Her goal is getting rid of the stigma attached to addiction.
First Lady Kathryn Helgaas Burgum wants to change the fundamental conversation around addiction.
"If there's one thing I want people to know, it's that this is a disease. It's a chronic brain disease. It is not a moral failing or a character flaw and there should be no shame or stigma related to having the disease of addiction,” said Burgum.
One year after becoming First Lady, she's optimistic that she is making progress.
"We'll have more people reach out and less people will be isolated and dealing or struggling with it on their own,” said Burgum.
But progress has been mixed. Opioid prescriptions are down 24 percent since 2011, but deaths have risen. From June 2016 to June 2017, 81 North Dakotans died of a drug overdose.
"It's really about prevention and education and it takes a whole community and a whole community's involvement in order to accomplish this,” said Sanford Medical Officer Dr. Chris Meeker.
A Surgeon General's report showed that only 1 in 10 people with a substance abuse problem gets treatment. Governor Burgum has taken actions to combat the crisis. In October, he signed an executive order that made naloxone training mandatory for all new law enforcement officers.