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Long-Term Alcohol Biomarkers

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Emerging Technologies That Allow for the Long-term Detection of Risky Drinking Behavior

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Bartender making alcoholic cocktail. | Source by Freepik© Stock

Alcohol abuse continues to be a significant health concern for the United States. In the United States, 15.3 million people are categorized as having an alcohol use disorder while 1.9 million have a drug use disorder.

Additionally, another 2.3 million have both an alcohol and drug use disorder (Stinsonet al, 2005). According to the Judicial Council of California, a survey of family law judges indicated that more than 50% of child custody decisions involved alcohol and drug abuse as a factor (Center for Families, Children,& the Courts, 2007). Reliable and objective measures of alcohol consumption can assist legal, healthcare, and addiction treatment professionals with the evaluation and monitoring of
their clients and allow the local substance abuse professional an opportunity to expand their list of available services in their community. Traditional methods to identify and evaluate individuals with alcohol use disorders include a variety of self reporting questionnaires, indirect alcohol biomarkers, and direct shortterm alcohol biomarkers. Selfreport questionnaires (such as AUDIT, MAST and CAGE) have limited utility because of participant self-incrimination and recall bias. Indirect alcohol biomarkers
(such as CDT, GGT, and MCV) measure the biological effects of abusive alcohol consumption and are not 100% specific risky alcohol behavior. Many indirect alcohol biomarkers are sensitive to various cancers, infections, and pregnancy. The direct measurement of alcohol in blood, breath, urine and oral fluid has a detection window of approximately 1 hour per drink. These tests are very effective for roadside safety, reasonable suspicion and post accident testing. However, a detection window measured in hours has limited utility in most circumstances. Many situations exist that would benefit from sensitive and specific alcohol biomarkers that detect abusive alcohol consumption. Originally, it was assumed that ethyl glucuronide and ethyl sulfate in urine was a result of beverage alcohol consumption.

Lower costs of more sensitive laboratory instruments have allowed laboratories to develop and offer a new group of tests for direct long-term alcohol biomarkers at a reasonable cost.

However, recent reports in the scientific literature indicate that these compounds can be found in urine due to transdermal absorption from the use of ethanol containing hand sanitizers (Rohrig & Ross, 2006) and innocent ingestion of ethanol containing products such as mouthwash, medicines and certain foods (Costantino et al, 2006). Testing urine for ethyl glucuronide and ethyl sulfate satisfies a critical need of ethanol abstinence compliance in our industry. However, the Substance Abuse and Mental
Health Services Administration (SAMHSA) warns substance abuse professionals to be very careful with the interpretation of these results (SAMHSA, 2006).

Lower costs of more sensitive laboratory instruments have allowed laboratories to develop and offer a new group of tests for direct long-term alcohol biomarkers at a reasonable cost. These tests are now available to the local substance abuse professional to offer to their community’s legal, healthcare, and addiction
professionals. Understanding the advantages and disadvantages of these new and exciting tools for the substance abuse profession could be the deciding factor that distinguishes you from other substance abuse testing sources.

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