Differences were observed in drug of choice, in all addiction severity scores except medical, in agreement of self-reported drug use and drug testing, and in the rate of treatment contacts. A large number of participants reported high levels of social deprivation and high levels of distress on the Addiction Severity Index (ASI). Whites had higher scores than Blacks on the ASI drug and psychiatric measures, as well as in the legal and family domains. Blacks had higher alcohol scores and Hispanics had greater employment difficulties. Whites and Hispanics had more treatment contacts and were also more likely to abstain from any drug compared to Blacks. Finally, Hispanics were less likely to disclose cocaine use than Whites. The findings suggest the urgent need for more trained interventionists who can deliver cognitive behavioral therapy and motivational enhancement in racial and ethnically sensitive and useful ways. Participants were 1,175 out-of-treatment cocaine and heroin users recruited from a trial of brief motivation in outpatient clinics located in an inner-city academic hospital. A researcher administered the ASI to each participant, which measures distress in seven domains: medical, legal, employment, drug, alcohol, family, and psychological functioning. Drug testing was conducted using a half-inch hair sample. Participants were randomly assigned to either an intervention group, which received a brief interaction designed to assist patients in recognizing the importance of changing their drug behaviors, or a control group, which received only a written handout containing advice and treatment referral numbers. Data analysis was carried out using SAS and included ANOVA and Pearson analyses. Future research should focus on the consequences of reduced intervention effectiveness and reduced treatment contact among Blacks. Tables, references