School-based random student drug testing (RSDT) is a controversial drug use prevention tool. RSDT is intended to be part of a comprehensive school-based prevention program that commonly includes: written substance use policies, student assistance programs, student and faculty education, parent involvement, and community support. RSDT should not be a stand-alone prevention strategy, but should reinforce other components of a school’s substance abuse prevention initiatives(1–2). If implemented effectively, RSDT may be a valuable substance use prevention tool.