This graduate level course explores how history, culture, and context frame the social and policy response that enables substance abuse treatment. The historical, political, economic, and cultural factors contributing to and defining substance abuse problems are examined. These factors are emphasized because they are important, critical, and supplemental contributors to the biological, medical, and disease model definitions of substance abuse. In particular, the differential impact of substance abuse problems in various communities and demographic groups is examined, e.g., African American, Asian, Latino, gender, age, LGBT, and socio-economic status.