This monograph provides a tool to help providers and other substance abuse treatment professionals gain a greater understanding of the cultural, social, political, and economic forces affecting substance abuse treatment among Hispanic Americans, African Americans, Asian Americans/Pacific Islanders, and American Indians/Alaska Natives. An introduction discusses: the health and social consequences of substance abuse (HIV/AIDS and other infectious diseases, violence, and crime); culture, help-seeking behavior, and access to care issues (barriers to treatment, homosexuality, and rural areas); engagement and retention issues; cultural competence; universal cultural themes in the development of culturally competent treatment programs (family structure, cultural healing, and spiritual beliefs); and managed care and culturally competent substance abuse treatment. The next four sections focus on the four cultural groups, looking at: population composition and sociodemographic profile; migration experience; substance abuse epidemiological data; health and social consequences of substance abuse; culture, help-seeking behavior, and access to care issues; practices to meet treatment needs; conclusions and recommendations; information resources and references. (SM)