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Based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), an estimated 22.5 million Americans are classified with a substance use disorder (Substance Abuse and Mental Health Services Administration, 2010). Of these, 3.2 million Americans are classified with a substance use disorder that includes both alcohol and illicit drugs (Substance Abuse and Mental Health Services Administration, 2010). Substance use disorders are the most commonly diagnosed psychiatric disorder in the United States (Compton, Thomas, Stinson, & Grant, 2007). Estimates of the overall costs of substance use disorders within the United States measured by diminished vocational and educational productivity, unemployment, domestic violence, child abuse, family disintegration, alcohol related accidents, rising medical costs, crime, and children born with substance related complications, exceeds $600 billion annually. This includes $181 billion for illicit drugs, $193 billion for tobacco and $235 billion for alcohol (National Institute on Drug Abuse, 2011). As staggering as these numbers are, they do not fully describe the breadth of the destructive public health and safety implications of substance use disorders.