Nearly 21 million Americans were directly affected by drug or alcohol addiction last year — roughly the same amount of Americans who have diabetes, according to a new report from US Surgeon General Vivek Murthy on addiction.

Yet just one in every 10 of those people got treatment.

"We would never tolerate a situation where only one in 10 people with cancer or diabetes gets treatment, and yet we do that with substance-abuse disorders," Murthy told the Washington Post.

RELATED: Opioid addiction reaches crisis level in the US



5 PHOTOS Opioid Addiction has reached crisis level in the US See Gallery Opioid Addiction has reached crisis level in the US (Photo: WPIX) (Photo: WPIX) (Photo: WPIX) (Photo: WPIX) (Photo: WPIX) Up Next See Gallery Discover More Like This HIDE CAPTION SHOW CAPTION of SEE ALL BACK TO SLIDE

Also in 2015, according to the new report, more than 27 million people reported misusing legal prescription drugs or using illegal ones. More than 66 million people said they had engaged in binge drinking sometime in the previous month.

The answer to the problem is complex, says Murthy, and should include things like increased screenings for addiction in doctor's offices. But, he argues, it's also time to change our perception of people who've struggled with addiction.

"We also need a cultural shift in how we think about addiction. For far too long, too many in our country have viewed addiction as a moral failing. This unfortunate stigma has created an added burden of shame that has made people with substance use disorders less likely to come forward and seek help," Murthy writes.

"We must help everyone see that addiction is not a character flaw — it is a chronic illness that we must approach with the same skill and compassion with which we approach heart disease, diabetes, and cancer.

Murthy's view is one that has been echoed time and again by neuroscientists, economists, psychiatrists, and people who themselves have struggled with addiction. Several peer-reviewed scientific studies done over the past decade support the idea as well.

In her recent book, "Unbroken Brain," neuroscience journalist and author Maia Szalavitz calls addiction a learning disorder, much like ADHD, and says it needs to be treated as such. This treatment regimen would vary based on the individual but could include things like cognitive behavioral therapy, a form of psychotherapy in which the therapist and patient work together to swap unhealthy learned patterns with more constructive ways of thinking, and potentially medication.

Addiction "is a form of pathologic learning," Szalavitz told Business Insider earlier this year. "Overwhelming changes occur in the brain region involving areas that evolved for things like love and sex and feeding."

RELATED: How opioids affect your health



12 PHOTOS What opioids do to your health See Gallery What opioids do to your health Opioid painkillers capitalize on our body's natural pain-relief system. We all have a series of naturally produced keys ("ligands") and keyholes ("receptors") that fit together to switch on our brain's natural reward system — it's the reason we feel good when we eat a good meal or have sex, for example. But opioids mimic the natural keys in our brain — yes, we all have natural opioids! When they click in, we can feel an overwhelming sense of euphoria. Photo credit: Getty Opioid painkillers can have effects similar to heroin and morphine, especially when taken in ways other than prescribed by a doctor. When prescription painkillers act on our brain's pleasure and reward centers, they can make us feel good. More importantly, though, they can work to reinforce behavior, which in some people can trigger a repeated desire to use. Photo credit: Getty You may also feel sleepy. Opioids act on multiple brain regions, but when they go to work in the locus ceruleus, a brain region involved in alertness, they can make us sleepy. Why? The drugs essentially put the brakes on the production of a chemical called norepinephrine, which plays a role in arousal. Photo credit: Getty Your skin may feel flushed and warm. Photo credit: Getty You'll begin to feel their effects 10 to 90 minutes after use, depending on whether they're taken as directed or used in more dangerous ways. Some drugmakers design versions of their medications to deter abuse. Extended-release forms of oxycodone, for example, are designed to release slowly when taken as directed. But crushing, snorting, or injecting the drugs can hasten their effects. It can also be deadly. Between 2000 and 2014, nearly half a million Americans died from overdoses involving opioid painkillers and heroin, a report from the US Centers for Disease Control and Prevention found. The most commonly prescribed painkillers were involved in more overdose deaths than any other type of the drug. Photo credit: Getty Your breathing will slow as well. Photo credit: Getty Depending on the method used, the effect can last anywhere from four to 12 hours. For severe pain, doctors typically prescribe opioid painkillers like morphine for a period of four to 12 hours, according to the Mayo Clinic. Because of their risks, it's important to take prescription painkillers only according to your physician's specific instructions. Photo Credit: Getty Overdosing can stop breathing and cause brain damage, coma, or even death. A 2014 report from the American Academy of Neurology estimates that more than 100,000 Americans have died from prescribed opioids since the late 1990s. Those at highest risk include people between 35 and 54, the report found, and deaths for this age group have exceeded deaths from firearms and car crashes. Photo Credit: Getty Combining them with alcohol or other drugs — even when taken according to the directions — can be especially deadly. Since they slow breathing, combining opioid painkillers with other drugs with similar effects can drastically raise the chances of accidental overdose and death. Yet they're often prescribed together anyway, according to the National Institute on Drug Abuse. "Unfortunately, too many patients are still co-prescribed opioid pain relievers and benzodiazepines [tranquilizers]," the institute said. In 2011, 31% of prescription opioid-related overdose deaths involved these drugs. Photo credit: Getty Abusing opioid painkillers has been linked with abusing similar drugs, like heroin. A CDC report found that people who'd abused opioid painkillers were 40 times as likely to abuse heroin compared with people who'd never abused them. The National Institute on Drug Abuse says that close to half of young people surveyed in three recent studies who'd injected heroin said they'd abused prescription painkillers before they started using heroin. Photo credit: Getty You may also develop a tolerance for the drugs so that you need more to get the same effect over time. Tolerance to opioid painkillers happens when the brain cells with opioid receptors — the keyholes where the opioids fit — become less responsive to the opioid stimulation over time. Scientists think that this may play a powerful role in addiction. Photo credit: Getty Suddenly stopping the drugs can result in withdrawal symptoms like shakiness, vomiting, and diarrhea. Taking prescription painkillers for an extended period increases the likelihood that your brain will adapt to them by making less of its own natural opioids. So when you stop taking the drugs, you can feel pretty miserable. For most people, this is uncomfortable but temporary. But in people who are vulnerable to addiction, it can be dangerous because it can spurn repeated use. "From a clinical standpoint, opioid withdrawal is one of the most powerful factors driving opioid dependence and addictive behaviors," Yale psychiatrists Thomas Kosten and Tony George write in a 2002 paper in the Journal of Addiction Science & Clinical Practice. Photo credit: Getty Up Next See Gallery Discover More Like This HIDE CAPTION SHOW CAPTION of SEE ALL BACK TO SLIDE

That means addiction will create what she calls "very powerful drives" — strong desires to take the drug repeatedly even if it's not providing any pleasant effects — something that runs contrary to what many people think of when they think of an addict who uses simply because it feels good.

"We've just been getting this completely backwards, by failing to address the role of learning," Szalavitz said. "If you want to call it a disease, the kind of disease it is is a learning disease."

Read the Surgeon General's full report, titled "Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health" >>

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