This chapter concentrates on the epidemiological literature on patterns of drinking among black people originally of African descent in the UK and USA. Drinking patterns in women and adolescents is not specifically dealt with. The World Health Organisation (WHO) has attempted to address the issue that different cultures differ in their views on what constitutes psychiatric illness including substance use disorders. The Cross-Cultural Applicability Research (CAR) study compared the reliability and validity of two epidemiological instruments for the definition and detection of substance use disorders in nine different countries with diverse cultures and languages. The national epidemiological studies undertaken in the USA indicate that compared to whites, black people drink less, have fewer alcohol use disorders and have a smaller problem of alcohol use among youths. Of all gender and ethnic groups, black women have the lowest rates of alcohol use and alcohol use disorders.