OBJECTIVES:  The United States Surgeon General Report on alcohol, drugs, and health addresses one of the largest health crises we face in America and proposes changes to the way we approach and care for substance use disorders. This research sought to quantify and validate healthcare utilization and costs for patients diagnosed with alcohol use disorder (AUD) using a US health insurance claims database. METHODS:  We identified AUD patients from Truven Health Analytics’ MarketScan^® Research Databases. Patients included had 12 months of continuous coverage in a health plan from January 1 - December 31, 2013. Data analyzed included demographics, resource utilization and costs from acute inpatient stays with the diagnoses of interest. Additional information from outpatient claims and electronic medical records (EMR) are reported. These data were reviewed by an expert panel of 10 clinicians and researchers who subsequently suggested solutions for reducing recidivism and costs. RESULTS:  There were 51,889 patients aged 10 – 59 years with a diagnosis of alcoholism, of which 26,978 patients were admitted to a hospital for treatment. The average number of hospital visits was 3.1 per patient for the year with most returning to hospitalization within 45 days. The average cost of admission was more than $14,000 for males and slightly lower for females. The panel of clinicians validated these findings and suggested clinical monitoring to augment current treatments. CONCLUSIONS:  As shown in this claims analysis, annual costs of AUD and recidivism in this population have substantial economic consequences. Proactive clinical monitoring and disease management, already used within general health care settings to address other potentially progressive illnesses, could be applied in emerging cases of substance misuse. Use of clinical monitoring and treatment management should be accompanied by informed clinical protocols to reduce the frequency and amount of substance use along with family education to support lifestyle changes.