In this quality improvement project, an assessment of staff perception of structural racism in an urban substance use disorder treatment organization was performed to determine areas for evidence-based practice recommendations. The framework of the Self-Assessment for Modification of Antiracism Tool (SMART) developed by the American Association of Community Psychiatry (AACP) was used to assess elements of clinical care, client outcomes, and workplace culture. Survey findings were consistent with current literature on racial disparities in mental health and indicated a potential for structural racism impacting treatment and diagnosis. Evidence-based recommendations were made regarding enhanced racial demographic data tracking, improved racial trauma assessment, and implicit bias training. Thorough organizational assessment with periodic re-assessment may reveal additional areas for quality improvement in the delivery of care that counteracts the effects of structural racism.