In antiquity, cultic groups were often defined by supernatural rituals and practices connected with religious deities and frequently entailed the use of psychotropic substances. Similar practices have been carried forth by contemporary civilizations, as in the ritualistic use of peyote, which in the past has been described as cultic. While this may be viewed as reductive, research has identified certain similarities between cult membership and drug addiction, such as the potential to alter consciousness. Although this historical conceptualization bears little resemblance to the modern construction of cults as groups subject to undue influence by a charismatic leader, drug use may still carry various functions in these more modern cults. Patterns of drug use within cults varies from abstinence to coerced use of psychoactive substances to facilitate indoctrination; most lie between these extremes. Due to the wide variation of different attitudes towards drug use among cults, membership in a cult does not predict drug use by members. Thus, when evaluating a cult member, a full and detailed substance use history should be collected and information regarding their particular cult’s practices should be gathered.