Substance use disorders and the harms associated with these diseases are a serious, growing public health problem in the United States. Almost 48,000 Americans died from an opioid overdose in 2017, which translates to 130 lives lost each day.

Yet these deaths do not reflect the full public health impact of substance use disorders. Individuals who misuse drugs or alcohol are more likely to develop chronic health conditions, experience poorer health outcomes, and have contact with the criminal justice system. The costs are high: The National Institute on Drug Abuse estimates that illicit drug and alcohol abuse accounts for more than $400 billion annually related to health care, lost work productivity, and crime.

More than 20 million Americans have a substance use disorder.However, only about 10 percent of these individuals receive any kind of treatment—whether through self-help programs, inpatient and outpatient treatment centers, or doctors’ offices. Effective care, including access to programs that provide medication-assisted treatment, remains elusive for many patients.

Public health experts and policymakers are now calling for evidence-based strategies to prevent substance misuse and improve treatment options for people with substance use disorders. Pew’s substance use prevention and treatment initiative develops and supports state and federal policies to support this effort.