Last updated: April 6, 2020
Rather than being used for workplace drug testing, the EtG test is called for when documentation is required to record alcohol abstinence. Methods used to administer the EtG alcohol test include all manner of drug testing. The most widely used EtG test is the urine test, however, blood, hair, saliva, and even nail testing are possible.
The EtG (ethyl glucuronide) test detects the presence of ethyl glucuronide. This is the breakdown product of ethanol which is the intoxicating agent in alcohol.
The EtG test is not recommended for use in employee drug testing programs because it doesn’t measure current impairment.
When to use the EtG alcohol test
When someone is addicted to alcohol, it’s hard to quit. Withdrawal symptoms range from shaky hands and anxiety to full-blown seizures in the case of extended periods of heavy drinking. Moreover, alcoholics are likely to try and hide the fact that they are abusing alcohol. Putting periodic EtG testing in place confirms whether or not someone is truly abstaining from use.
As previously mentioned, the EtG test is commonly used by programs that require abstaining from alcohol use. Of course, alcohol treatment programs top the list.
Other programs that implement this form of alcohol testing are:
- DUI or DWI programs
- Liver transplant patients
- Schools or the military
- Professional monitoring programs (such as airline pilots, attorneys, and healthcare professionals)
- Court cases (often involving child custody)
- Probation programs
The hair follicle test detects any alcohol or drug use for ninety days. Consequently, this makes it a very accurate test for determining behavioral use.
As with drug metabolites, EtG is stored throughout the body until it is completely eliminated from the system. However, a hair follicle test leaves a permanent record of drug and alcohol use because of the fact that the remnants grow out into the hair shaft.
Subsequently, this test will not be positive for use if someone has just used alcohol for the first time just a few days prior to the test. It takes time for the metabolite to grow out into the hair.
Normally, the hair is cut to a length of one and one-half inches before the test is performed. Human hair grows about one-half inch per month, thus the ninety-day detection period. There are times, say, for a court case, that a longer test period is required. If that is the case, the hair length used for testing is adjusted accordingly.
Other methods used to look for EtG have much shorter detection periods.
- The urine test detects EtG in the body from within a few hours of consumption for up to four days.
- A saliva test only detects the metabolite for ten to twenty-four hours.
- A blood test detects the EtG metabolite for up to thirty-six hours, but it’s most accurate between six and twelve hours after the last drink.
There are a number of reasons that the detection times vary. They include age, gender, weight, frequency of use, and metabolism rate.
Ethanol isn’t just for drinking
The problem with EtG testing is that many normal household products contain ethanol. That coupled with the fact that these tests are very sensitive can result in a false positive.
Some of these products include:
- Over the counter cold and flu medications
- Foods prepared with alcohol
- Cleaning products
- Breath sprays
- Hand sanitizers
- Antiperspirants and other hygiene products
- Hair dye
In regard to determining the results of an EtG test, the Substance Abuse and Mental Health Services Administration (SAMHSA) suggests the cutoff values be as follows:
“High” positive EtG test (>1,000ng/mL)
This result may indicate light drinking on the day the test is administered or heavy drinking the day of the test or the day before.
“Low” positive EtG test (500 to 1,000ng/mL)
A low positive result may indicate heavy drinking within one to three days of the test. It can also be a result of light drinking within 24 hours of the test. However, this result also indicates possible exposure to environmental products that contain alcohol.
“Very low” positive EtG test (100 to 500 ng/mL)
Again, this result may indicate heavy drinking within one to three days of administering the test. It also indicates the possibility of light drinking within 12 to 36 hours prior to the test. Lastly, it can also be due to recent exposure to environmental products containing alcohol.
Negative EtG test
There is no reason to suspect alcohol consumption if a test result is negative.
Admissible in court
Both the court system and scientific community agree that 500 ng/mL is a reasonable cutoff level to use as evidence in court. Anything below this level can’t accurately determine alcohol use because environmental products may have come into play.
Alcohol and the body
From the moment you begin drinking, alcohol impacts your body. Over time, the body develops a physical and emotional dependence on alcohol. Of course, this makes it extremely hard to stop drinking on your own.
Acute alcohol withdrawal syndrome comes on suddenly within the first couple of weeks after someone quits drinking. They include delirium tremens, hallucinations, and seizures. In fact, withdrawal symptoms can become so severe that they result in death.
Depending on the severity of alcohol abuse, Post-Acute Withdrawal Syndrome (PAWS) can last from a few weeks up to one year. This makes it difficult for many recovering alcoholics to maintain sobriety.
Common symptoms of PAWS are:
- Irritability and emotional outbursts
- Low energy
- Trouble sleeping
- Memory problems
- Prone to accidents
- Delayed reflexes
In addition to these lasting effects, a person that drinks even occasionally can experience short-term effects.
- Slurred speech
- Upset stomach
- Breathing difficulties
- Distorted vision or hearing
- Impaired judgment
- Decreased perception and coordination
Someone that drinks large amounts of alcohol over an extended period of time or who is a binge drinker is likely to experience many health problems.
- Unintentional injuries, such as falls, burns, car crashes, or drowning
- Intentional injuries acquired as a result of the use of firearms, sexual assault, or domestic violence
- Alcohol poisoning
- High blood pressure, stroke, or other heart-related diseases
- Liver damage
- Nerve damage
- Sexual dysfunction
- Permanent brain damage
- Amnesia, apathy, or disorientation caused by a Vitamin B1 deficiency
- Cancer of the throat or mouth
Monitoring is an excellent resource
Someone that seeks help for alcohol abuse wants to stop. However, the above lists make it clear that it is much easier said than done.
Alcohol addiction is a devastating disease, not only for the addict. Family and friends suffer along with them. It’s horrible to watch someone you love deteriorate right before your eyes. Moreover, the dysfunction caused has a negative effect on loved ones, possibly for a lifetime.
EtG testing is an excellent deterrent for someone who suffers from alcohol addiction. If they don’t know when to expect a test, or even if they know the schedule, it can be reason enough to keep them on the straight and narrow.