Last updated: January 25, 2021
Ethanol, of course, is the intoxicating component of alcohol. The EtG (ethyl glucuronide) test identifies EtG, the breakdown product of ethanol. The test easily applies to blood, hair, and nails. However, administering it by means of the alcohol urine test is the common testing method. These tests aren’t recommended for workplace drug testing because they don’t measure current impairment.
So, rather than being used by employers in the workplace, the alcohol urine test is mainly used to document alcohol abstinence.
Reasons for abstinence testing
Abstinence testing is appropriate in cases where alcohol use is not allowed. Of course, alcohol treatment programs spring to mind. These tests are an excellent source of monitoring someone who is in danger of regression when treating their disease.
There are many circumstances that warrant monitoring someone who is likely to abuse alcohol.
- A DUI or DWI program
- Liver transplant patients
- Schools or the military
- Court cases—for instance, child custody or probation programs
- Professional monitoring systems—Often required for airline pilots, attorneys, and healthcare professionals
- Parents may use them to discourage underage drinking
- Researchers use the EtG test to assess the success of intervention programs
The EtG test is extremely sensitive and detects ethanol in the system for up to five days after consumption. Of course, the amount consumed affects the period of time that ethanol remains in the body.
There are three cutoff values determining the amount of—and the time period in which— alcohol was consumed.
“High” positive EtG test
The “high” positive result—for example, >1,000 ng/mL—may indicate heavy drinking on the same or previous day. It definitely indicates light drinking on the same day as the test.
“Low” positive EtG test
The “low” positive result—for example, 500 to 1,000 ng/mL—may indicate heavy drinking within the last one to three days or light drinking within the last 24 hours. It also indicates the possibility of recent intense exposure to environmental or household products containing alcohol.
“Very low” positive EtG test
The “very low” positive EtG test—for example, 100 to 500 ng/mL—is indicative of heavy drinking within the last one to three days or light drinking within the last 12 to 36 hours. It’s also possible that the test subject recently used environmental or home products containing alcohol.
Studies show that the EtG test accurately identifies a person who has recently consumed alcohol up to 85% of the time.
However, that doesn’t bode well for the remaining 15%, now, does it?
Government-issued warnings exist regarding the possibility of false positives when using the EtG test. One instance of such is documented in the Libray of Medicine National Institutes of Health (NCBI) stating:
Both EtG and EtS have been shown to be sensitive and specific in detecting alcohol consumption in alcohol-dependent patients (Junghanns et al., 2009), although a cutoff concentration above the detection limit is generally favored to minimize false positive results arising from non-beverage ethanol ingestion (e.g., in foods, mouthwashes, and other over-the-counter products).
The U.S. Food and Drug Administration never approved EtG tests.
Unintentional exposure to alcohol from environmental or home products containing alcohol can result in a positive result.
- Foods prepared or flavored with alcohol—including extracts!
- Cleaning products
- Breath sprays
- Hand sanitizers
- Hygiene products
- Styling products
- Hair dye
- Medications and cough syrups
- Herbal therapies
The number of products containing alcohol grows quite extensive. You can see from our list that you find it in virtually everything. Therefore, it’s wise to scan a product’s ingredients prior to purchase just for good measure.
When using an EtG test to monitor someone for alcohol abstinence, a false positive can negatively impact their progress, both in medical and forensic settings. In fact, SAMSHA (Substance Abuse and Mental Health Services Administration) issued a statement addressing that fact.
False positive responses can be harmful in medical and forensic settings. Individuals’ freedom or career can be in jeopardy.
Therefore, always confirm a positive EtG test result before proceeding with any type of consequence.
Further research needed
Those that use the alcohol urine test for monitoring individuals who must abstain from use agree that further research is needed to solve the dilemma of the false-positive result. It’s hoped that technology continues to present increasingly accurate ways to distinguish between true alcohol use and the use of environmental and home products.
Research continues to discover how exposure to these products affects EtG levels. Furthermore, they want to discover how such factors as disease, race, gender, and genetics affect the test.
Not everyone tested for abstinence suffers from an addiction to alcohol.
But, for those that do, a false positive result can have devastating results. For some, it could mean losing custody of or visitation privileges with your kids. It could be the “last straw” that causes the break-up of a relationship—a marriage, perhaps. If you’re the recipient of a new liver, a false positive result can put you in a world of trouble with your medical team until resolving the situation.
The scenarios can go on and on.
The bottom line—when monitoring for abstinence, you are dealing with someone’s life. Once they’ve found themselves in this position, the threat that a mandatory test could change it forever shouldn’t be hanging over their heads.
Not for a second.
Fighting addiction is hard, but the battle can be won. Having a supportive group of people around the recovering addict at every turn is key to their success. That includes those of us that play a part in monitoring their sobriety.
Let’s unite and strive for that.