Psychoactive drug use occurs in essentially all human societies. A range of disciplines contribute to our understanding of the influence of drugs upon the human world. For example pharmacology and neuroscience analyse biological responses to drugs, sociology examines social influences upon people’s decisions to use drugs, and anthropology provides rich accounts of use across a variety of cultural contexts. This article reviews work from multiple disciplines to illustrate that drugs influence aspects of culture from social life to religion, politics to trade, while acting as enablers of cultural change throughout human history. This broad view is valuable at a time when the influence not only of traditional drugs but a growing armoury of novel drugs is felt and debated.