By Freepik© Studio

Kenosha County, Wisconsin, was one of the first counties in Wisconsin – and Wisconsin is still the only state in the nation – to use direct biomarker testing to help the population of impaired drivers served by the local assessment agency, the Hope Council on Alcohol and Other Drug Abuse, where I was Executive Director. Starting in July 2011 with the help of Pamela Bean, PhD, who had dedicated herself to reducing the number of drunk drivers on Wisconsin’s roads, the Hope Council, partnering with USDTL, implemented testing of convicted impaired drivers who were assessed for three or more offenses. In 2014 we expanded testing to include any person convicted and assessed for any number of offenses who was referred to treatment.

Testing the intoxicated driver population was the single most impactful change made in this programming since assessments were mandated in the late 1970s, and I truly don’t understand how every county in every state in the nation hasn’t jumped on board.

Dr. Bean laid the groundwork for Wisconsin counties by securing permission for the use of direct biomarker testing, but these aren’t just any tests. These tests specifically identify those who use alcohol problematically. We aren’t looking to “catch” drinkers. We’re looking to help those who have significant substance use disorders to recognize that their use is problematic and then guide them into treatment and provide tools for them to begin a life of abstinence…or at least to not drink during the Driver Safety Plan (DSP) that’s developed with them at the assessment.

Clients at the Hope Council with three or more offenses are required to have at least three Ethyl Glucuronide (EtG) tests during the one-year duration of their DSPs. EtG is detected in fingernails and shows a detection window of up to approximately 3-months of use. For those clients who have deliberately underplayed their use at the time of assessment, it’s likely that a follow-up Phosphatidylethanol (PEth) test would be scheduled within a month of the surprise positive test results. The PEth test uses dried blood spots and shows a detection window up to approximately 2-4 weeks of use. Many clients are surprised by the quality of these tests, so they may not be truthful at the assessment. The follow-up PEth allows the clients the opportunity to show that they are abstaining, as required by the assessment.

And if they aren’t? Well, that gives the assessment agency the opportunity to provide additional support and oversight for those who are having a hard time remaining abstinent. Addiction is a chronic, progressive, lethal disease, and it needs to be treated as such. Every other disease uses tests to provide valuable information for disease management, so why not the disease of addiction? Finger sticks for diabetes determine if blood sugar levels are balanced. Blood tests for international normalized ratio (INR) for heart disease determine if the blood is clotting properly. Direct biomarker tests should be used to determine if those assessed as having significant substance use disorders are maintaining appropriate levels of substances – specifically none – in their systems.

These tests are the best tools to help those suffering from the disease of addiction to recognize it and move toward treating it.

Click here to learn more on Guided by Guida. Click here to learn more about Alcohol by the Numbers.

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