Underappreciated and undertreated are the two terms the U.S. surgeon general uses to describe the crisis of alcohol and drug addiction in the United States.

Surgeon General Vivek Murthy issued the first-ever surgeon general’s report on substance abuse Thursday. Murthy said he hopes it will galvanize work on the issue the way a similar report 50 years ago sparked decades of effort to combat smoking.

Every dollar invested in treatment saves $4 in health care costs and lost productivity and $7 in criminal justice costs.

Drug overdoses in the U.S. hit an all-time high in 2014. There were 47,055 reported deaths due to prescription painkiller and heroin abuse, according to the Centers for Disease Control and Prevention.

“Alcohol and drug misuse and related disorders are major public health challenges that are taking an enormous toll on individuals, families, and society,” Murthy wrote in an address on his website. “Neighborhoods and communities as a whole are also suffering as a result of alcohol- and drug-related crime and violence, abuse and neglect of children, and the increased costs of health care associated with substance misuse. It is estimated that the yearly economic impact of substance misuse is $249 billion for alcohol misuse and $193 billion for illicit drug use.”

He adds, however, that this is also a “time of great opportunity.”

[lz_bulleted_list title=”Contributing to Substance Abuse in U.S.” source=”https://addiction.surgeongeneral.gov”]The inability to access or afford care.|Fear of shame and discrimination.|Lack of screening for substance misuse and substance use disorders in general health care settings.|About 40% of individuals who know they have an alcohol or drug problem are not ready to stop using.[/lz_bulleted_list]

There has been a concerted effort in recent months to erase the stigma surrounding addiction so that people can get treated. Currently, the stance that it is somehow more of a character flaw and something people can get arrested for has prevented thousands if not millions from accessing the resources available — especially pregnant women, who have more than their own life at stake.

Every dollar invested in treatment saves $4 in health care costs and lost productivity and $7 in criminal justice costs, Murthy stated.

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In 2015, there were 20.8 million people who met the diagnostic criteria for a substance use disorder — but only 2.2 million individuals received any type of treatment.

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Murthy added that how we respond to this crisis is a moral test for America. “Are we a nation willing to take on an epidemic that is causing great human suffering and economic loss? Are we able to live up to that most fundamental obligation we have as human beings: to care for one another?”