The United States department of Health and Human Services declared the opioid epidemic a public health emergency in 2017. Since that time significant medical, clinical, and financial investments have been put into ending the crisis. Nonetheless, major discrepancies in rates of overdose, access to treatment, and treatment outcomes exist among racial and ethnic minority groups, especially in the Black community. Reasons for these disparities include, poverty, racial bias, fear of legal consequences, stigma, and lack of access to culturally competent health care. Although Buprenorphine treatment is the current standard of care for medication assisted treatment for Opioid Use Disorder, Black Americans are more likely to receive Methadone treatment and at a higher rate than their White counterparts. This is both more labor intensive and more stigmatizing than Buprenorphine treatment. Studies have found Black individuals who do engage in Buprenorphine treatment are far less likely to be retained in treatment after a year, thus negatively affecting their likelihood for long term sobriety. Finally, minority opioid users experience longer wait times for care, further increasing their likelihood for drug use, overdose, and death. In 2017, non-Hispanic Black individuals had the highest rate of overdose deaths attributed to synthetic opioids when compared to the national population. This presentation seeks to highlight the history of racial inequality in opiate addiction treatment and the current impact that racial disparities have on treatment outcomes. Additional time will be spent addressing methods to mitigate the impact of sociopolitical and provider bias.