There are a number of predicted trends which will impact the future of substance use disorders and mental health treatment including: an increase in substance use and mental health crisis nationwide as technology erases millions of jobs; the use of AI and other technologies in treatment; high staff turnover; increased use of evidence based practices; greater emphasis on addressing co-occurring conditions and trauma informed care; younger and older clients; a counselor shortage, a leadership crisis; funding based upon outcomes; changing demographics; increase in the peer workforce; the need to anchor treatment and recovery in the natural environment; more potent drugs; the need for non-traditional funding streams; the need to address the impact of natural disasters which increase SUD use and mental health crisis.