unintended consequences?

Ethical decision-making doesn’t stop once you act. It evolves. You must be willing to re-examine your choices, especially if things didn’t go as expected.

Step 9: Reflect

This part? It’s where the growth happens.

What did you learn? What would you do differently next time? What support or training were you missing that could’ve helped?

Reflecting isn’t about regret. It’s about getting sharper. If you’re not reflecting, you’re not growing.

I’ve made calls I still think about, not because they were wrong but because they taught me what this work costs.

Step 10: Reassess

If the outcome didn’t serve the client, the team, or the ethics you stand by, go back to step one.

Start over. Adjust. Don’t double down just because you picked a lane.

Ethical decision-making is a living process. It changes when new information comes in, and it’s okay to pivot.

What’s not okay? Digging in your heels out of pride or fear.

Why This Matters for Substance Use Counselors

Let me be crystal clear.

You cannot wing this stuff.

You’re holding people’s lives as a CASAC, CAC, or CADC. And not just metaphorically. You’re in the middle of court mandates, MAT access, domestic violence disclosures, suicidal ideation, system failures, and raw, unfiltered trauma.

You’re risking more than your license if you’re not using a structured process like the NAADAC ethical decision-making model. You’re endangering people’s safety.

This model isn’t a formality. It’s the difference between reacting and responding, playing defense and showing up like a real professional.

A Personal Note

I once had a client who told me their partner was abusing them. They begged me not to say anything, swore they’d be fine.

My gut told me they weren’t.

I ran the NAADAC ethical decision-making process from top to bottom. I consulted two colleagues, called the DV hotline, documented every move, and made the call.

The client was pissed.

Three weeks later, they said, “I didn’t like what you did. But I think it saved my life.”

That’s ethical decision-making in action. It’s not clean, and it’s not easy, but it’s how we keep showing up with integrity when everything’s on the line.

So, if you’re in the field, print the model, post it by your desk, and burn it into your brain.

Because the next time you get hit with an ethical crisis, you won’t have time to figure it out from scratch.

You’ll need a compass. The NAADAC ethical decision-making model is that compass.

Use it. And keep doing the work that matters.