Alcohol Urine Testing – Understanding EtG Testing

The test for detecting alcohol in urine is called an ethyl glucuronide test, or EtG test. There are different EtG tests that can test blood, nails and hair, but the urine screen is most popular.

Understanding EtG Alcohol Testing

The first time EtG testing was used to detect alcohol in human urine was in 1997. Since then it has become a common way to confirm abstinence from alcohol and products that contain ethanol.

Once alcohol has been eliminated from the body, a breath test or saliva test can no longer detect alcohol. Using these methods to confirm abstinence is difficult unless the person is tested at a minimum of once per day.

How Does An EtG Urine Test Work?

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

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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, a breathalyzer can not.

EtG tests are extremely sensitive and can detect low levels of alcohol ingestion. This can lead to some false positives if a person was exposed to one of the many products that contain alcohol.

Who Uses An EtG Alcohol Test?

EtG tests are most often used to make sure that people are abstaining from alcohol.

Any number of reasons and situations may require a person to be tested for alcohol abstinence, including:

  • alcohol abuse treatment programs
  • programs that monitor people who have DUI
  • liver transplant protocol
  • school or military
  • court cases
  • employers
  • probation offices
  • court cases
  • court mandated parenting programs

This type of test measures previous alcohol consumption, so it is not considered a standard test for individuals suspected of impairment while driving or at work. Those situations are better suited for a breathalyzer test.

EtG Test Limitations

The EtG test can only confirm that a person has not consumed alcohol or alcohol containing products in the days leading up to the test.

Unfortunately, there are many items that contain alcohol people can encounter on a daily basis, such as:

  • mouthwash
  • breath spray
  • kombucha
  • “non-alcoholic” beverages (NA beer)
  • some cough syrups and cough drops
  • cleaning products
  • hand sanitizer
  • antiperspirant
  • makeup
  • hair dye
  • aftershave
  • food prepared with alcohol

The Household Products Database, published through the National Library of Medicine, allows individuals to search for products that contain alcohol. All of those products have the potential to affect the results of an EtG test.

Interpreting An EtG Test

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

A positive EtG test usually confirms a person was exposed to ethanol within the days leading up to the urinalysis. The results will show the levels of EtG in the urine, and the Substance Abuse and Mental Health Services Administration (SAMHSA) has provided some interpretation guidelines for the results of EtG tests.

Levels higher than 1,000ng/mL of EtG in the urine is considered a “high” positive, and usually is indicative of heavy drinking within the previous day or same day, or even light drinking the day of the test.

“Low” positive tests have levels of EtG between 500 to 1,000ng/mL. These amounts of EtG could be due to heavy drinking within three days of the test, light drinking in the past 24 hours, or intense exposure to products containing alcohol recently.

Positive EtG levels of less than 500ng/mL are observed as “very low”, and may indicate heavy drinking several days prior or light drinking twelve to 36 hours before. However, it could also mean that the person was exposed to alcohol-containing products as well.

False Positives In EtG Testing

In addition to ethanol exposure, there are some situations and circumstances in which a person may have a positive EtG test without consuming an ethanol product.

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

A person with diabetes who has a urinary tract infection may produce EtG and result in a positive test. This can only occur in individuals who have diabetes.

EtG Alcohol Testing And Treatment Options

Failing a drug or alcohol screen can be an indication that a person is struggling with a substance abuse problem, especially if the testing is expected. Being unable to abstain from alcohol long enough to pass an EtG alcohol screen may suggest a person has an alcohol addiction.

Fortunately, there are several options for a person who struggles with an alcohol misuse disorder. Alcohol abuse treatment centers provide many options for those seeking sobriety.

Detoxification in a medically supervised environment can help a person safely remove alcohol from their life. Medications and other supplements are used to ease the discomfort associated with alcohol withdrawal.

Inpatient or outpatient substance abuse options are available as the next step in the recovery process. These options can be explored with a trained professional who can assess the level of addiction and the best solution for you or your loved one.

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.

Alcohol and Addiction - https://academic.oup.com/alcalc/article/42/4/317/160166

Drug Alcohol Dependence - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663163/

National Library of Medicine - https://householdproducts.nlm.nih.gov/cgi-bin/household/list?tbl=TblChemicals&alpha=A

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