A new federal report released Thursday calls for a shift in the way America addresses substance addictions, finding one in seven Americans will face such disorders. Only 10% of those now addicted receive treatment, the study said.

Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health marks the first report from a U.S. surgeon general dedicated to substance addiction, raising the profile of the widespread epidemic and advocating proven treatment options. An American dies every 19 minutes from opioid or heroin overdose alone, and Thursday’s report spells out the cost of substance abuse. The economic impact of drug and alcohol misuse and addiction amounts to $442 billion each year — topping diabetes at $245 billion, said Vivek Murthy, the surgeon general.