US Surgeon General Vivek Murthy wants Americans to see addiction as a brain disorder instead of a moral failing.

In a new report released today, Murthy writes that, though substance abuse disorders are a public health crisis, many don’t receive the support they need. More people have a substance abuse disorder than have cancer, but only 10 percent receive treatment. And part of the reason people don’t get help is because they’re ashamed of their disease, he says.

"I’m calling for a culture change in how we think about addiction"

It’s not news that substance abuse is a big problem. People have paid a lot of attention to growing rates of addiction, including the so-called opioid epidemic. (Opioids are a class of painkiller, and abuse of prescriptions drugs is on the rise.) More people died from drug overdoses in 2014 than in any year on record, according to the Centers for Disease Control and Prevention. More than six out of 10 of these overdoses involved an opioid.

But one important change is Murthy’s explicit statement that addiction should be seen as a medical condition. One part of the report explains the neuroscience of addiction, and how drugs disrupt self-control and make recovery very difficult.

Activists have long supported this shift, but the stigma against those with substance abuse disorders remains strong. Earlier this year, police in Ohio publicly posted photos of a couple that had overdosed, a move that many condemned as public shaming. But research has showed that this kind of shaming is not effective in helping people recover, and can even make people turn to drugs or alcohol more.

Murthy hopes that dispelling some of the stigma around addiction will lead to better treatment. "I’m calling for a culture change in how we think about addiction," he told The Washington Post. "Unless we eradicate the negative [stereotypes] . . . we won’t create an environment where people feel comfortable coming forward and asking for help."