The introduction of EtG testing gives programs the ability to detect consumption that may have gone undetected using traditional ethanol testing methods.
drug court, comparing 2,669 urine samples screened using both EtG and ethanol tests, which yielded 76 positive results. In only six instances did a standard ethanol screen detect alcohol consumption (EtG was also positive in these six). Oſten participants in alcohol abstinence
monitoring programs have assumed that weekend consumption could not be de- tected. Te introduction of EtG testing gives programs the ability to detect consumption that may have gone undetected using tradi- tional ethanol testing methods. Te majority of positive urine samples identified in the Drug Court Review study—46 of 76—were collected on Mondays, presumably detecting weekend alcohol consumption. Predictably, Tuesday’s samples were second with 13 pos- itive screens. Study coordinators concluded that these results were consistent with prior research, suggesting EtG and EtS testing is a superior tool for detection of alcohol use. Te study also noted the potential
financial burden of conducting EtG screens on all program participants. Tis particular Midwestern metropolitan drug court was paying $7 for a 9-panel drug screen and $18 for a laboratory EtG screen for a total cost of $25. Te study revealed a 2.8 percent
30 datia focus
Figure 1: Potential Cost Savings Laboratory EtG screen of all samples
Rapid EtG screen of all samples
Laboratory confirmation of Rapid EtG positives
Subtotal Savings
positive rate for the EtG test (76 of 2,669), including 70 more positive results than traditional ethanol testing identified. EtG screening of all 2,669 samples at $18 each would have cost more than $48,000. Until recently, all EtG tests had to be com- pleted by a laboratory11
. As with other Point
of Care Testing (POCT) drug screening tests, the ability to conduct a urine screen onsite can be an effective tool to save time and money. In the example above, if a Rapid EtG test was used to screen all 2,669 samples at a cost of $5.50 each and only the 76 positive samples were then sent to the laboratory for confirmation at a cost of $18 each, total EtG- related costs would have been approximately $16,000, thereby saving nearly $32,000. One of the primary objectives of treat-
ment and abstinence programs is to help the participants overcome their alcohol dependency. To that end, alcohol testing has advanced from observing objective symptoms like HGN and PBT screening for current impairment to now being able to test for specific biological markers of recent alcohol use, similar to drugs of abuse screening. While there is more to learn about EtG and other alcohol biomark- ers, these tests, coupled with traditional methodology, offer additional resources for achieving successful outcomes in absti- nence monitoring programs. ❚
Endnotes 1
Psychophysical Tests for DWI Arrest. Burns, M. and Moskowitz, H. (1977). DOT-HS- 802 424, NHTSA, U.S. Department of Transportation.
2
DATIA-Resources: U.S. Department of Labor; How long are drugs in one’s system
3
$18 x 2,669 $5.50 x 2,669
$18 x 76
$48,042.00 $14,679.50
$1,368.00
$16,047.50 $31,994.50
Ethyl glucuronide in hair and fingernails as a long-term alcohol biomarker. Lisa Berger, et al. Dec 2013 Addiction 109, 425–431.
4
EtG & EtS: A new way to look at alcohol testing. Pat Pizzo, Alere Toxicology Feb 2013
5
Ethyl sulfate: A direct ethanol metabolite reflecting recent alcohol consumption. Addiction Wurst, F. M., Dresen, S., Allen, J. P., Wisebeck, G., Graf, M., & Weinmann, W. (2006)., 101(2), 204–211
6
Comparison of urinary excretion characteristics of ethanol and ethyl glucuronide. Dahl H1
, Stephanson N, Beck O, Helander A; 2002 May-Jun;26(4):201-4 J Anal Toxicology. 7
Production of urinary ethanol after sample collection. J.J. Saady, A. Polkis, H.P Dalton (1993) Journal of Forensic Science
8
SAMHSA Advisory: The Role of Biomarkers in the Treatment of Alcohol Use Disorders, 2012 Revision. Sring 2012; Volume 11 Issue 2
9
Clinical application of EtG measurement: Are we ready? Jatlow, P., & O’Malley, S. S. (2010). Alcoholism:Clinical and Experimental Research, 34(6), 968–975
10
Drug Court Review, 2014 Vol IX, Issue 1, The Efficacy of Enhanced Alcohol Monitoring; B. Gibbs and W. Wakefield
11
In June 2014, Express Diagnostics Int’l released a forensic use only onsite lateral-flow DrugCheck® Rapid EtG™test. Providing a longer window of detection of up to approximately 48 hours for EtG.
Rich Strasser began his career in the drug testing industry in 1999 when he co-founded a drug testing TPA in California, where he was also working as a
sheriff’s detective investigating narcotics- related crimes. In addition to being a drug abuse recognition instructor, he is also a DATIA Certified Professional Collection Trainer®
POCT products. In
(CPCT). In 2004, Strasser co-found-
ed Express Diagnostics Int’l (EDI) in Blue Earth, Minn., where they manufacture and distribute DrugCheck®
2012, after a 20-year career, he retired from the sheriff’s office as a cold case homicide detective and assumed the role of chief operating officer at EDI.
spring 2015
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