Several studies show that African-Americans are less likely than whites to use alcohol or drugs. However, if African-Americans use drugs then they are more likely to become heavy and persistent users. African-Americans are also more likely to have a current substance abuse disorder. There is not much in the literature to explain this phenomenon. The purpose of this study is to examine the alcohol and drug abuse, use and dependence of blacks and whites in order to explain the differences in the course of the substance disorder, using data from the National Comorbidity Survey. There are many variables thought to contribute to the racial difference, such as socio-economic status (measured by income and education), religion, insurance, employment status, and marital status. The data in this literature indicate that the aforementioned variables do not explain the racial difference in substance disorders. However, after performing interaction analyses, it is clear that the effects of treatment are different for blacks and whites. Treatment is more effective for whites, and it may even cause the substance disorder to become worse for blacks. Several studies indicate that this may be the result of cultural differences between the treatment staff and the clients.