This Pennsylvania State Epidemiological Outcomes Workgroup (SEOW) brief examines how the COVID-19 pandemic impacted substance use, mental health, and overdose trends among Pennsylvania youth, young adults, and adults before and after the first year of the pandemic. Drawing on statewide surveys, national datasets, and peer-reviewed research, the report highlights age-specific trends, regional differences, and racial disparities, particularly the disproportionate impact on Black Pennsylvanians. For the prevention workforce, this resource provides timely, local data to support needs assessments, guide prevention strategies, inform funding decisions, and strengthen data-driven planning and equity-focused responses.