The statistics are rather jarring: nearly 21 million people in the United States are living with a substance use disorder. The majority of motor vehicle traumas involve alcohol use. There are more people with substance abuse disorders than people with cancer. One in five Americans binge drink. And substance abuse disorders cost the U.S. more than $420 billion a year.

Dr. Vivek Murthy, who is closing in on his second year as surgeon general, said that, “These substance use disorders cost over $420 billion a year in the form of health care costs, lost economic productivity, and cost to the criminal justice system. We measure numbers like this for other illnesses, too, and the cost for substance abuse disorders far exceeds the cost of diabetes.”

While many point to narcotics (opioids) as a problem Dr. Murthy points to alcohol, “In 2015, about 66 million people reported that they’d engaged in at least one episode of binge drinking in the previous month. That’s a pretty astounding number. And in 2015, roughly 28 million people reported that they had driven under the influence of drugs and alcohol.”

These are not diseases of moral flaws, they are not diseases of character, these are diseases that are often as a result of stress, and the inability to handle stress.  It is easy to turn to alcohol or drugs for the quick fix of stress, but Dr. Murthy wants to use evidence-based approaches to teach stress relief to people in communities.  To teach kids to avoid alcohol and drugs.

“I’ve just understood that addiction really touches everyone’s life,” the surgeon general said. “It’s a disease that doesn’t discriminate, and it’s one that’s taking an extraordinary toll on our communities across the country.”

It is the most important Surgeon General Report since the 1964 report about smoking.