Trends in the field of service among those with alcohol and other drug addictions highlight the urgent need for schools of social work to effectively train students to serve clients with substance use disorders, as well as to have cultural competence to effectively serve disproportionately affected and historically underserved lesbian, gay, bisexual, transgender (LGBT) consumers. Online surveys and interviews examined graduate social work (MSW)/certified alcohol and drug counselor (CADC) student preparedness to work in the field of addictions with members of the LGBT community within one university located within the United States. Overall, results indicated that students and alumni did not feel adequately prepared through coursework to practice with LGBT populations affected by substance use, while still feeling clinically competent to practice with LGB populations moreso than with transgender consumers. Similar findings related to unique differences associated with perceptions of faculty support, introducingLGBT topics and how they are handled in the classroom, along with field preparedness to practice with LGB individuals when compared to members of the transgender community. A majority of service providers noted an overall commitment and competence to serve LGBT consumers as well as positive perceptions of students and alumni to do the same. Implications will examine the critical role of faculty in addressing some of the challenges related to effective preparation of social work students to practice with LGBT consumers affected by substance use disorders, along with suggestions for changes within the curricula, and the need for ongoing field trainings and unique placement experiences.