Following an overview of the incidence of substance abuse in the United States and its costs to organizations, the author notes that urinalysis is the most commonly used technique for detecting substance abuse, but does not detect alcohol or nicotine use. Three examples of drug-testing lawsuits illustrate difficulties inherent in substance abuse screening. Four issues concerning urinalysis are examined: costs, chain-of-custody, validity and reliability, and constitutional challenges. This discussion emphasizes that the cost of a basic program is over $3,000, not including its effect on employee morale, motivation, and satisfaction, and time lost due to employees discussing the drug-testing program. In addition, chain-of-custody procedures are costly, cumbersome, and humiliating to the employee. The section on reliability questions the ability of urinalysis to indicate a relationship between drug intoxication and job performance and the accuracy of the RIA and EMIT tests. The article proposes effective supervision; establishment of an employee assistance program; and coordination among managers, personnel officials, and health professionals as alternatives to urinalysis. Tables and 12 footnotes.