Aims: This study describes the amounts and effects of drug use in bar and club sex work, and the use of healthcare for the drug-related needs of sex workers (SW). Methods: A cross-sectional study was carried out in Belgium. In a quantitative component, 120 bar and club SW were interviewed face-to-face by means of a semi-structured questionnaire. In a qualitative component, 25 SW were interviewed face-to-face and 5 focus group discussions with key actors professionally involved with the study's subject were conducted. Findings: Many bar and club SW drink frequently alcohol and engage in heavy drinking. Illegal drugs such as cannabis, cocaine and benzodiazepines are also frequently used. The drug use often involves poly or combined drug use. More than one-third experienced a certain degree of dependence on a product and many experienced effects from drug use on their sex work. The study shows that SW have difficulties accessing drug-related healthcare. Conclusions: SW use often legal and illegal drugs. The prevalence and influence of drug use among bar and club SW illustrates the need for drug and sex work related healthcare. Distribution of more information about the risks of drug use, the possible negative effects, and the available drug-related healthcare is needed.