Individuals with alcohol and/or drug use disorders often fail to receive care, or evidence‐based care, yet the literature shows health economic benefits. Comparative effectiveness research is emerging that examines approved approaches in terms of real, total healthcare cost/utilization. Comprehensive retrospective insurance claims analyses are few but tend to be nationally distributed and large. The emerging pattern is that, while treatment in general is cost effective, specific therapeutics can yield different health economic outcomes. Cost/utilization data consistently show greater savings with pharmacotherapies (despite their costs) versus psychosocial treatment alone. All FDA‐approved addiction pharmacotherapies (oral naltrexone, extended‐release naltrexone, acamprosate, disulfir…