EtG / EtS - Ethyl Glucuronide
Ethyl Sulfate Alcohol Drug Test
_____________________
Also known as "The 80 Hour Alcohol Test"
EtG/EtS is a laboratory
based urine test that will detect the presence of alcohol up to 80 hours after
consumption. This is sometimes referred to as “The 80 Hour Alcohol Test” and
tests for Ethyl Glucuronide and Ethyl Sulfate. This is the Ethyl Glucuronide
urine test or EtG testing of alcohol in urine.
Ethyl Glucuronide (EtG) and
Ethyl Sulfate (EtS) are metabolites produced by the body only after the
consumption of alcohol has been consumed. EtG and EtS are excreted from the body
in various ways. Our laboratory is one of only a few laboratories in the
country that has the ability to identify and quantify these two metabolites.
EtG and EtS testing
will allow you to quantify alcohol consumption up to 80 hours
afterward.
This is a LCMSMS Lab Test (a.k.a. LC-MS-MS
or LCMS, LC-MS) for professional laboratory
testing of human urine for the presence of metabolized alcohol.
#LAB-LCMSMS-EtG Alcohol Test
Ethyl Glucuronide FAQ
What is EtG testing?
EtG testing is a reliable
and accurate method of verifying abstinence from alcohol use and of detecting
alcoholic beverage consumption. EtG testing reveals alcohol use up to
three-and-a-half days from the time of the urine collection
How accurate is EtG
testing?
EtG testing is not subject
to adulteration, fermentation, or cross-reactivity; it is simple, precise and
reliable. EtG testing reveals alcohol exposure from the prior approximately
80-hours; the actual “window of detection” will, of course, vary from person to
person, related to dose, individual metabolism, and test sensitivity.
There are over forty
peer-reviewed articles on EtG, published in major international scientific
journals. Compared to other alcohol testing systems that claim continuous
monitoring, EtG testing has by far the most scientific validity.
Because alcohol is
extremely common in the environment, inadvertent alcohol exposure, typically
related to frequent use of high-alcohol content cleaning products, has been
known to create innocent positives. Such cases are relatively rare, but must be
considered when reviewing a non-negative EtG test result. As in all substance
abuse testing, professional assessment of non-negative test results is always
appropriate. See our
list of products which contain alcohol.
How is EtG testing used?
EtG testing is used to
monitor impaired health professionals throughout the United States. Doctors,
dentists, nurses, pharmacists and other health care professionals all benefit
from the routine verification of abstinence provided by EtG tests.
It is used increasingly by
treatment agencies, courts and community corrections programs.
It is used in accident
investigations, when alcohol consumption is considered a potential contributing
factor.
What about the different
levels of EtG testing?
Three different test
levels are commonly available:
100 ng/ml LC/MS/MS testing
– This level of sensitivity is most commonly used to monitor individuals for
professional or clinical reasons, such as impaired health professionals. It is
often used by criminal justice agencies. Testing at this level will occasionally
(about 1 non-negative in 500) pick up incidental exposure.
250 ng/ml LC/MS/MS testing
– This level of testing will detect about 97% of episodes of alcohol use as
compared to 100 ng/ml testing). This level has a high enough cut-off to avoid
most incidental exposure.
500 ng/ml LC/MS/MS testing
– This level of testing will detect about 90% of episodes of alcohol use as
compared to 100 ng/ml testing. This level is used increasingly, especially for
routine clinical and forensic applications as most "innocent positives" (that
is, non-negative results due to inadvertent alcohol exposure) occur below the
500 ng/ml level. This is the cut off level that we use for our Ethyl
Glucuronide test. It provides the fewest false positives from
secondary exposure to alcohol.
What about confirmation?
Our Ethyl Glucuronide test
is a confirmation test! Our EtG test is performed by the LCMSMS method and
simultaneously detects both EtG and EtS. EtS is another alcohol marker,
allowing for immediate confirmation, saving time and getting the report to the
requesting agency quickly.
What is the significance
of the EtG level reported in a positive result?
As with all drug test
results, it is best to think of EtG results as simply Negative or Non-Negative.
The level of EtG reported, which might, for example, be as low as 600, or as
high as 100,000 does not necessarily reflect greater or lesser drinking. Many
factors can affect the level of EtG detected in an individual’s urine sample, so
avoid making undue assumptions based on EtG detection levels reports.
Are there
any meds that would give a positive EtG?
So far only
ethyl alcohol seems to produce EtG or EtS. The issue is really more where did
the alcohol come from? Many medications include ethanol as a solvent (cough
syrup, etc) and therefore could cause very low level of EtG or EtS. For more
information, see our list of
products that show positive for EtG / EtS.
What about
polyethylene glycol? Can it cause a positive EtG?
Probably not
but no studies to our knowledge! Polyethylene glycol can be found as an
ingredient in various tablets and OTC meds. There is no evidence that
degradation of this compound produces ethanol, especially in enough quantity to
cause a positive EtG/EtS test.
Does warm
weather during shipment cause a more rapid breakdown of EtG in urine?
Recent
experiments show that heating urine to 100 C (boiling point of H2O) actually
increased the stability of EtG. The data are showing that at room temperature,
in some individuals with nitrites and/or blood in urine, that EtG can
deteriorate over a week. We are surmising that esterases associated with
infection may be causing breakdown of EtG. Heating seems to prevent breakdown,
possibly due to neutralizing the bacteria. So, the fact is that heat doesn't
cause breakdown of EtG, it actually increases stability.
Questions
concerning the AWOL vaporizer:
This “new”
method of alcohol abuse known as Alcohol Without Liquid (AWOL) vaporizer is
discussed on the web sites. Following is the response from Dr. Ed Barbieri from
National Medical Services, Willow Grove PA:, regarding an opinion about how this
would affect EtG.
”We have looked
into the AWOL machine from the website. Alcohol may enter the bloodstream in
the manner that is described on the web site. For ethanol to get to the brain it
MUST enter the bloodstream. If ethanol enters the bloodstream, it will be
distributed to other tissues throughout the body including the liver and,
therefore, will be metabolized. Once metabolized, ethyl glucuronide can be
formed and will be eliminated (along with some ethanol) into the urine. In
summary, if someone is choosing to take in ethanol in this manner, it will still
be metabolized through traditional pathways that may result in positive EtG
findings. The EtG results would be dependent upon the time from exposure,
amount etc., all of the same things that would need to be considered if alcohol
was ingested in a liquid form through drinking.”
What about
incidental alcohol use, such as in food, mouthwash, communion wine, etc?
This is an
important question and an important issue to understand. Ethanol, unlike other
drugs, is fairly common in our environment. It's in food (ie vanilla extract).
It's used as solvent in "over-the-counter" meds. It's used in ceremonies (ie
communion, etc). It is recommended that anyone being tested (i.e. those in
monitoring following alcohol problems) be advised that they should not consume
food containing alcohol, avoid OTC meds containing alcohol, mouthwash with
alcohol, and/or communion wine or anything else containing alcohol. It is
possible in some circumstances that the urine EtG level could exceed the cutoff
levels by this type of "non-beverage alcohol" exposure. For more information,
see our page that details common environmental considerations for Ethyl
Glucuronide testing.
Why Perform EtG / EtS
Testing?
Alcohol
abuse creates numerous problems:
Alcohol is the
most commonly abused drug in the United States.
Alcohol abuse
is highly associated with problematic behaviors of all kinds, including:
a. Impaired driving
b. Physical assault
c. Sexual assault
d. Other criminal acts
e. Anti-social behaviors of all
kinds
Alcohol abuse
and dependence are highly associated with other substance abuse.
Individuals with alcohol problems
have trouble stopping drinking.
Denial and minimization make it hard
for alcohol abusers to recognize their drinking problem.
Many excessive drinkers are poorly
motivated to stop drinking.
Despite agreement to stop drinking,
secret drinking is a common problem.
Episodes of secret drinking are
often hard to detect.
EtG testing allows for detection of
secret drinking.
When persons with alcohol problems
know that secret drinking will be detected, they usually stop drinking.
EtG testing reduces alcohol abuse.
In organized
treatment programs, routine testing for drugs of abuse (including EtG alcohol)
results in greatly reduced rates of substance abuse.
Drug courts that use EtG testing
report greatly reduced alcohol abuse rates:
-Initial EtG tests typically detect
drinking in ~50% of participants.
-When EtG testing becomes routine,
the drinking rate falls to 5% or less.
EtG testing
confirms alcohol abstinence.
When alcohol
abusers stop drinking, it is often difficult for others to trust that they are
truly sober. EtG testing provides an external verification of abstinence - it
allows programs, treatment professionals and families to "trust but verify."
The Testing
Process / Procedure
EtG testing
is a process similar to other lab-based drugs of abuse testing. The following
steps are typically followed:
Step 1:
A chain of custody
form is completed
Step 2:
The subject voids into
a standard collection cup. The temperature of the urine is checked, using a
temperature strip on the collection cup, to assure it is a valid sample.
Step 3:
A urine specimen
syringe device is used to collect a sample of the urine.
Step 4:
The syringe device,
and related paperwork are sent to the lab. This is easier, cleaner and less
expensive than sending a bottle of urine.
Step 5:
The test samples are
shipped to our lab by the US Postal Service or by UPS or FedEx. The most
economical and effective method of getting your sample to the lab will depend on
your location.
Step 6:
Results are typically
reported within three days of receipt at the lab.
RESEARCH QUALITY LABORATORY
SERVICES
In the United States, alcohol abuse has reached
epidemic proportions. The overall risks to physical and mental health can be
devastating. More severe are the tens of thousands of fatalities annually which
are attributed directly to alcohol intoxication. The costs associated with
enforcing laws, prison systems, governmental programs and non-profit funding is
exorbitant.
Until recently, testing methods for alcohol
consumption have remained unchanged and unreliable. Urine ethanol has it’s flaws
such as false positive results. The window of detection for breath alcohol
testing is small and always had to be confirmed by laboratory blood testing
which may not occur for many hours after suspected consumption.
Our Laboratory has changed the face of alcohol
testing industry. We have the capability of measuring consumption up to 80 hours
afterward. Ethyl Glucuronide (EtG) and Ethyl Sulfate (EtS) are metabolites
produced by the body only after alcohol has been consumed. EtG and EtS are
excreted from the body in various ways and our Laboratory is one of the few
laboratories in the country able to identify and quantify these two metabolites.
The New Front Runner: EtG & EtS
• EtG and EtS are easily quantifiable with
Liquid Chromatography Mass Spectrometry not GC/MS and proper measurement of both
metabolites can differentiate consumption vs. environmental exposure
• EtG/EtS confirmation is the perfect testing
method for ‘Zero Tolerance’ situations and an effective and noninvasive tool for
voluntary treatment facilities and school systems
• EtG/EtS can not be masked by
illnesses i.e. urinary tract infections, and false positive results from
diabetes are eliminated.
The Most Advanced Technology Available
Our Laboratory has the most accurate technology
available for the drug and alcohol testing community. Liquid Chromatography Mass
Spectrometry (LC/MS/MS) is research quality laboratory equipment, and can
accurately quantify substances well below cutoff levels. This technology
surpasses Gas Spectrometry, which in the past had been labeled the ‘gold
standard’. Western Slope Laboratory currently owns and operates 4 LC/MS/MS and
we are constantly investing in our technology.
Collection Process & Shipment
The urine collection device developed by our
Laboratory is as innovative as the testing process. An absorbent material
encased in a sealable tube. The design provides ample volume of specimen for the
lab and is less bulky than urine transport cups. Our collection device minimizes
accidental spills or specimens destroyed in transport . Because our Laboratory’s
collection devices are compact and lightweight, this reduces transportation
costs.
More information on the Ethyl Glucuronide Test
Ethyl Glucuronide urine testing -
EtG and EtS metabolite detection services with full quantitation included.
Urine-Based Alcohol Testing
EtG testing PLUS! All EtG testing
includes EtS! We have the capability to measure metabolites not measurable by most
laboratories in the USA. EtG (ethyl glucuronide) testing alone, offered by
virtually every laboratory in the drug and alcohol testing industry, does not
provide a dispositive confirmation of alcohol consumption within the detection
window of 0 – 80 hours (average of 36-48). Coupling EtG with EtS (ethyl sulfate)
does, since the EtG metabolite is often “masked” by urinary tract infections.
The ability to detect EtS using LC/MS/MS separates us from other
laboratories in the United States. Only LC/MS/MS is capable of doing this!
Our lab has become a leader in alcohol
testing—offering services that present unique opportunities for its customers.
Among our many customers, we provides EtG
and EtS testing services for other laboratories providing services in the drug
and alcohol testing industry. Generally speaking, this is due to the universal
use of Gas Mass Spectrometry within the industry. GC/MS cannot be used to detect
EtG and EtS.
There is also no wet chemistry/re-agent (EMIT) screening! The industry is seeing
a growing number of laboratories offering EtG "screening" as opposed to full
testing. The price might be slightly lower, but the accuracy is lower as well.
In addition, if the positive results from "screening" have to be confirmed,
why screen at all? Send your alcohol tests to use for
Ethyl Glucuronide testing, we test every sample!
In addition to the EtG tests, we also offer a wide range of other alcohol tests:
urine test for alcohol, as well saliva test for alcohol and breath alcohol test.
For more information on the different
types of drug tests, click on one of the links to the left.
