There is a lack of literature exploring substance misuse issues of the West African-born population in the United States. Thirty-four participants born in West Africa participated in one of three focus groups in a U.S. city to discuss their attitudes toward alcohol and drug use. Based on a qualitative analysis of the discussions, stigmatization of substance abusers and negative attitudes toward U.S. substance abuse treatment were identified as barriers to service utilization for West African immigrants. Community cohesion, importance of family, and a strong sense of spirituality were identified as essential resources to inform substance misuse prevention and treatment strategies.