Positive signs in substance-abuse trends for 2006 are a decline in steroid use among students, a decline in smoking among adult men and women, a decrease in binge drinking among adults, and a decline in the number of reported methamphetamine laboratories/dumpsites (the lowest number since 1999). Some negative trends are a dramatic increase in the death rate from alcohol-related motor vehicle crashes, a rapid increase in the drug-induced death rate, and one out of five students being a problem drinker by 12th grade. Waiting lists for treatment under the Alcohol and Drug Abuse Treatment and Support Act have quadrupled since 1991 and have increased rapidly in the past 5 years. Regarding the economic costs of substance abuse in the State, 59 percent of the costs were due to alcohol use and 41 percent to the use of drugs. The largest costs were related to death, crime, and disease. Data on the adverse impacts of substance abuse pertain to unhealthy babies born to substance-using mothers, accident risks, health consequences, infectious diseases, crime, violence, and family distress. Data are presented to show the cost-benefit of substance-abuse prevention and treatment programs. Among the policy issues confronting the State are brief intervention in emergency department and health care settings, drinking by college students, problem and pathological gambling, substance abuse and child welfare, and the use of medications in addiction treatment. Sources and descriptions for national and Washington State substance-abuse data are described. Tables and figures