About Urine Ethylglucuronide (EtG) Testing What is EtG? Where Does it Come From? EtG, or ethylglucuronide, is a byproduct of ethanol (alcohol that one drinks) and glucuronide a common biological compound made in the liver that binds various toxins and drugs in the body that allows them to be excreted in the urine.
When someone drinks, even relatively small amounts of alcohol, EtG is formed and can be detected in the urine. Why is Urine EtG Detection Any Better than a Blood or Breath Alcohol Test? EtG can be found in the urine much longer than alcohol in the blood or breath. After a few drinks, EtG can be present in the urine up to 48 hours, and sometimes up to 72 or hours or longer if the drinking is heavier.
Can the EtG Amount Indicate How Much Alcohol Someone Has Actually Consumed (i.e. Number of Drinks)? Not really. While higher amounts of EtG might indicate larger amounts of alcohol consumption, the exact number is influenced by several factors: the amount and when it was consumed.
The longer the time since consumption, the lower the EtG level (see above). Also, some people might convert more alcohol into EtG than others and/or excrete it more quickly. Finally, there is a maximum amount of EtG that can be measured, so drinking above that limit might not raise EtG more than can be detected (ceiling effect).
It was designed to detect “any drinking”, not heavy drinking. If you wish to detect heavy drinking consider ordering %dCDT (see other information). Why Do You Report EtG Levels at Two Different Cut-Offs 100 ng/ml & 500 ng/ml? We do this to provide complete information on which to base a sound clinical decision.
EtG can be detected by our assay system at levels even below 100 ng/ml, but we build in a “margin of safety” so that at 100 ng/ml we are very certain that EtG is present, indicating even small amounts of drinking. However, there have been some reports in the literature, as well as concern raised in legal cases, that other sources of alcohol (e.g.
mouthwash, hand sanitizer) might cause levels of EtG above 100 ng/ml to be detected in the urine. Although these situations are rare, and hard to replicate under controlled conditions, in those instances where a higher level of certainty is needed (forensic cases etc.) the clinician might want to use the 500 ng/ml cut-off.
Contents
Will I pass an EtG test after 80 hours?
Ethyl Glucuronide (EtG) Ethyl Glucuronide (EtG) is a direct biological marker that is formed in the body after the consumption of ethanol from drinking alcoholic beverages. When someone consumes even relatively small amounts of alcohol, EtG is formed and can be detected.
Unique biological markers of alcohol use (only alcohol consumed can create EtG) Detects recent use Longer detection window than the previously recognized urine alcohol test called, ethanol or ETOH Longer detection window than breath alcohol Highly specific and sensitive to alcohol consumption
According to the National Council on Alcoholism and Drug Dependence, Inc., alcohol is the most commonly used addictive substance in the U.S., with 1 in every 12 adults suffering from alcohol abuse or dependence. EtG testing is not used to check for current impairment, rather screens for ethanol use.
EtG and EtS are the only biomarkers recognized as appropriate for abstinence monitoring, based primarily on the time to return to normal levels following abstinence from alcohol. EtG testing allows for detection of drinking when individuals look to keep their use a secret. When persons with drinking problems know they will be tested, they usually will stop drinking to avoid penalty.
Reduced rates of substance abuse has been reported from organized treatment programs utilizing routine EtG testing programs. Drug courts that use EtG testing also report greatly reduced alcohol abuse rates. EtG testing confirms alcohol abstinence. When alcohol abusers stop drinking, it is often difficult for others to trust that they are not.
Individuals younger than the legal drinking age and members of the Armed Forces in combat zones where, regardless of age, drinking is prohibited. Individuals on probation, including adolescents, who have committed alcohol-related crimes. Individuals who have previous alcohol-related problems but have been allowed visitation with or custody of children with the stipulation that these individuals remain abstinent. Motorists who have had alcohol-related traffic convictions and who are now required to abstain as a condition of maintaining driving privileges. Medical personnel, professionals, attorneys and others who, because of previous alcohol or drug-related problems, have agreed to maintain total abstinence and accept ongoing monitoring as conditions for continuing their license or employment.
– Meghan, State Probation/Parole Officer Relapse assessment is commonly used as a way to measure alcohol dependence. However, the methods of assessing relapses range from questionnaires to biological markers of alcohol for different time spans. The aim of this was to compare the relapse rates of weekend home stays during long-term alcohol dependence treatment, assessed by EtG, breath alcohol tests and self-reports.
RESULTS: Of the total, 37.7% of the patients participating in the study were positive for EtG at least once. Breath alcohol tests had been positive in as little as 4.4% and when interviewed only 5.7% of the patients admitted to their relapse.15.6% of EtG tests were positive, but breath alcohol tests were negative.93% of the relapses were only detected by EtG.
CONCLUSION: In addition to breath alcohol tests and interviews, urinary EtG can clearly improve the verification of relapse in inpatient treatment programs. Without EtG testing, a high amount of relapses will stay undetected. (Source: ) Instant/Rapid Tests for EtG
Longer window of detection time – up to 80 hours No calibration required Used to detect recent alcohol consumption, even after the ethanol alcohol is no longer measurable
Breathalyzer
Short detection window – less than 10 hours Purchase of mouth pieces Calibration required on a regular basis Measures Impairment Sensor can be unstable Sensitive to changes in temperature, humidity and breath flow patterns Preliminary screen
Similar to standard drugs of abuse screening (marijuana, cocaine, etc.) EtG screening poses the same advantages for INSTANT results vs the laboratory screening result: IMMEDIATE POSITIVE RESULT = ADMIT TO DRINKING Why does this happen?
Scenario Onsite Screen: The offender knows that he/she drank alcohol. Within minutes of giving their specimen they are confronted by their officer, case manager, or their counselor that they are positive for EtG. How likely is the offender to admit to drinking when the positive result is right in front of them and they are given the opportunity to explain themselves? Very likely! Why? Because when an offender is confronted with evidence immediately, he or she is likely to admit use.
In addition, the offender may plea to the offense in order to receive a lesser sentence. This outcome can save the agency money as it removes the need for a confirmation test. Scenario Lab Screen: The offender knows that he/she drank and they are just hoping that you are not going to catch him, right? When a specimen is collected, NOT tested on an instant/rapid screen but then sent to a lab for the EtG screen, how likely is that offender to admit to drinking? Not likely! Why? Because they are hoping to delay the punishment, resulting in a slim chance of changing any behavior for the good.500ng/mL – considered the “Goldilocks”, or “just right”, cut-off level for EtG in criminal justice testing.
Positive results at this cut-off are consistent with recent ingestion of alcohol (approximately 48 hours prior to specimen collection). At a cut-off of 500 ng/mL, studies indicate that positive results are NOT associated with incidental exposure (e.g.
mouthwash, hand sanitizer). The Court System and the Scientific Community agrees that 500 ng/mL is the not too low and not too high for court mandated drug and alcohol testing programs. When EtG was first made available to the courts in the laboratory setting, the laboratories had the ability to test for EtG at various different cut-off levels, 100 ng/mL, 250 ng/mL, 500 ng/mL, and even 1,000 ng/mL.
The scientific community had the ability to test lower, but that created positives that were caused by incidental exposure; making prosecuting violations difficult. In contrast, the higher cut offs were not sensitive enough and false negatives were widely reported.
- Although various screening cut-offs are still available to agencies using EtG biomarker, the courts and scientific community most often defer to 500 ng/mL.
- While EtG can be detectable as soon as 2 hours after use and up to 80 hours past consumption, there are many variables that may affect this detection window.1.
Individuals metabolism 2. % alcohol content in drinks consumed 3. How quickly was the alcohol consumed 4. Hydration levels 5. Frequency of drinking.i.e. did drinking occur only on one occasion or is it more regular and ongoing Every 15 minutes for 8 hours used hand sanitizer, no subject had more than 62 ng/mL EtG. The screening cut off level for EtG 500 ng/mL – way under the threshold. Three daily dose of 1oz. of Vicks Nyquil with 25% alcohol, the subject with the highest had only 246 ng/mL of EtG. That daily dose is well above the recommended dosage and it is still under the 500 ng/mL cut-off. 55 people used mouthwash 3 times a day for 5 straight days. Each time holding the mouthwash in their mouths for 30 seconds (a long time). The highest EtG concentration, 120ng/mL. Rapid EtG is the best tool we have for abstinence monitoring and gives us the ability for immediate detection as opposed to waiting a few days after sending out to the lab. : Ethyl Glucuronide (EtG)
How much alcohol can an EtG test detect?
Highlights –
Multiple cutoffs for ethyl glucuronide immunoassay (EtG-I) were compared with drinking self-report. The 100 ng/mL cutoff is most likely to detect heavy drinking up to five days. The 500 ng/mL cutoff is likely to only detect heavy drinking during the previous day.
Can you get a false positive on an EtG alcohol test?
Ethyl Glucuronide and Ethyl Sulfate – EtG/EtS is a marker that can be detected for a period of a few days following alcohol ingestion, EtG is a minor metabolite of ethanol resulting from ethanol conjugation with glucuronic acid, Both EtG and EtS are minor products of phase II ethanol metabolism representing <0.1% of total ethanol disposition. EtG is formed by conjugation with glucuronic acid catalyzed by the enzyme UDP-glucuronosyltransferase, while EtS formation is catalyzed by sulfotransferase. Both of these markers can be detected in the blood for ~36 hours and for several days in urine and tissues for several days following cessation of alcohol intake, Blood spot analysis has also been shown to be a viable matrix, Consumption of a relatively small quantity of alcohol such as 7 g may result in detectable EtG level in urine up to 6 hours. Detection time is longer after consumption of higher amounts of alcohol. EtG/EtS species are also present in hair and represent a promising marker for postmortem investigations of alcohol use, In general, the EtG level in hair in 95% of abstainers studied was <1.0 pg/mg of hair, while 30% of abstainers exhibited EtG levels below the detection limit of the highly sensitive liquid chromatography combined with tandem mass spectrometry assay (LC/MS/MS: detection limit: 0.5 pg/mg of hair). Hair color, gender, age, body mass index, smoking, and cosmetic treatment of hair did not appear to influence hair analysis for EtG. Various cutoff concentrations have been proposed for analysis of EtG in hair where value is expressed as pg/mg of hair. Morini et al. stated that 27 pg/mg exhibits a strong sensitivity (92%) and specificity (96%), A metaanalysis indicated that a cutoff of 30 pg/mg limits the false negatives in differentiating heavy from social drinking and abstinence, EtG in meconium is also measured to investigate possible exposure of a fetus to maternal alcohol use. Bana et al. used a cutoff of 50 ng/gm of meconium for EtG and 1000 ng/gm of meconium for FAEEs for their study and reported that 34.6% women consumed alcohol during pregnancy while 17% women showed positive results with both markers, For hair, EtG sensitivity of 96% and specificity of 99% has been reported at a cutoff concentration of 30 pg/mg of hair to identify individuals who are drinking alcohol chronically at amounts exceeding 60 g/day, Urinary glucuronide at a cutoff of 100 ng/mL, exhibited a sensitivity and specificity was 76% and 93%, respectively. The sensitivity and specificity of urinary EtS at 25 ng/mL cutoff was 82% and 86% respectively when utilized to detect drinking 3–7 days prior to clinic visits, False positive and false negative results have been reported with both EtG and EtS. False positive test results may be due to incidental exposure to alcohol-containing products such as mouthwash and hand sanitizers, especially if a lower cutoff concentration is used. Consuming nonalcoholic beer and wine in larger amounts may also produce false positive results because such products may contain a small amount of alcohol. Eating baker's yeast with sugar, drinking large amounts of apple juice, or even eating ripe bananas may cause detectable amounts of EtG and EtS in urine. Urinary tract infections may also produce false negative test results due to degradation of EtG in urine by the beta-glucuronidase enzyme present in Escherichia coli, In contrast, EtS is not affected by this process. In 2006, an advisory was issued due to potentially false positive test results with EtG testing and warned against use of EtG as the sole evidence in determining abstinence in criminal justice, regulatory, or legal settings, Read full chapter URL: https://www.sciencedirect.com/science/article/pii/B9780128156070000034
What is the longest time EtG can be detected?
INTRODUCTION – In patients with liver disease the detection and monitoring of alcohol consumption is important, particularly given the high prevalence of alcohol-associated liver disease with or without concurrent viral hepatitis, and the deleterious effect of excessive alcohol use on viral hepatitis ( Reuben, 2008 ).
Alcohol use in clinical settings has mainly been assessed by self-report. Screening instruments such as the CAGE (Cut down, Annoyance, Guilt, Eye opener) and AUDIT (Alcohol Use Disorders Identification Test) have been shown to be useful as screening tools, but are vulnerable to underreporting and variable sensitivity across heterogeneous populations ( Berner et al., 2007 ; Fiellin et al., 2000 ).
Direct ethanol detection in breath or body fluids can supplement self-report, but the information it provides, on even heavy drinking, extends back no further than the evening prior to a clinical visit ( Swift, 2003 ). Some laboratory tests such as carbohydrate-deficient transferrin, gamma-glutamyltransferase, and mean corpuscular volume can identify chronic, heavy alcohol use over the preceding weeks ( Salaspuro, 1999 ).
- However, limited sensitivity and specificity have precluded their use as stand-alone screening tools for alcohol consumption, and all have diminished specificity in liver disease patients ( Hock et al., 2005 ; Neumann and Spies, 2003 ).
- The need for alcohol consumption biomarkers that supply information on recent drinking, extend the detection window relative to direct ethanol measurement, and also detect moderate drinking in patients who should either drink very little or abstain, has raised interest in urinary ethyl glucuronide (EtG) and ethyl sulfate (EtS) measurement.
In humans, 0.5–1.5% of ingested alcohol is eliminated in the urine after undergoing glucuronidation to form EtG ( Dahl et al., 2002 ; Goll et al., 2002 ). EtG can be detected in the urine for as long as 5 or more days after the consumption of alcohol, but more typically becomes undetectable within 48 to 72 hours ( Wurst et al., 2002 ).
- EtS is another non-oxidative direct metabolite of ethanol that results from sulfate conjugation.
- This pathway is responsible for the elimination of less than 0.1% of ethanol consumed and has a similar elimination profile to EtG ( Helander and Beck, 2005 ).
- Both EtG and EtS have been shown to be sensitive and specific in detecting alcohol consumption in alcohol-dependent patients ( Junghanns et al., 2009 ), although a cutoff concentration above the detection limit is generally favored to minimize false positive results arising from non-beverage ethanol ingestion (e.g., in foods, mouthwashes, and other over-the-counter products).
While the use of these ethanol metabolites has promise to improve alcohol assessments in clinical care, little is known about the optimal interpretation of urine EtG and EtS in the setting of liver disease. Erim et al demonstrated that urine EtG could identify otherwise undetected drinking in liver disease patients ( Erim et al., 2007 ), and this was recently confirmed in patients with alcoholic liver disease ( Staufer et al., 2011 ).
What can throw off an EtG test?
Monday, September 23, 2019 According to the National Survey on Drug Use and Health conducted in 2015, 86.4% of people over the age of 18 reported drinking alcohol at some point in their lifetime, with 33.9% of these individuals reporting either binge drinking or heavy alcohol use in the past month.1 Of those that drink alcohol, approximately 15.1 million adults have been diagnosed as having alcohol use disorder (AUD), with only 6.7% of adults with AUD receiving treatment.1 With alcohol use and abuse both incredibly high in the US, it is important for providers to be aware of their patients’ use patterns and the potential drug interactions with their prescribed medications.
- However, as with all testing, there are things providers should be aware of when considering the interpretation of their patients’ test results regarding alcohol findings.
- Ethanol can be directly detected in all matrices offered by Aegis – blood, oral fluid, and urine – at a threshold of 10 mg/dL.
- Ethanol is only detectable for up to 8 hours post ingestion, which is indicative of recent ingestion.
Aegis can also analyze samples for two ethanol metabolites, ethyl glucuronide (EtG) and ethyl sulfate (EtS), with detection periods up to 72 hours post-ingestion at positive thresholds of 500 ng/mL and 200 ng/mL respectively. Period of detection is influenced by patient-specific factors, amount ingested, and chronicity of ingestion.2,3 Due to the variability of ethanol metabolism, it is possible to observe differing amounts of the metabolites or the presence of one metabolite in absence of another.
There are several scenarios that providers should be aware of that may result in unexpected positives. Post-collection fermentation is a common cause of positive results for ethanol and/or EtG only and has been shown to be responsible for up to one-third of unexpected positive results.4 Post-collection fermentation is of particular concern when the sample has been left at room temperature for a day or longer, which can allow yeast naturally present in the body to ferment excreted glucose and form ethanol, which in turn can be converted to EtG in the presence of bacteria.5,6 This phenomenon is often seen in samples from diabetic patients as they can excrete a greater than normal amount of glucose in their urine.
EtG and EtS testing may have unexpectedly positive results stemming from “incidental exposures” such as electronic cigarette use, heavy use of hand sanitizer, or consuming certain foods/beverages.7-9 Though generally an uncommon practice, the consumption of raw, live Baker’s yeast, when taken in combination with a source of sugar, can result in in vivo fermentation.10 Some patients consuming large amounts of grape juice may have detectable EtS levels due to the natural fermentation of fruit’s sugar.11 When considering positive results, it is important to discuss the use of “nonalcoholic” beers and wines with patients as these beverages may contain up to 0.5 vol.
Ethanol.12 Heavy consumption of these “nonalcoholic” beers and wines can lead to EtG and EtS levels at or above the Aegis reporting threshold.11,13,14 Other fermented beverages such as kombucha, a drink consisting of tea, sugar, bacteria, and yeast, may have up to a 3% alcohol content despite being listed as a non-alcoholic beverage and may cause an unexpected positive result.15-17 Providers should also keep alcohol-containing medications in mind (prescription and over the counter ), which patients may not report using prior to their test.
Certain formulations of particular concern are: cough and cold syrups, tinctures, allergy medications, anti-diarrheals, laxatives, and toothache, cold sore, and canker sore medications. Advise patients to consult product labels or their pharmacist for alcohol content in OTC or prescription medications.
While OTC medications are restricted to a maximum of 10% alcohol content, some prescription drugs may exceed this level. If heavy medication use is suspected or known, or if the presence of alcohol metabolites conflicts with a patient’s treatment agreement, advise patients to use non-alcoholic formulations when possible.
Clinicians should be aware of the rare possibility that a patient may have auto-brewery syndrome. This syndrome causes patients to naturally make large amounts of ethanol in vivo, Individuals affected by this disease will likely have severe bowel dysfunction, an overabundance of yeast, and a carbohydrate rich diet which worsens their symptoms.18,19 A common misconception regarding alcohol testing is that mouthwash or perfume/cologne use may lead to a positive test.
Aegis has not found any data that indicates that proper use of mouthwash or personal scent products will result in a positive test, however, improper use, such as purposefully consuming these products for their alcohol content, can produce positive results.14,20 Additionally, when conducting definitive testing for alcohol, it must be noted that there is no correlation between the amount ingested and the concentration detected in urine.
Furthermore, there is not a correlation between the amount detected and the patients’ impairment or intoxication when the sample was collected.21 Though definitive testing reports concentrations of ethanol, EtG, and EtS, these concentrations cannot be used to infer the exact time or amount of alcohol last ingested.
- NOTICE: The information above is intended as a resource for health care providers.
- Providers should use their independent medical judgment based on the clinical needs of the patient when making determinations of who to test, what medications to test, testing frequency, and the type of testing to conduct.
DOWNLOAD CLINICAL UPDATE References: 1. National Institute on Alcohol Abuse and Alcoholism – Alcohol Facts and Statistics: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics 2. Kissack JC, Bishop J, Leatherwood Roper A.
Ethyl glucuronide as a biomarker for ethanol detection. Pharmacotherapy.2008;(6):769-81.3. Helander A, Beck O. Ethyl sulfate: a metabolite of ethanol in humans and a potential biomarker of acute alcohol intake. J Anal Toxicol,2005;29(5):270-4.4. Crews B, West R, Gutierrez R, et al. An improved method of determining ethanol use in chronic pain population.
J Opioid Manage.2011;7(1):27-34.5. Sulkowski HA, Wu AHB, McCarter YS. In-vitro production of ethanol in urine by fermentation. J Forensic Sci.1995;40:990-3.6. Helander A, Olsson I, Dahl H. Postcollection synthesis of ethyl glucuronide by bacteria in urine may cause false identification of alcohol consumption.
Clin Chem.2007;53(10):1885-7 7. Valentine GW, Jatlow PI, Coffman M, Nadim H, Hueorguleva R, Sofuoglu M. The effects of alcohol-containing e-cigarettes on young adult smokers. Drug Alcohol Depend.2016;159:272-6.8. Reisfield GM, Goldberger BA, Crews BO, et al. Ethyl glucuronide, ethyl sulfate, and ethanol in urine after sustained exposure to an ethanol-based hand sanitizer.
J Anal Toxicol.2011;35(2):85-91.9. Arndt T, Schröfel S, Güssregen B, Stemmerich K. Inhalation but not transdermal resorption of hand sanitizer ethanol causes positive ethyl glucuronide findings in urine. Forensic Sci Int.2014;237:126-30.10. Thierauf A, Wohlfarth A, Auwärter V, Perdekamp MG, Wurst FM, Weinmann W.
Urine tested positive for ethyl glucuronide and ethyl sulfate after the consumption of yeast and sugar. Forensic Sci Int.2010;202(1-3):e45-7.11. Musshoff F, Albermann E, Madea B. Ethyl glucuronide and ethyl sulfate in urine after consumption of various beverages and foods-misleading results? Int J Legal Med.2010;124:623-30 12.U.S.
Food and Drug Administration. CPG Sec.510.400 Dealcoholized wine and malt beverages-labeling.U.S. Food and Drug Administration website. https://www.fda.gov/iceci/compliancemanuals/compliancepolicyguidancemanual/ucm074430.htm Published Oct 1, 1980. Updated November 29, 2005.
- Accessed August 27, 2019.13.
- Thierauf A, Gnann H, Wohlfarth A. et al.
- Urine tested positive for ethyl glucuronide and ethyl sulphate after the consumption of “non-alcoholic” beer.
- Forensic Sci Int.2010;202(1-3):82-5.14.
- Hoiseth G, Yttredal B, Karinen R, Gjerde H, Christophersen A.
- Levels of ethyl glucuronide and ethyl sulfate in oral fluid, blood, and urine after use of mouthwash and ingestion of nonalcoholic wine.
J Anal Toxicol.2010;34(2):84-8.15. Nummer BA. Kombucha brewing under the Food and Drug Administration model food code: Risk analysis and processing guidance. J Environ Health.2013;76(4):8-11.16. Ebersole B, Liu Y, Schmidt R, Eckert M, Brown PN. Determination of ethanol in kombucha products: Single-laboratory validation, First Action 2016.12.
- J AOAC Int.2017;100(3):732-6.17.
- Ombucha Information and Resources.
- Alcohol and Tobacco Tax and Trade Bureau website https://www.ttb.gov/kombucha/kombucha-general.shtml.
- Updated March 29, 2019.
- Accessed August 27, 2019.18.
- Welch BT, Coelho Prabhu N, Walkoff L, Trenkner SW.
- Auto-brewery syndrome in the setting of long-standing Crohn’s disease: A case report and review of literature.
J Crohns Colitis.2016;10(12):1448-50.19. Logan BK, Jones AW. Endogenous ethanol “Auto-Brewery Syndrome” as a drunk-driving defence challenge. Med Sci Law.2000;40(3):206-15.20. Reisfield GM, Goldberger BA, Pesce AJ, et al. Ethyl glucuronide, ethyl sulfate, and ethanol in urine after intensive exposure to high ethanol content mouthwash.
- J Anal Toxicol.2011;35(5):264-8.21.
- Ingall GB.
- Alcohol Biomarkers.
- Clin Lab Med.2012;32(3):391-406 Additional Resources 1.
- Clinical Reference Guide: Drug Testing in Healthcare,
- Aegis Sciences Corporation, 2019.2.
- National Institute of Drug Abuse: https://www.drugabuse.gov/drugs-abuse/alcohol 3.
- Auto-brewery Syndrome Stat Pearls: https://www.ncbi.nlm.nih.gov/books/NBK513346/ 4.
Aegis Labs Clinical Update Site: https://www.aegislabs.com/resources/clinical-update/ 5. Athena Clinical Page: https://athena.aegislabs.com/departments/clinicalscience/Pages/Home.aspx
What medications can cause a false positive for alcohol?
Medications that May Affect Breathalyzer Tests – Breathalyzers test for the presence of methyl group chemicals, which are compounds similar to the ethanol alcohol found in beer, wine, and liquor. These chemicals generally correlate with someone’s consumption of alcoholic beverages.
Asthma medications – The medication found in asthma inhalers tends to linger in the lungs, and these medicines often contain trace amounts of methyl compounds. Albuterol, budesonide, salmeterol, and other medications with different brand names can cause a false positive breathalyzer test. Over-the-counter cold medicines – Certain Vicks products, NyQuil, and other cold and cough medications contain minimal amounts of alcohol, which can skew a breathalyzer test. If you took several cough drops in the hours before a breathalyzer test, that could also skew the result. Oral gels – These medications are commonly used to treat canker sores and toothaches. Some gels contain Anbesol, an anesthetic that can affect the result of breathalyzer tests. Mouthwash and breath spray – Certain types of oral hygiene products contain alcohol, which can affect the result of a breath test. If you used these products just prior to a breathalyzer test, it’s more likely that the test result will be compromised.
Does water affect EtG?
Abstract – This study compared the urinary excretion characteristics of ethyl glucuronide (EtG) with that of ethanol, with focus on the effect of water-induced diuresis. Six healthy volunteers ingested an ethanol dose of 0.5 g/kg (range 25.0-41.5 g) as 5% (v/v) beer in 30 min and the same volume of water after 3 h. Urine collections were made before starting the experiment and at timed intervals over 31.5 h. The concentration of EtG was determined by an LC-MS method (LOQ = 0.1 mg/L). The urine samples collected immediately before starting drinking were all negative for ethanol and EtG, thus confirming that the participants had not recently ingested alcohol. Intake of beer resulted in a marked increase in excreted urine volume and a concomitant drop in creatinine concentration. The concentration of ethanol peaked at a mean value of 17 mmol/L in the 1.5-h urine collection. Except for one subject, EtG was first detectable (range 0.9-5.5 mg/L) at 1 h. Intake of water at 3 h produced another increase in urine volume and a drop in creatinine. The ethanol concentration curve was not influenced by the water diuresis, whereas this caused a distinct drop in the EtG concentration. When EtG was expressed relative to the creatinine value, this ratio was seemingly not affected by the intake of water. The ethanol concentration returned to zero at 6.5 h, whereas EtG was still detectable for up to 22.5-31.5 h, albeit at low levels in the end (< 1 mg/l). Only about 0.02% of the administered dose of ethanol (on a molar basis) was recovered in the urine as EtG. The results demonstrated that EtG remains detectable in the urine for many hours after the ethanol itself has been eliminated. Moreover, it was possible to lower the concentration of EtG by drinking large amounts of water prior to voiding, whereas this strategy did not influence the EtG/creatinine ratio or the concentration of ethanol.
Can a urine alcohol test be wrong?
How Accurate Are Alcohol Urine Tests? – DWI urine testing is based in science but isn’t the most dependable method to measure BAC. The samples are very sensitive and can be contaminated easily. If lab technicians and/or healthcare workers are inadequately trained, your results could be skewed.
- A more damning fact about urine testing is it can’t determine when a person has used or consumed a controlled substance.
- It can only detect what substances are currently in your system.
- Because certain substances can stay in your system for days, weeks, and sometimes months—urine testing can very easily provide inaccurate results.
You could be charged with DWI for consuming a substance weeks or even months ago. Listed below are some detection times for common controlled substances:
Type of Drug: | Detection Time |
Cocaine | One day |
Lysergic Acid Diethylamide (LSD) | One day |
MDMA, Ecstasy, or Molly | Two days |
Ketamine | Two days |
Codeine | Three Days |
Amphetamine | Three Days |
Hydrocodone | Three Days |
Fentanyl | Three Days |
Methamphetamine | Three Days |
Oxycodone | Three Days |
Morphine | Three Days |
Flunitrazepam | Five Days |
Moderate Marijuana Use | Five Days |
Methadone | Seven Days |
Phencyclidine (PCP | Eight days |
Diazepam | 10 days |
Marijuana Daily Use | 10 days |
Marijuana Chronic Use | 30 days |
Urine testing can also yield false results due to human error and fault equipment including:
Issues with sealing samples Storing samples improperly The samples were diluted The sample was contaminated The testing kit was faulty Results were read incorrectly The sample was tampered with
Can mouthwash make you fail an EtG?
Abstract – Two studies were performed to evaluate the effect of alcohol containing mouthwash on the appearance of ethyl glucuronide (EtG) in urine. In the first study, 9 volunteers were given a 4-oz bottle of mouthwash, which contained 12% ethanol. They gargled with all 4 oz. of the mouthwash at intervals over a 15-min period. All urine samples were collected over the next 24 h. Of 39 provided urine samples, there were 20 > 50 ng/mL, 12 > 100 ng/mL, 5 > 200 ng/mL, 3 > 250 ng/mL, and 1 > 300 ng/mL. The peak concentrations were all within 12 h after the exposure. In the second study, 11 participants gargled 3 times daily for 5 days. The first morning void was collected. Sixteen of the 55 submitted samples contained EtG concentrations of greater than 50 ng/mL. All of them were less than 120 ng/mL. These studies show that incidental exposure to mouthwash containing 12% ethanol, when gargling according to the manufacturer’s instructions, can result in urinary EtG values greater than 50 ng/mL. All specimens were negative for ethanol. The limits of detection and quantitation for the EtG testing were 50 ng/mL.
Can you fail an EtG drinking non alcoholic beer?
Types Of Tests – There are various types of urine tests used to detect alcohol in the body. One common test is the Ethyl Glucuronide (ETG) test, which looks for a specific alcohol metabolite called ethyl glucuronide. This test is sensitive and can detect even trace amounts of alcohol consumption.
Can I drink tea before urine test?
Locate the test you are having below and follow any added instructions. – Do not eat any seafood for 48 hours prior to the test. – Avoid alcohol, coffee, tea and tobacco for 72 hours before collection and up to collection time. – Avoid strenuous exercise 8-12 hours before the test.