With the passing of May as Mental Health Awareness Month, it is the perfect time to appreciate the tremendous gains we’ve made in understanding, accepting, and managing mental health issues. No longer viewed as character flaws or weaknesses, mental illness has steadily moved from the shadows of shame and doubt into a routine practice of chronic illness management. In keeping with this theme, we must recognize a lingering hurdle in the quest for effective mental health services. Substance use disorder (SUD), often referred to as “addiction,” remains poorly understood, harshly judged, and seriously undertreated.