A drug is a substance that changes a person’s mental or physical state, so given that definition, alcohol is a drug, period. It’s a drug; it’s a drug; it’s a drug, no matter what anyone wants to believe. Just because it’s legal and just because there’s a humongous lobbying effort throwing a boatload of money at it doesn’t make it less of a drug. So why are we confused, and when will the confusion stop?
The National Highway Traffic Safety Administration, NHTSA, talks about drunk driving and drug-impaired driving.
https://www.nhtsa.gov/risky-driving
But then NHTSA’s “Drug-Impaired Driving” page indicates:
“You can’t drive safely if you’re impaired. That’s why it’s illegal everywhere in America to drive under the influence of alcohol, marijuana, opioids, methamphetamines, or any potentially impairing drug–prescribed or over the counter. Driving while impaired by any substance—legal or illegal—puts you and others in harm’s way. Learn the latest research on drug-impaired driving, misconceptions about marijuana use, and what you can do to make smarter choices to drive safely” (NHTSA Drug-Impaired Driving).
So explain to me again why we make a distinction between drunk driving and drugged driving? It’s ALL drugged driving, right?
And don’t get me started on “buzzed driving.” I have never understood that campaign!
Right now we use the phrase “alcohol and drugs” or “drugs and alcohol” or just “drugs” when we are talking about drugs that we don’t drink. But I have a few phrases for consideration; perhaps we can come to consensus so that drugs – all drugs, whether they be legal or not – will be considered to be drugs.
How about “drugs”? Too confusing today, but if we all stipulate to alcohol being a drug, albeit a legal one, it may catch on.
“Mood-altering substances”? This gets a little tricky because people will quibble about their mood having been altered. (Cue the buzzed driving contingent.) Still, it’s got potential!
“Illicit drugs” is a nonstarter because alcohol isn’t illicit, nor is cannabis in some states.
“Alcohol and other drugs”? It had a good run in the 1980s; I suggest we bring it back!
“Controlled substances”? Alcohol, nicotine, and even cannabis are controlled, even if they are legal (as cannabis is in some states).
Why does it matter? Because we are at a crossroads. We have consistently changed the language of this field to the point that we are no longer communicating, which, by definition means transferring information. What information is transferred if I say “drugs” and mean “alcohol and other drugs,” but you hear “drugs” and think misused prescription drugs and heroin? How are we communicating if I’m talking about the rules of impaired driving, and you think it’s only about drunk driving, despite the 2022 Safety Research Report from the National Transportation Safety Board that indicates that “Between 71% and 99% of drivers […] studied tested positive for one or more potentially impairing drugs, and about half of drivers tested positive for more than one category of drug.” https://www.ntsb.gov/safety/safety-studies/Documents/SRR2202.pdf
I’m all for calling a spade a spade. Alcohol is a drug. It’s a drug. It’s a drug, so let’s use that: “drugs.” While we transition, we’ll all have to say things like, “You mean alcohol, too, right?” But the effort will be worth it in the long run.
Are you with me?
Guided by Guida 
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