The invention discloses a drug use monitoring system used for distributing new drugs and collecting old drug bottles. The outline of the drug use monitoring system is a vertical cabinet and comprises a new drug distribution part and a drug bottle recycling part; the new drug distribution part comprises an identity confirmation device and a plurality of drug cabinets; each drug cabinet comprises a conveyor belt driven by a motor to move, a baffle and a drug bottle accommodation part; and the drug bottle recycling part comprises a recycling cabin and a recycling barrel arranged below the recycling cabin. The intelligent drug distribution cabinet realizes accurate statistics, can avoid the careless omission caused by manual check, eliminates the opportunity of the lawbreakers to obtain narcotic drugs, and meanwhile avoids the medical workers with poor professional ethics in hospitals reselling precious drugs for profits.