In its current form Federal legislation will require both pre-employment and random drug screening for any employees whose work activity requires a commercial vehicle operator's license. Given the investment and economic hardship these regulations are going to require, there should be unequivocal evidence for the cost-effectiveness of drug testing for the organizations required to do it. There are two issues that must be addressed in determining the value of employee drug testing. First, has there been a significant reduction in work-related accidents and related incidents that can be traced to drug use? Although this is a key evaluation question, the author is unaware of any quantitative data that have addressed this issue. Second, are drug users out of the workforce? A variety of evidence suggests that drug use in the workforce has declined dramatically. The deterrent effects of drug testing may have contributed to a reduction in drug use in the workplace. The key issue is whether the cost of the screening has been worth the results that can be documented; and if the drug users are out of the workforce, then where are they? Performance testing can be an alternative to drug testing as a means of assessing the quality and safety of employee performance. In its ideal form, performance testing focuses on the abilities needed to perform an individual's job assignment. Urine-based drug testing, on the other hand, focuses simply on whether or not an employee currently has a proscribed drug in his/her system. It does not address how and whether a particular drug in the amounts detected affects the performance of the particular tasks assigned the employee.