Mental health, substance misuse, addiction, and their related health and social impacts such as overdose and suicide are dynamic and evolving. With the ready availability of illicitly made fentanyl and other potent synthetic opioids such as nitazenes, the emergence of substances like xylazine, medetomidine, and illicit benzodiazepines, and increasing polysubstance use, Americans face an illicit drug supply that is more toxic, unpredictable, and dangerous than ever. In addition, the proliferation of social media and other technology that is inundating America’s young people coupled with other social stressors in homes and communities across the Nation have contributed to declining mental health and well- being and rising rates of suicide in the past two decades. We know that mental health and substance use conditions are part of the chronic disease crisis plaguing our nation. Research shows that substance misuse and early health risk behaviors that take root during childhood and adolescence are closely linked to risk for chronic disease, substance use disorders, and mental health conditions later in life and contribute to a significant proportion of the health and social costs associated with chronic disease. By addressing mental health and substance misuse head-on through a comprehensive approach in partnership with states, communities, and tribes, we can help to achieve the Administration’s goal of Making America Health Again (MAHA) (PDF | 3.8 MB). As we embark on a bold new path to MAHA, having timely data to inform policy, program and practice are essential. For more than four decades, SAMHSA’s National Survey on Drug Use and Health (NSDUH) has been the federal government’s trusted source of information on substance use and mental health.