In recent years, there has been a significant increase in the number of employers who use drug tests to screen current and/or potential employees. In the pre-employment context, one is not required to submit to the requested drug test. However, since there is no employment contract in effect, an employer is not required to hire someone who refuses the request to be tested.

Generally, North Carolina adheres to an employee-at-will doctrine, which holds that absent a contract for employment for a definite term, either party can terminate an employer-employee relationship, at any time, for any reason, or for no reason. An exception to this general rule exists where the contract is terminated for an unlawful reason or for a purpose that contravenes public policy. The US Supreme Court has established that random drug testing of urine in the workplace can be constitutional if the reasonableness of the search is judged by balancing its intrusion on the individual's Fourth Amendment rights against the promotion of legitimate governmental interests. If there is a showing by the employer that the employees required to undergo such testing have responsibilities or duties which are connected to the safety of others or for the public safety, and the enforcement of the tests are uniform and fair, the employer will be permitted to perform the tests as a condition of continued employment.