Recovery and public health, safety, and welfare protection are physician health program (PHP) and alternative to discipline (ATD) foundations. Abstinence is a proxy to these foundations and is fundamental to monitoring programs. PHP and ATD research recommend up to weekly participant testing. Toxicology volume in monitoring necessitates a thorough understanding of panels, reliability, and varying testing methods. Session will cover panel composition with shifting drugs of availability, interpreting medical review officer reports, techniques to circumvent common donor excuses, and when to consider an alternative testing method. The toxicology experience in monitoring has generalizability to employee assistance programs.