EtG Alcohol Tests: What You Need to Know

The EtG alcohol test is used to determine if a person who is not supposed to be drinking has consumed alcohol. Many of New Life Medical Addiction Services’ patients have questions about EtG alcohol tests and we are here to provide answers to this complex subject.

The ethyl glucuronide (EtG) test for alcohol use is used to detect the presence of ethyl glucuronide, a breakdown product of ethanol, the intoxicating element in alcohol. The EtG test most often analyses a person’s urine but It can also screen for EtG in samples of a patient’s hair, nails or blood, hair, and nails. In most situations the urine test is used.

The EtG test was first used to detect alcohol in human urine in 1997 and has subsequently become one of the most common ways to determine someone’s abstinence from alcohol and other consumables that contain ethanol.

In What Situations is an EtG Alcohol Test Used?

The EtG test is used to determine if someone is using alcohol when they should be abstaining from drinking. Some of the many situations where this test might be used include:

  • If someone is enrolled in an alcohol treatment program
  • As a liver transplant protocol
  • In the military and in school situations
  • DWI and DUI programs
  • Criminal probation
  • Some legal situations such as child custody proceedings
  • Professional monitoring of healthcare professionals, airline pilots and others
  • Certain employer mandated programs
  • Other

In many of these scenarios the person is being given the test because it is the best interests of their health or for the well-being of others. It is important to understand this because the administrators of the tests are very serious about the results.

It is also important to note that the EtG test is not typically used when a person is suspected of alcohol use while driving or at work. In those situations, where impairment is suspected, a breathalyzer test is typically employed.

How Sensitive is the EtG Alcohol Test?

Breath or saliva tests can no longer detect alcohol once it has been naturally eliminated from the body so using these tests to confirm that a person is abstinent is hard unless the patient is tested at a minimum of once per day.

The shortened effective time from of these tests is one of the reasons that the EtG test was developed. The EtG test is highly sensitive and can detect the presence of alcohol at extremely low levels. For patients who are suffering from alcohol use disorder (AUD), the EtG test has been able to detect alcohol in urine up to 5 days after consuming it. For people who do not have an alcohol use disorder, it can be detected in urine up to 80 hours after consumption.

 How Does The EtG Alcohol Test Work?

Ethyl Glucuronide (EtG) is a metabolite of ethyl alcohol. When a person consumes alcohol, the body breaks it down into different metabolites and one of them is EtG. EtG remains present in the body for about one to five days after drinking alcohol, depending on the quantity a person consumes.

The EtG test is very helpful when monitoring abstinence from alcohol. An EtG test can confirm that a person did not consume alcohol in the days prior to the test when a breathalyzer can’t. The concern about EtG testing is that it is extremely sensitive and can produce false positives if a person has been exposed to alcohol in even tiny amounts.

Some of the common ethanol-containing products that can produce false positives in EtG testing include:

  • Hand sanitizers
  • Mouthwash
  • Breath spray
  • Aftershave
  • Cosmetics
  • Household cleaning products
  • Foods that are made with alcohol
  • Hair dies
  • Deodorants & antiperspirants
  • “Near beer” and other “non-alcoholic” beverages (these actually contain trace amounts of alcohol

This is only a partial list. In truth there are many, even hundreds of every-day products that contain ethanol and which can trigger an EtG test to produce a positive result.

Understanding the Results of an EtG Alcohol Test

The EtG test is most reliably used in confirming that a person has not consumed alcohol or any alcohol-containing products in the days prior to the test. A positive EtG test usually confirms a person was exposed to ethanol within the days leading up to the urinalysis

Even with this as its goal, the test will only accurately detect ethanol in a person who recently consumed alcohol 70 percent or more of the time. One study showed that for moderate to heavy drinking, this number jumps to 85 percent.

A negative EtG test shows that a person was not exposed to ethanol within the testing time frame (up to five days).

SAMHSA (Substance Abuse and Mental Health Services Administration) has developed the following guidelines for the results of EtG tests.

High Positive Results

Levels higher than 1,000ng/mL of EtG in the urine is considered a “high positive”, and usually indicates:

  • Heavy drinking on the same day or previous day
  • Light to moderate drinking on the same day as the test

Low Positive Results

“Low positive” EtG tests have levels of EtG between 500 to 1,000ng/ml. These amounts of EtG can be associated with:

  • Heavy drinking within the last one to three days
  • Light drinking within the last 24 hours
  • Recent, high exposure to environmental products containing alcohol (within the last 24 hours)

Very Low Results

Positive EtG levels of less than 500ng/mL are observed as “very low” and may indicate:

  • Heavy drinking within the last one to three days
  • Light drinking within the last 12 to 36 hours
  • Recent exposure to environmental products containing alcohol

EtG Testing False Positives

In addition to ethanol exposure through the consumer products mentioned earlier, there are some situations where a person may have a positive EtG test without consuming a product with ethanol.

For instance, if a person’s urine sample is not stored properly and remains too long at room temperature, EtG levels can rise due to bacteria growth in the sample. Refrigeration of samples is suggested for any EtG test that cannot be shipped within the recommended time frame.

Also, a patient with diabetes who has a urinary tract infection may produce EtG, which can result in a positive test. This situation can only occur in an individual who has diabetes.

SAMHSA does provide the following warning on the exclusive use of an EtG alcohol test:

Currently, the use of an EtG test in determining abstinence lacks sufficient proven specificity for use as primary or sole evidence that an individual prohibited from drinking, in a criminal justice or a regulatory compliance context, has truly been drinking. Legal or disciplinary action based solely on a positive EtG, or other test discussed in this Advisory, is inappropriate and scientifically unsupportable at this time. These tests should currently be considered as potential valuable clinical tools, but their use in forensic settings is premature

Click Here to download a PDF with the full SAMHSA briefing on the EtG test.

EtG Alcohol Testing And Treatment Options

Failing a drug or alcohol screen can be an indication that a person is struggling with addiction or  substance abuse. Someone who cannot refrain from consuming alcohol long enough to pass an EtG alcohol screen may be suffering from Alcohol Use Disorder or Alcoholism.

If you or someone you care about is struggling with alcohol use then the doctors and staff at New Life Medical Addiction Services in Marlton, New Jersey can help. Our state of the art out-patient addiction clinic specializes in medical detoxification for alcohol and other drugs.

Contact our addiction treatment specialists today and let us help explore the available options with you. We can help you find the treatment you or your loved one need. To speak to someone at New Life, call us at: 856-942-3700 or send us a Text Message.

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