Today, EtG test results are legal proof in courts and probation departments in the U.S.
Ethanol is known by different names, like drinking alcohol, simply alcohol, or ethyl alcohol. The fermentation of sugars is produced by yeast.
Ethanol is the principal type of alcohol found in alcoholic beverages.
Ethyl glucuronide (EtG) is the immediate metabolite of alcohol.
One of the easiest ways to trace the alcohol usage of a person is the presence of ethyl glucuronide detected in urine.
The EtG alcohol test can verify the presence of ethyl glucuronide up to 80 hours after consuming alcohol. It is considered long after ethanol is no longer measurable in the body.
Alcohol Test: An Overview
Alcohol is the most abused substance in America and the world over.
There are several testing solutions to detect alcohol consumption. For example, a breathalyzer is a commonly used testing device to detect the recent consumption of alcohol and measures blood alcohol content (BAC). Other tests include hair, nails, urine, blood, and saliva. Most alcohol testing methods allow a detection window of a few hours to a few days. Traditional ethanol and alcohol tests do not always indicate abstinence.
The ethanol metabolites, ethyl glucuronide (EtG), and ethyl sulfate (EtS) are biomarkers of recent alcohol consumption that provide objective abstinence measures.
Besides urine, screening for EtG in your blood, hair, and nails is possible.
What Is EtG Test
Ethyl glucuronide (EtG) is a direct biological marker for detecting alcohol in your system. A significant amount of EtG is formed in the body within a few minutes after consuming ethanol from alcoholic drinks or diets.
The presence of EtG in the urine may be used to detect recent alcohol consumption, even after ethanol is no longer measurable. The presence of EtG in urine indicates that alcohol was ingested directly or indirectly.
Importantly, even in those who consume a negligible amount of alcohol, EtG is formed and detectable via test.
Usually, about 2 hours after consuming alcohol, EtG is traceable in urine, and its presence is detectable for 80 hours.
It should be noted that several key variants affect the detection window of EtG detection in urine, hair, or nails.
Key features of the EtG test
The EtG alcohol test detects ethyl glucuronide, a metabolite produced by drinking alcohol. It is used to detect alcohol levels in the urine. Some of the key advantages and benefits of this test include the following:
- Detects recent use of alcohol
- Unique biological marker of alcohol use
- Longer detection window than other conventional urine tests like ETOH or ethanol.
- Longer detection time than a breathalyzer test
- Suitable for monitoring zero tolerance
- Help confirm alcohol abstinence
- Aids in monitoring patients in alcohol treatment
- Works as a warning system to detect trends toward relapse.
- Provides up to 36 hours turnaround time from receipt of the specimen.
- Other drug testing panels can be conducted with the same urine specimen used for the EtG test.
Different uses and purposes of the test
The EtG test is primarily useful for registering the evidential documents required for alcohol abstinence. This test can also identify people with alcohol use disorder.
It also helps in detecting alcohol abstinence in situations that strictly prohibit alcohol use, such as:
- Schools, colleges, and defense staff like the military and police
- Patients with liver transplantation
- A DUI or DWI program
- Probation programs
- Court cases involving child custody or when visiting children
- Professional jobs that require total abstinence from alcohol use, like airline pilots, attorneys, doctors, teachers, etc.
Possible detection period
According to a research paper published by Oxford Academic, “During alcohol detoxification, EtG and EtS remained detectable in urine for several days.” “The detection times showed wide inter-individual variations, also after adjusting values for urine dilution and to the estimated times for completed ethanol elimination.”
Surprisingly, only 0.5 to 1.5 percent of alcohol consumed is eliminated from the body in EtG form.
One of the biggest advantages of using the EtG test is its ability to detect even very low levels of alcohol in the body. Some studies suggest this test can detect alcohol in the urine up to five days after consumption.
Limitations and drawbacks
It is appalling to note that even without consuming alcohol, a person can show positive results. When you consume or use some common products with alcohol content, you may test positive for EtG in your urine or saliva.
Some of the common foods and consumer products that contain alcohol are:
- Breath sprays
- Cough syrups
- Foods like cakes and delicacies flavored with alcohol
- House cleaning products
- Hand washes and mouthwashes
- Cosmetics
- Aftershave lotions
- Hygiene products like antiperspirant
Numerous recipes contain alcohol as a chief ingredient. Your urine sample may contain EtG after you have consumed such foods.
Many commonly used household and industrial products contain ethanol. Breathing in the particles of such products can put a bit of alcohol in the system, detectable by the EtG test.
Here are a few important facts regarding EtG tests worth noting:
- Ethyl glucuronide is a direct, minor metabolite used medically as a biomarker for ethanol exposure.
- If a urine sample is not properly stored, degradation of the level of EtG may occur over time.
- In some cases, incidental exposure to ethanol from non-beverage sources may result in a positive drug test for EtG.
- Some testing instances show that in-vitro creation of EtG can occur in certain rare physical conditions.
- The EtG level in the urine cannot exactly indicate the amount of alcohol an individual ingests, but it provides a rough estimate.
- EtG results have been accepted as valid evidence in courts of law.
Standards for interpreting alcohol test results
Unfortunately, the EtG test cannot exactly calculate how much alcohol was ingested or the level of intoxication.
However, the Substance Abuse and Mental Health Services Administration (SAMHSA) suggested the following cutoff values:
- Heavy drinking within the last five days: “high” positive EtG test (>1,000 ng/mL).
- Light drinking within the last 24 hours or heavy drinking within the last three days: Low positive EtG test (500 to 1000 ng/mL)
- Light drinking or exposure to alcohol-based products: Very low positive EtG test (100 to 500 ng/mL)
The cutoff levels can vary for some individuals depending on various factors specific to the individual.
The Final Thought
In addition to breath alcohol tests and interviews, the urinary EtG test for alcohol helps with job screening and deaddiction treatments.
The EtG test is a beneficial method for detecting recent alcohol ingestion. This test also can be a false positive, like all other tests.
For this reason, the positive EtG test must be re-confirmed with another test or verification method.
From all expectations, further research and development in EtG testing and other alcohol biomarkers can reveal a clear cutoff value. This will aid in correctly distinguishing between true alcohol use and exposure to alcohol-based products.
Recommended reading list:
Reference source:
- Wetterling, L. Dibbelt, et al, Ethyl Glucuronide (EtG): Better than Breathalyser or Self-Reports to Detect Covert Short-Term Relapses into Drinking, Oxford University Press, February 2014, Pages 51–54.
- Alcoholism: Clinical and Experimental Research, Ethylglucuronide and Ethyl Sulfate Assays in Clinical Trials, Interpretation and Limitations: Results of a Dose-Ranging Alcohol Challenge Study and Two Clinical Trials, 2014 Apr 28
- Anders Helander, Michael Böttcher, Et al, Detection Times for Urinary Ethyl Glucuronide and Ethyl Sulfate in Heavy Drinkers during Alcohol Detoxification, Oxford University Press, 29 October 2008.
- Staufer K, Yegles M. Biomarkers for the detection of alcohol consumption in liver transplantation. World J Gastroenterol. 2016;22(14):3725-34. doi:10.3748/wjg.v22.i14.3725
- Dahl H, Voltaire Carlsson A, Hillgren K, Helander A. Urinary ethyl glucuronide and ethyl sulfate testing for detection of recent drinking in an outpatient treatment program for alcohol and drug dependence. 2011;46(3):278-82. doi:10.1093/alcalc/agr009