The best and worst of 2018, and hopes and fears for 2019

With public understanding growing every day about the need to address substance use disorders (SUDs) with the full array of health responses our nation deploys for other major illnesses, we hope to see great progress in the coming year. Progress should include dramatic expansion of all quality prevention, treatment services and medications, and recovery supports, with financial investment increased sufficiently to meet the need; full coverage of all SUD treatment services and medications by every state's Medicaid program and by Medicare; much stronger enforcement of federal and state requirements for parity in commercial insurance and Medicaid, including prohibitions on prior authorization, fail‐first, overly burdensome utilization review and inadequate reimbursement for care; availability of all effective and quality SUD treatment and medications at every level of the criminal justice system and throughout the child welfare system; and elimination of discriminatory barriers facing people still suffering or in recovery from SUD, including those with criminal histories, as they seek employment, housing, government benefits, the right to vote and other necessities of life.