Used as a valuable tool in guiding public policy decisions at both the State and local levels, this annual report presents a wealth of information on the effects that tobacco, alcohol, and other drugs have upon the health and well-being of an individual, their prevalence among youth and adults, and the toll they enact upon Washington State families and communities. The report is an important part of Washington State’s Division of Alcohol and Substance Abuse (DASA) to document the impact and effectiveness of prevention and intervention efforts, and to highlight the importance of working with partners on the local, State, and Federal levels. The report contains a new DASA in Brief section which provides an update on the Division’s budget and the results of the most recent legislative session. The report is divided into six main sections: (1) the economic costs of substance abuse, (2) substance abuse prevalence and trends, (3) areas of substance abuse impact, (4) solutions in prevention and treatment, (5) outcomes in prevention and treatment, and (6) future policy issues confronting Washington State. Tables, charts and graphs