Drug testing began as a prevention strategy during the Vietnam war. In 1970 the U.S. Navy began drug testing all active duty personnel following a tragic accident on the carrier Nimitz traced to impairment resulting from the use of illegal drugs.

Subsequently, responding to concerns about public safety, drug testing expanded to all workers in safety-sensitive industries regulated by the Federal government (nuclear energy, petroleum, aviation, railroad, maritime, road transportation and others). Shortly thereafter, pre-employment and employment drug testing became standard for the Federal government and most large private employers. At a time that drug use was at an epidemic level in the United States, these workplace programs made prevention, referral of employees to treatment, and providing a drug-free workplace high priorities.

Since 1995, many public and private schools have incorporated drug testing into their comprehensive drug prevention programs. The strength of such comprehensive programs is that they combine drug education and prevention curricula with drug testing and student assistance services that provide referrals to treatment.

On May 10, 2001, President George W. Bush said, "My administration will send a clear and consistent message that drug use is dangerous and drug use is wrong." He set a two-year goal of reducing drug use by 10 percent, and a five-year goal of reducing use by 25 percent. In his January 2004 State of the Union Address he called for increased spending on student drug testing programs. These goals were challenging, but recent data show that thanks, in part, to student drug testing programs, the two-year goal not only has been met, it has been surpassed. However, the rate of drug use by young people is still unacceptably high. Today young people under 26 represent 55 percent of the dependent or abusing population.