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The United States has a serious substance misuse problem. Substance misuse is the use of alcohol or drugs in a manner, situation, amount, or frequency that could cause harm to the user or to those around them. Alcohol and drug misuse and related substance use disorders affect millions of Americans and impose enormous costs on our society. In 2015, 66.7 million people in the United States reported binge drinking in the past month and 27.1 million people were current users of illicit drugs or misused prescription drugs. The accumulated costs to the individual, the family, and the community are staggering and arise as a consequence of many direct and indirect effects, including compromised physical and mental health, increased spread of infectious disease, loss of productivity, reduced quality of life, increased crime and violence, increased motor vehicle crashes, abuse and neglect of children, and health care costs.