I use it, but there are times I wonder why I bother.
Alignment is rarely a driving force in any of the games I've run, and my interpretation of the different alignments and the interpretations of my players rarely meet. Yes, even after reading the exact same section in the rules. Needless conflict ;)
I'm beginning to wonder if more general good / indifferent / evil type of axis would be more effective in future campaigns for my usual group. More latitude and less "various interpretations".
So, do you use alignment as is? Do you tweak it? Drop it all together?