EtG Test | Pros And Cons Of This Urine Alcohol Test Revealed

Ethanol is known in different names like drinking alcohol, simply alcohol, or ethyl alcohol. It is produced by the fermentation of sugars by yeast.

Ethanol is the principal type of alcohol found in alcoholic beverages.

The ethyl glucuronide (EtG) is the immediate metabolite of alcohol.

One of the easiest ways to trace the alcohol usage of a person is by detecting the presence of ethyl glucuronide in urine.

EtG test can verify the presence of ethyl glucuronide up to 80 hours after alcohol consumption. It is considered a long time after ethanol is no longer measurable in the body.

The Advent of EtG Test

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 which measures blood alcohol content (BAC).  Other tests include testing of hair, nail, urine, blood, and saliva. Most of the alcohol testing methods allow the detection window for a few hours to a few days. Traditional ethanol 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 measures of abstinence.

Besides urine, it is possible to screen for EtG in your blood, hair, and nails.

Currently, the ethyl glucuronide (EtG) urine test is widely used to detect the presence of ethyl glucuronide in urine. It is more accurate than other tests in monitoring alcohol abstinence.

What is EtG Test?

Ethyl Glucuronide (EtG) is a direct biological marker for detecting alcohol in your system. EtG is formed in the body within a few minutes after consuming ethanol from alcoholic drinks or diets.

Its presence in urine may be used to detect recent alcohol consumption, even after ethanol is no longer measurable. The presence of EtG in urine is a clear indicator 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 drinking alcohol, EtG is traceable in urine, and its presence is detectable for 80 hours.

It should be noted that several key variants that affect the detection window of EtG detection in urine, hair, or nail.

Key Features of EtG Test

The EtG test detects the Ethyl Glucuronide, a metabolite produced from drinking alcohol. It is used to detect alcohol levels in urine. Some of the key advantages and benefits of this test include:

  • Detects recent use of alcohol
  • Unique biological marker of alcohol use
  • Longer detection window than other conventional urine alcohol tests like ETOH or ethanol
  • Longer detection time than a breathalyzer
  • Suitable for monitoring zero tolerance and abstinence conditions
  • Aids in monitoring patients in alcohol treatment
  • Works as a warning system to detect trends towards relapse
  • Provides up to 36 hours turnaround time from the receipt of specimen
  • Other drug testing panels can be conducted in conjunction with the same urine specimen used for the EtG test.

EtG can be detected in samples at very low levels, it can also be positive after incidental exposure or exposure to alcohol from non-beverage sources, which can lead to false positives.

Different Uses and Purposes

The EtG test is primarily useful for registering the evidential documents required for alcohol abstinence.

It also helps in detecting alcohol abstinence in situations that strictly do not allow alcohol consumption, such as:

  • Schools, colleges, and defense staffs like 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.

EtG testing is typically used to evaluate and monitor whether an individual is abstaining from the consumption of alcohol.

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 a 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 a very low level of alcohol in the body. Some studies suggest that this test can detect alcohol in urine up to five days after consumption.

Most studies on EtG tests show that ethyl glucuronide is detectable in urine samples for up to 80 hours (3.3 days) after moderate to heavy exposure to alcohol.

Limitations and Drawbacks

It is appalling to note that even without consuming alcohol a person can be tested positive in the EtG test. When you consume or use some of the common products with alcohol content, you may test positive for EtG in urine or saliva test.

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 of the commonly used household and industrial products contain ethanol. Breathing the particles of such products can put a bit of alcohol in the system detectable in the EtG test.

You can be falsely tested for EtG even without drinking the real alcohol after incidental exposure to alcohol-based products.

Facts Worth Noting

Here are a few important facts regarding EtG tests worth noting:

  • Ethyl glucuronide is a direct, minor metabolite medically used as a biomarker for ethanol exposure.
  • If a urine sample is not properly stored degradation 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 ingested by an individual but a rough estimate.
  • EtG results have been accepted as valid evidence in courts of law.

Standards of Interpreting Test Results

Unfortunately, the EtG test cannot exactly calculate the amount of alcohol ingested or level of intoxication.

However, the Substance Abuse and Mental Health Services Administration (SAMHSA), suggested the following cutoff values:

  • Heavy drinking within the last 5 days: High” positive EtG test (>1,000ng/mL)
  • Light drinking within last 24 hours/Heavy drinking within last 3 days: Low” positive EtG test (500 to 1000ng/mL)
  • Light drinking or exposure to alcohol-based products: Very low positive EtG test (100 to 500 ng/mL)

The cut-off levels can vary for some individuals depending on various factors specific to the individual.

The Bottom Line

All in all, the EtG test is considered a beneficial testing method of detecting recent use of alcohol ingestion.  For many reasons, this test also has a chance for a false positive test 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 unfold a clear cut-off value. This will aid in rightly distinguishing between true alcohol use and exposure to alcohol-based products.

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