Mayo Clinic Laboratories > Ethanol testing in behavioral health

Ethanol testing in Behavioral health

Identify excessive alcohol use and support recovery

Excessive alcohol use is a leading preventable cause of death in the United States, shortening the lives of those who die from excessive drinking by an average of 24 years.1 As part of an evidence-based addiction treatment program, testing can serve as a tool to assess and manage patients across all phases of recovery from excessive alcohol use, including substance use disorder (SUD) and alcohol use disorder (AUD). The American Society of Addiction Medicine recommends incorporating alcohol biomarker testing to help diagnose these conditions and support patient recovery.2

Ethanol testing case examples

Behavioral health providers have access to a range of indirect and direct biomarker testing options to identify individuals who engage in excessive alcohol use and monitor ongoing use as part of a treatment plan. Which test to choose depends on the clinical situation. Aligning with the American Society of Addiction Medicine recommendations, our evidence-based guide includes case examples to help providers identify and monitor patients who engage in excessive alcohol use or have alcohol use disorder (AUD), optimize treatment plans, and improve outcomes for their patients. Cases include:

  • Assessing patients for liver transplant
  • Assessing patients for polysubstance use
  • Identifying patients with AUD
  • Chronic disease management for AUD or alcoholic liver disease

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ETHANOL TESTING: Guide to screening and monitoring in behavioral health settings

What is excessive alcohol use?

Excessive alcohol use includes:4

  • Heavy drinking – 8 or more drinks per week for a woman or 15 or more drinks per week for a man.
  • Binge drinking – 4 or more drinks on an occasion for a woman or 5 or more drinks on an occasion for a man. Binge drinking is responsible for more than 40% of the deaths and three-quarters of the costs due to excessive alcohol use.
  • Any alcohol use by pregnant women. Alcohol use by a pregnant woman can lead to fetal alcohol syndrome in the child.
  • Any alcohol use by anyone younger than 21.

What is alcohol use disorder?

AUD is a serious psychiatric medical condition that causes individuals to be unable to control or stop drinking, and can lead to lasting changes in the brain that make patients vulnerable to relapse. When supported by treatment plans that may include behavioral therapies, support groups, and/or medications, patients have a better chance of recovery.6


Direct ethanol biomarker testing
Direct ethanol biomarker testing accurately assesses alcohol use and AUD. This methodology enables detection of even small amounts of ethanol eliminated via non-oxidative pathways into ethyl glucuronide (EtG), ethyl sulfate (EtS), and phosphatidylethanol (PEth).2

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Comprehensive drug profiles
Comprehensive profiles assess a range of commonly misused or abused drugs, including alcohol.

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  1. Deaths from Excessive Alcohol Use in the United States. Centers for Disease Control and Prevention. Reviewed April 16, 2024.
  2. Appropriate Use of Drug Testing in Clinical Addiction Medicine. American Society of Addiction Medicine (ASAM). Updated Dec 2023.
  3. Bohm MK, Liu Y, Esser MB, et al. Binge Drinking Among Adults, by Select Characteristics and State – United States, 2018. MMWR Morb Mortal Wkly Rep.. 2021 Oct; 70(41):1441-1446.
  4. Excessive Alcohol Use. Centers for Disease Control and Prevention. Reviewed July 11, 2022.
  5. Chaudhari R, Moonka D, Nunes F. Using biomarkers to quantify problematic alcohol use. J Fam Pract. 2021 Dec;70(10):474-481. doi:10.12788/jfp.0317
  6. Understanding Alcohol Use Disorder. National Institute on Alcohol Abuse and Alcoholism.

Learn more about how testing can support evidence-based diagnosis and treatment strategies.