Policy makers and service providers have recognised the need for culturally sensitive service provision for people from ethnic minority backgrounds. This paper reports on the findings of a study undertaken to inform policy makers and service providers of the needs of service users from minority ethnic groups with drug and alcohol problems, and issues related to access and utilisation of services. A rapid needs assessment was carried out in a London borough. One-to-one and focus group interviews were carried out with service users, family members, and representatives of voluntary and statutory service providers. Interviews were recorded and transcribed for content analysis. The findings showed differences in access to services by people from minority ethnic groups, and varying perceptions of underlying factors and attitudes to drug and alcohol misuse. The need for culturally competent services was expressed. The implications for service provision for a multiculturally diverse population, and the need for a programme of education in cultural competence are discussed.