Selected by the Atlanta Hawks with the 7th pick of the 1974 NBA draft, Drew quickly made an impact with the club, averaging 18.5 points per game, 10.7 rebounds per game, and leading the NBA in offensive rebounding during his rookie season. From 1974 to 1982, the immensely talented Drew starred for the Hawks, with whom he was a two-time All-Star, averaging more than 20 points per game on five occasions. After being traded by Atlanta for Dominique Wilkins, Drew played three seasons with the Utah Jazz, retiring with 15,291 career points. He joined Artis Gilmore and Eddie Lee Wilkins as the only alumni of Gardner–Webb University to play in the NBA. With Jason Kidd, Drew holds the NBA record for most turnovers in a regular season game. Drew set that mark with the Hawks in a March 1, 1978 game against New Jersey.
Drew battled cocaine addiction during his professional basketball career. He missed 38 games during the 1982-83 season as he spent eight weeks in drug rehab. He made a successful return in 1983-84 and won the league's Comeback Player of the Year award, but relapsed the next season and was waived by the Jazz, then was arrested in 1985 for passing bad checks. Drew spent the next two years with the Continental Basketball Association's Wyoming Wildcatters, becoming an All-Star in the CBA. In 1986, he was arrested in Atlanta twice in less than three months, first on October 2 for selling cocaine to an undercover agent and then on December 17 for cocaine possession and purchasing the drug from an undercover agent. After seeking treatment for the fourth time in his career, Drew became the first player to be banned by NBA commissioner David Stern for multiple violations of the league's new substance abuse policy, despite not being on an NBA roster at the time of his arrest. He could not seek reinstatement until the 1987-88 season. Drew opined that the NBA's drug policy "will keep guys from coming forward and admitting they still have a problem." The Washington Bullets expressed interest in signing him that season but were prohibited from doing so by the league due to his past infractions. After several years out of the public eye, he resurfaced in 2002, when he claimed to the Atlanta Journal-Constitution that he "finally" had a grip on his addiction without going into further details.