Last week, U.S. Surgeon General Vivek Murthy issued the kind of call to action that the nation rarely sees: a report directly addressing the country’s attitude toward drug and alcohol abuse and misuse.

Little in the report is new — we already know things like opioid addiction are tearing apart families and killing people on an unprecedented scale — but it provides striking, even stunning context for people struggling to wrap their heads around an issue fraught with misinformation and emotion.

More people now use prescription opioids than tobacco; more Americans today are dealing with substance abuse disorders (20.8 million) than cancer diagnoses (13.86 million); those disorders cost the country more than $420 billion per year. And that’s not counting the millions of people who are misusing drugs and alcohol but don’t yet have a full-blown disorder or addiction.

“I want our country to understand the magnitude of this crisis,” Murthy said in an interview. “I’m not sure everyone does.”

Take binge drinking. The tendency is to believe it’s the purview of college students. But last year 66.7 million people reported binge drinking at least once, according to the report. There are only 20.5 million college and university students in the entire country, according to the U.S. Department of Education. Even if every single one of them are binge drinkers — which seems unlikely — that still leaves more than 45 million people unaccounted for by “conventional wisdom” on the topic.

Stereotypes like this are not just wrong, they are damaging. They keep addicts from seeking the help that might help them to overcome their dependence on alcohol and drugs. They divide families and communities along fictitious fault lines and have helped obscure an unprecedented rise in mortality among middle-aged white Americans that has largely been driven by alcohol, drugs and suicide.

This is not a red state issue or a blue state issue, a middle class issue or a working class issue, an inner city issue or a rural issue: it is an American issue. If we confront that fact and commit to pursuing effective solutions, we can effect real change. It has happened before.

More than four decades ago U.S. Surgeon General Luther Terry issued a report on the health impacts of smoking that sparked a sea-change in the way tobacco was packaged, marketed, regulated and, ultimately, viewed and consumed by the American people. In 1965 nearly 45 percent of American adults were smokers. By 2014 that number was 16.8 percent, according to the Centers for Disease Control and Prevention.

Only time will tell whether Dr. Murthy’s report sparks the same kind of cultural shift and produces the same kind of dramatic results that Terry’s has. But such a result will not be achieved without compassion, open-mindedness and the kind of dedication that has rallied people around causes like breast cancer and heart disease.