The United States faces a huge health care problem that afflicts far more people than cancer and heart disease combined. Nearly 49 million Americans aged 12 and above suffer from Substance Use Disorder, more than the populations of California, Oregon, and Nevada combined.1 This problem directly affects a large majority of the population and directly and indirectly costs trillions of dollars in productivity loss, accidents, and excess health care resulting from the condition. As this document will show, there are two models of care by which to respond to this problem. One is highly medicalized, expensive, and appropriate for about 30% of those afflicted, while the other is much less expensive and highly effective for the remaining 70%. Differentiating individual patient needs and selecting an appropriate response seems logical, yet employers and insurance carriers currently only reimburse for the more expensive model.