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Then, it's estimated that 20 million Americans with substance abuse problems are going without treatment, in a crisis that claimed more than 100,000 American lives last year. Carl Erik Fisher, MD, addiction physician, bioethicist, and Assistant Professor of Clinical Psychiatry in the Division of Law, Ethics, and Psychiatry at Columbia University, and author of "The Urge: Our History of Addiction,” says it often doesn't help to refer to addiction as a disease.