OBJECTIVES: To examine the bivariate relationships between CAM use for treatment of a specific illness and prescription drug use among African American adults and to describe the extent of complementary and substitutive CAM use. METHODS: Using the 2002 National Health Interview Survey, the data included 4,256 AA adults representing 23,828,268 African American adults nationwide. Respondents were asked if they used certain CAM modalities in the past 12 months to treat a specific condition. Our study focused on those who used CAM for treatment and whether or not they also used prescription medication in the last 12 months. RESULTS: A total of 99.4 percent of African Americans who used CAM in the past 12 months used at least one CAM modality to treat a specific illness. Of these, 77.7 percent also used prescription medication during the past 12 months (complementary CAM users) while 22.3 percent did not (possible substitutive CAM users). For 13 of the 14 CAM modalities examined, a majority of CAM for treatment users (60.4 to 100.0%) also used prescription medication. The exception was folk medicine where 65 percent did not use prescription medication. A total of 13.6 percent of users of mind-body therapies (e.g., relaxation) were potentially substitutive users compared to 23.0 percent of manipulative therapy (e.g., massage) users, 25.2 percent of alternative medical system (e.g., acupuncture) users, and 25.7 percent of biologically-based therapy (e.g., folk medicine, herbals) users. Complementary CAM users had more medical conditions (p<0.0001) and were more likely female (p<0.0001) and publicly insured (p<0.0001) compared to possible substitutive CAM users, who were more likely younger (p<0.0001) and better educated (p<0.01). CONCLUSION: While the majority of African Americans who use CAM for treatment for a specific condition also use prescription medication (complementary users), more than 20 percent may substitute CAM for conventional treatment.