This issue of Substance takes you in depth into the world of alcohol biomarker testing. The number of people in the U.S. with an alcohol use disorder outnumber those with a drug use disorder by four to one. The annual economic, healthcare, and social fallout from hazardous alcohol use is staggering: 88,000 alcohol related deaths each year; more than 10,000 alcohol related driving fatalities; more than $223 billion in annual economic costs. Alcohol biomarker testing is a tool to help the legal, healthcare, and addiction treatment professional to track patient alcohol consumption patterns. We know you’ll find the information in this issue helpful in navigating the confusing world of alcohol biomarker testing. And that’s our mission, too. To help you find simple answers in a complex drug and alcohol testing world. Connect with us through our social media and let us know how we’re doing.
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EtG EtG EtG EtG E t E E G t t • E t E E G t t • E t E E G t t • E t E E G t • E t E E G t t E t E E G t t • E t E E G t t • E t E E G t t • E t E E G t • E t E E G t t E t E E G t • E t E E G t t • E t E E G t t • E t E E G t t • E t E E G t t E t E G t • E t E E G t t • E t E E G t t E t E E G t • E t E E G t t Substance 4 PEth testing using dried blood spots. 6 Emerging technologies in long-term alcohol biomarkers. 8 The Rule of Three for alcohol biomarker testing. Clarity in Toxicology | v.6 i.1 The Alcohol Issue Ethanol biomarker testing comes of age in advanced alternate specimens. Winter 2015
6Emerging technologies in long-term alcohol biomarkers.
8The Rule of Three for alcohol biomarker testing.
Clarity in Toxicology | v.6 i.1
The Alcohol IssueEthanol biomarker testing
comes of age in advanced
alternate specimens.
Winter
2015
2 Winter 2015 Substance
Letter from the editor
WHAT’S OLD IS NEW
Welcome to your new quarterly newsletter.
You might be wondering what happened to your USDTL Quarterly Newsletter. Of course, as you can see, we’ve changed it. We’ve even renamed it.
Welcome to the first issue of Substance, USDTL’s quarterly newsletter of forensic toxicology.
This isn’t the end of our old newsletter - the longest running newsletter of any forensic toxicology laboratory in the U.S. It’s the beginning of something better. The world of drug and alcohol testing is a dynamic forum. We felt it was time to improve our newsletter, to better update you on the latest news, science, and data you need to keep up to speed.
We’re bringing you more news, more science, and better data visualization. Our larger format is easier and, hopefully, more fun to read. We sincerely hope you like it, and we’ll be looking for your feedback in the coming months. If you enjoy this new design, we hope you’ll let us know.
This first issue of Substance takes you in depth into the world of alcohol biomarker testing. The number of people in the U.S. with an alcohol use disorder outnumber those with a drug use disorder by four to one. The annual economic, healthcare, and social fallout from hazardous alcohol use is staggering: 88,000 alcohol related deaths each year; more than 10,000 alcohol related driving fatalities; more than $223 billion in annual economic costs.
Alcohol biomarker testing is a tool to help the legal, healthcare, and addiction treatment professional to track patient alcohol consumption patterns. We know you’ll find the information in this issue helpful in navigating the confusing world of alcohol biomarker testing.
And that’s our mission, too. To help you find simple answers in a complex drug and alcohol testing world. Connect with us through our social media and let us know how we’re doing.
Thanks for reading,Michelle Lach, Editor-in-Chief
3USDTL
SubstanceWinter 2015volume 6issue 1
Michelle LachEditor-in-Chief
Joseph Salerno, MSManaging & Design Editor
Dru Winn, MAGraphic Designer
Substance is a quarterly newsletter of toxicology science, data, and news. It is our mission to distil the technical world of toxicology, drug testing, and addiction science into plain words. If you have suggestions for topics you would like to know more about, let us know.
PEth testing in dried blood spot specimens offers legal and addiction treatment professionals the highest degree of sensitivity and reliability of any alcohol biomarker.
6
THE LONG GAME | Joseph Jones, MS, NRCC-TC
Long-Term Alcohol Biomarkers: Emerging technologies for long-term detection of risky drinking behavior.
8
MIXOLOGY | Dru Winn and Joseph Salerno
As a rule of thumb for alcohol testing, think 3-3-3 - three days, three weeks, three months - to figure out which test, and which window of detection, meets your needs.
PEth testing in dried blood spot specimens offers legal and addiction treatment professionals the highest degree of sensitivity and reliability of any alcohol biomarker.
by Joseph Salerno
Alcohol abuse is a significant health and economic concern in the United States today. Almost 17 million people can be categorized as having an alcohol use disorder. Alcohol use is the third leading preventable cause of death, accounting for more than 88,000 alcohol related deaths each year. In 2012, alcohol-impaired driving was the cause of 10,322 driving fatalities. In the United States, alcohol abuse accounts for more than $223 billion in annual economic costs. More than 50% of child custody cases involve alcohol and drug abuse as a factor for judges to consider.
There are several measures of alcohol use to help healthcare, addiction treatment, and legal professionals evaluate their clients’ alcohol use issues. The measurement of the objective ethanol biomarker phosphatidylethanol (PEth) in blood samples offers the most unbiased, sensitive, and reliable method for evaluating alcohol use.
Self-report of alcohol use has several limitations due to social stigma, self-incrimination, and recall bias. Indirect biomarker testing (CDT, GGT, and MCV) measures the biological effects of alcohol consumption on the body - not alcohol consumption itself - and can be confounded by several factors such as age, cancer, changes in liver function, infection, and pregnancy.
Other direct alcohol biomarkers can even be problematic. Urine is a very easily adulterated testing sample, and testing for ethyl glucuronide/sulfate (EtG/EtS) in urine provides a very short
window of detection (1-3 days). EtG testing in hair samples, although far superior to urine testing and indirect biomarkers, can be dramatically affected by the use of cosmetic hair treatments such as dyes, straighteners, and bleaching. Additionally, a sufficient hair specimen - 1.5 inches in length from the scalp - is not always available.
PEth testing in blood does not suffer from any of these issues. PEth is an abnormal phospholipid molecule that is created and captured in red blood cell membranes. The more often a person consumes alcohol, the more PEth is accumulated in the resevoir of the cell membrane.
Blood is a universal specimen that is always available. The collection of blood samples is an observed collection, making adulteration impossible. Despite being a blood sample, PEth testing does not require a blood draw, but can instead be accomplished using dried blood spots from a finger stick.
Dried blood spot collection is simple, quick, and is accomplished by the donor under observation by a collection professional (after a brief training session). The donor pricks their finger using a lancet (similar to those used in diabetic testing) and then deposits the blood drops on a filter paper card. This avoids the expense of a phlebotomist and can be accomplished in a non-clinical setting. Blood spot cards are compact and very simple to ship.
Laboratory professionals are able to extract the Continued on page 14, PEth.
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PEth is an abnormal phospholipid molecule that is created and captured in red blood cell membranes. The more often a person consumes alcohol, the more PEth is accumulated in the resevoir of the cell membrane.
6 Winter 2015 Substance
THE LONG GAME
Long-Term Alcohol Biomarkers: Emerging technologies for long-term detection of risky drinking behavior.
by Joseph Jones, MS, NRCC-TC
This article was originally published in DATIA Focus Magazine, Fall 2011.
Alcohol abuse continues to be a significant health concern for the United States. In the United States, nearly 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 short-term alcohol biomarkers. Self report 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 to 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 limitedutility in most circumstances. Many situations exist that would benefit from sensitive and specific alcohol biomarkersthat detect abusive alcohol consumption. Originally, it was assumed that ethyl glucuronide and ethyl sulfate in urine was a result of beverage alcohol consumption.
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
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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.
FAEE HairThe first long-term alcohol biomarker that came
to this market was testing for Fatty Acid Ethyl Esters (FAEEs) in hair. FAEEs are a group of non-oxidative metabolites that are produced in the presence of ethanol and various fatty acids. FAEEs can be found in a number of specimen types such as hair, fat and a variety of organ tissues. Testing for FAEEs has been used to identify newborns exposed to alcohol in the womb and has been used to evaluate the decedent’s alcohol history in post-mortem examinations.
Testing for FAEEs in hair has two main drawbacks. The use of ethanol containing hair care products will produce detectable amounts of FAEEs in the hair and the exposure of clipped hair to ethanol vapor will produce FAEEs in the hair sample (Gareri et al, 2011). The production of FAEEs occurs in the skin cells that surround the hair shaft and in the hair itself. These two facts have limited the usefulness of this test.
EtG HairEtG is a minor metabolite of ethanol produced
by the conjugation of ethanol with glucuronic acid. Using urine for EtG analysis has been available commercially for almost 10 years, first in Europe and later in North America. Using head hair, which grows at approximately ½ inch per month, to detect EtG was first reported at a scientific conference in 1995 and the data was later published in 2000 (Skopp, 2000). Following the Society for Hair Testing’s (www.soht.org) release of the “Consensus of the Society of Hair Testing on hair testing for chronic excessive alcohol consumption 2009”,
several organizations in Europe and North America began offering EtG hair analysis. In summary, the Society of Hair Testing claims that a 1½-inch hair sample containing greater than 30 pg/mg of EtG is a strong indicator of “chronic excessive alcohol consumption” during the previous 3-month period.
One limitation of using hair for EtG analysis is that certain haircare treatments (bleaching, permanent waving, dyeing) negatively affect hair EtG levels (Morini et al, 2010). This limitation must be considered when attempting to declare that a donor has been abstinent. This observation was independently confirmed in a report recently released at the Research Society on Alcoholism’s (RSA) national conference in June 2011 (Jones et al, 2011). This study demonstrated that there may be a gender bias when comparing male and female hair EtG levels to their self-reported drinking histories and more research is needed in this area.
Another limitation (or advantage depending on your point of view) is that consumption of single or small doses of alcohol will not produce a positive hair EtG result. Krondstrand et al (2011) reported that when a group of volunteer women consumed 1 drink per day for 3 months (90 drinks) and a group of volunteer men consumed 2 drinks per day for 3 months (180 drinks) that the vast majority of the subjects did not exhibit measurable levels of hair EtG. Those that did have detectable levels of EtG in their hair were significantly below the cutoff of 30 pg/mg. Again, this observation was independently confirmed with data released at the June 2011 RSA national conference (Jones et al, 2011).
EtG NailFingernail, which grows approximately 3 mm per
month, is very similar in structure to hair in that Continued on page 10, Biomarkers.
Reliable and objective measures of alcohol consumption can assist legal, healthcare, and addiction treatment professionals with the evaluation and monitoring of their clients...
High alcohol consumption =any drinking that elevates
blood alcohol concentration to
or higher.0.08 g/dl
3
EtG/EtS
EtG
PEth
Indicates alcohol consumption within
three days of collection
Indicates high alcohol consumption within
the 3 weeksprior to collection
AYS
URINE BLOOD NAIL &HAIR
WEE
KSONTH
S
When requesting alcohol testing,think 3-3-3
8 Winter 2015 Substance
MIXOLOGY
As a rule of thumb for alcohol testing, think 3-3-3 - three days, three weeks, three months - to figure out which test, and which window of detection, meets your needs.
by Dru Winn and Joseph Salerno
The most objective alcohol testing results are accomplished using direct alcohol biomarkers such as phosphatidylethanol (PEth), ethyl glucuronide (EtG), and ethyl sulfate (EtS). PEth, EtG, and EtS are direct products of alcohol metabolism. In contrast, indirect biomarkers (e.g. MCV and CDT, among others) indicate physiological effects of alcohol consumption on the body, and can often be confounded by non-alcohol related factors such as disease states, changes in liver function, infection, and even pregnancy.
Direct biomarker testing is accomplished in several different specimen types, including alternative matrices such as hair and fingernails. A positive EtG result in fingernail or hair specimens can indicate multiple occurrences (six or more) of high alcohol consumption (0.08% BAC) within a three month window of detection prior to testing.
PEth is detected in dried blood spot samples and can indicate high alcohol consumption within the three weeks prior to specimen collection.
An EtG/EtS positive result in urine can indicate alcohol consumption within three days of specimen collection.
D 3 M
&3
EtG = Ethyl Glucuronide
PEth = PhosphatidylethanolIndicates multiple
occurrences of high alcohol consumption
within 3 months
High alcohol consumption =any drinking that elevates
blood alcohol concentration to
or higher.0.08 g/dl
3
EtG/EtS
EtG
PEth
Indicates alcohol consumption within
three days of collection
Indicates high alcohol consumption within
the 3 weeksprior to collection
AYS
URINE BLOOD NAIL &HAIR
WEE
KSONTH
SWhen requesting alcohol testing,think 3-3-3
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10 Winter 2015 Substance
Biomarkers, continued from page 7.
it is composed of keratinized protein. Originally, it was assumed that analytes were incorporated into the nail where it originates (the matrix). Under this assumption, a clipping of nail would give a two-week history that occurred 6 months ago,
severely limiting the usefulness of this specimen type. This assumption was proved to be incorrect in 1991 when analyzing fingernails following the oral administration of a new fungicide (Johnson et al, 1991).
Johnson et al (2011) found that the drug was appearing in the nail clippings after a couple of days indicating that another mechanism was occurring. The researchers proved that not only was drug incorporated in the matrix (where the nail material originates) but that nail material (and drug) was being incorporated from underneath as the nail grows along the nail bed toward the tip of the finger. The nail gets thicker as it grows in length. A simple clipping of fingernail provides a history of the entire trip down the nail bed.
The National Institute of Alcohol Abuse and Alcoholism (NIAAA) funded a study (1R44AA016463-02) that included the collection of head hair, fingernail, and an extensive battery of self-report questionnaires to 606 college-aged
students. The hair and fingernail specimens were analyzed for EtG at our laboratory. This group was chosen because in theory they should provide a more accurate self-report because their drinking patterns tend to be more consistent and the stigma and negative effects of alcohol abuse have yet to manifest themselves even though they engage
in risky alcohol drinking behavior. In other words, they have not yet lost a wife, kids, or a job because of their drinking pattern; they are just fun loving college kids. The
preliminary results of this study were released at the RSA national conference in June 2011 (Jones et al, 2011).
The findings of the study were twofold. First, a gender bias may exist when using hair for EtG analysis. When comparing the association between the self-reported number of drinks for the previous 3-months and hair/nail EtG levels, the female hair association was significantly less than female nail, male nail, and male hair (Table 1). One possible explanation for the diminished association for the female hair could be the increased likelihood for female hair care treatments as exemplified in Chart 1, where the female subject self-reported that she had bleached her hair, had a negative hair result, but had a positive nail finding. Males may also bleach, perm or dye their hair but in this demographic it is expected that these types of hair care treatments are much more prevalent in the female population. This would be consistent with the diminishing effects of certain hair care
treatments previously described by Morini et al (2010), but more research is needed in this area.
Secondly, EtG in both hair and nail was not found unless the participant engaged in risky alcohol drinking behavior (binge drinking - alcohol consumption which raises BAC to 0.08%). Charts 2 and 3 illustrate this observation. Both subjects consumed a similar number of drinks (53 and 58
The individuals with an alcohol use disorder outnumber those with a drug use disorder by a factor of over 4 to 1, yet
our industry tends to emphasize drug testing.
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drinks) during the previous 90-day period however the positive subject had 18 drinking episodes (4.84 drinks/drinking day/100 kg) while the negative subject reported 28 drinking episodes (2.77 drinks/drinking day/100 kg). These two participants demonstrate that the number of drinks is less important than the number of drinks per episode (drinking behavior).
Phosphatidylethanol in BloodA new test that has become available recently is
Phosphatidylethanol (PEth) in blood. PEth is an abnormal phospholipid that is formed only in the presence of ethanol and has been reported in a number of tissues and fluids. Once produced in humans, it is incorporated into cell membranes where no enzymatic or metabolic mechanism of elimination is available. PEth decomposes with a very predictable half-life of 4-5 days giving a detection window of 2-4 weeks depending on the starting levels.
Testing blood for the presence of PEth has been used for several years by various medical examiners in Europe to gain insight of the alcohol history of decedents during post-mortem examinations. Several laboratories in the United States are now offering this assay routinely. Originally, the assay required a venipuncture performed by a licensed phlebotomist, making the collection too expensive or logistically problematic for widespread use. The test has been adapted to use dried blood spots which allows for collection of a simple finger stick in a non-clinical setting without the services of an expensive phlebotomist (Jones et al,).
ConclusionThe individuals with an alcohol use disorder
outnumber those with a drug use disorder by a factor of over 4 to 1, yet our industry tends to emphasize drug testing. Because of a number of new breakthroughs, a new group of tests for detecting chronic excessive alcohol consumption are now commercially available to assist legal, health care, and addiction professionals assess the drinking behavior of their clients. The results of a
12 Winter 2015 Substance
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combination of tests (EtG/EtS in urine, PEth in blood spot, and EtG in nail) reveal to the substance abuse professional the alcohol history of the donor over the past 3 days, 3 weeks, and 3 months. This level of information using objective measures is new and novel to our industry. These new tests provide the local substance abuse professional powerful additions to the evaluation tool belt, an opportunity to expand their offerings, and the opportunity to distinguish their level of services from their competitors.
Abbreviations• AUDIT—Alcohol Use Disorder Identification Test• MAST—Michigan Alcohol Screening Test• CAGE—an acronym for the 4 questions asked• CDT—Carbohydrate Deficient Transferrin• GGT—Gamma-Glutamyl Transferase• MCV—Mean Corpuscular Volume
References1. Center for Families, Children, & the Courts. (2007). Drug and alcohol testing in child custody cases: Implementation of Family Code Section 3041.5 Final report to the California Legislature. San Francisco, CA: Judicial Council of California/Administrative Office of the Courts.2. Costantino, A., DiGregorio, J., Korn, W., Spayd, S. and Rieders, F. (2006). The effect of the use of mouthwash on ethyl glucuronide concentrations in urine. Journal of Analytical Toxicology, 30(8), 659-662.3. Gareri, J., Appenzeller, B., Walasek, P. and Koren, G. (2011). Impact of hair-care products on FAEE hair concentrations in substance abuse monitoring. Analytical and Bioanalytical Chemistry, 400(1), 183-188.4. Johnson, M., Comaish, J., Shuster, S. (1991). Nail is
produced by the normal nail bed: A controversy resolved,
British Journal of Dermatology, 56, 61-68.
5. Jones, J., Jones, M., Plate, C. and Lewis, D. (2011).
The detection of 1-palmatoyl-2-oleoyl-sn-glycero-3-
phosphoethanol in human dried bloodspots. Analytical
Methods, 3, 1101-1106.
6. Jones, J., Jones, M., Plate, C. and Lewis, D. (2011,
June). Correlation of the ethanol biomarker ethyl
glucuronide in fingernails and hair to reported alcohol
consumed. Poster presented at the Research Society on
Alcoholism National Conference, Atlanta, GA.
7. Kronstrand, R., Brinkhagen, L. and Nystrom, F. H.
(2011). Ethyl glucuronide in human hair after daily
consumption of 16 or 32g of ethanol for 3 months.
Forensic Science International, 215(1-3), 51-55.
8. Morini, L., Zucchella, A., Polettini, A., Politi, L.
and Groppi, A. (2010). Effect of bleaching on ethyl
glucuronide in hair: An in vitro experiment. Forensic
Science International, 198(1-3), 23-27.
9. Palmeri, A., Pichini, S., Pacifici, R., Zuccaro, P.
and Lopez, A. (2000). Drugs in nails: Physiology,
pharmacokinetics and forensic toxicology, Clinical
Pharmacokinetics, 38(2), 95-110.
10. Rohrig, T. and Ross, W. (2006). Detection of ethyl
glucuronide in urine following the application of
Germ-X. Journal of Analytical Toxicology, 30(8), 703-701.
11. SAMHSA (2006). The Role of Biomarkers in the
Treatment of Alcohol Use Disorders. http://www.kap.
Adderjan, R. and Mattern, R. (2000). Ethyl glucuronide
in human hair. Alcohol, 35(3), 283-285.
13. Stinson F., Grant, B., Dawson, D., Ruan, J., Huang,
B., and Saha, T. (2005) Comorbidity between DSM-IV
alcohol and specific drug use disorders in the United
States: Results from the National Epidemiologic Survey
on Alcohol and Related Conditions. Drug and Alcohol
Dependence, 80 (1), 105-116.
Joseph Jones is the Senior Vice President of Laboratory Operations for USDTL in Des Plaines, Illinois with over 28 years of experience in the drug and alcohol testing industry. He has nearly two dozen peer-reviewed publications covering a variety of specimen types and is recognized as a Toxicological Chemist by the National Registry of Certified Chemists.
blood drops from the cards and test them for PEth levels. Capturing the blood spots on the filter cards fixes the cells at the moment they were collected, and prevents any further degradation or production of PEth, eliminating any possible change in the testing result.
PEth testing is able to detect binge alcohol consumption in the 2-3 weeks prior to collection of the sample. The window of detection is far superior to that of urine testing. The simplicity of collection makes repeat testing during long-term monitoring simple and minimally invasive, both physically and in terms of a donor’s time.
Several studies have demonstrated that PEth is unaffected by age, race, gender, disease states, changes in liver function, infection, or pregnancy, in contrast with indirect alcohol biomarkers. PEth testing has also been shown to improve alcohol use self-report in a number of studies.
PEth testing has been used successfully in several counties in the State of Wisconsin to reduce drunk-driving recidivism and lower costs associated with 12-month driver’s safety plans following DUI convictions. Other outpatient treatment programs
have associated PEth testing with a reduction in patient relapse rates.
References1. Viel, G., Boscolo-Berto, R., Cecchetto, G.,
Fais, P., Nalesso, A., and Ferrara, S.D. (2012).
Phosphatidylethanol in blood as a marker of chronic
alcohol use: A systematic review and meta-analysis.
International Journal of Molecular Sciences, 13, 14788-14815.
2. Bean, P., Brown, G. and Lewis, D. (2012). Direct
alcohol biomarkers as tools to guide meaningful
intervention while monitoring recent repeat intoxicated
drivers in Kenosha County. Research Society on
Alcoholism National Conference. Poster Presentation.
San Francisco, CA.
3. Helander, A., Peter, O. and Zheng, Y. (2012).
Monitoring of alcohol biomarkers PEth, CDT and
EtG/EtS in an outpatient treatment setting. Alcohol and
N.I., Kigozi, I., Shiboski, S. and Wurst, F.M. (2012).
Phosphatidylethanol (PEth) as a biomarker of alcoholism
consumption in HIV-positive patients in sub-Saharan
Africa. Alcoholism Clinical and Experimental Research,
36(5), 854-862.
PEth is an abnormal phospholipid molecule that is created and captured in red blood cell membranes. The more often a person consumes alcohol, the more PEth is
It is USDTL’s mission to use the best science available to provide cutting edge tools for the detection of alcohol and substances of abuse. To better accomplish our mission, we are updating our collection procedures for fingernail specimens. Effective March 1, 2015, cosmetic treatments of any kind must be removed from fingernail specimens prior to being submitted to USDTL for testing. Specimens received with cosmetic treatments still applied to them will be rejected and will not be processed. Cosmetic treatments include artificial acrylic, gel or silk overlays; nail polish; basecoats; topcoats; hardeners; and any application to the nail that is not the natural nail material.
This change to our fingernail collection procedures was made after carefully considering what collection processes would best ensure the integrity and validity of our clients’ testing results. If you have any questions regarding these changes to our fingernail collection guidelines, please contact our client advocates at 800.235.2367, or at [email protected].
Sincerely,
Adam Negrusz, Ph.D.Laboratory Director
AttentionWe have updated our fingernail collection
instructions.
EVENTS & EXHIBITS
• March 11-12 – When Nuts are Loose and Bolts Don’t Fit: Advanced Practices in Parenting Coordination – Chicago, IL
• March 17-20 – National Organization of Alternative Program 2015 Annual Education Conference – West Plam Beach, FL
• March 23-26 – International Symposium on Child Abuse – Huntsville, AL
• March 30-April 2 – Foundations Recovery Network, Innovations in Recovery Conference – San Diego, CA
• April 6-9 – National Rx Drug Abuse Summit – Atlanta, GA • April 8-10 – 17th Annual Louisiana Drug Court Conference –
New Orleans, LA• April 23-26 – American Society of Addiction Medicine
Annual Conference – Austin, TX• April 24-27 – Federation of State Physician Health Programs –
Fort Worth, TX• April 30-May 2 – Midwestern Psychological Association
Annual Meeting – Chicago, IL
1700 S. Mount Prospect Rd. | Des Plaines, IL 60018 | 800.235.2367 | USDTL.com
United States Drug Testing Laboratories, Inc.1700 S. Mount Prospect Road|Des Plaines, IL|60018Main: 847.375.0770|www.USDTL.com|Fax: 847.375.0775
