The current opioid epidemic substantially affects African Americans given their historical rate of disparities in access to effective substance use disorder (SUD) treatment. Yet, there is limited information about factors that may improve access to effective opioid use disorder (OUD) treatment for members of this racial group. This chapter describes policy, management, and treatment practices that may enhance access and engagement of African Americans in OUD treatment considering the current opioid epidemic and the state of public treatment systems in the United States. Drawing from a sociocultural framework on disparities in access to care, I present a comprehensive approach based on culturally competent and medication-assisted treatment that may reduce the wait time to enter treatment and increase treatment engagement and recovery rates among African Americans seeking OUD treatment. I focus on the role of public insurance (i.e., Medicaid), the diversification of the workforce, as well as delivery of adequate dosages of maintenance opioid medications (methadone, buprenorphine, and naltrexone) to improve engagement and recovery. Implications for health policy, program design, and service delivery are discussed to abate the effect of the opioid epidemic on African American communities.