Monitor use and support recovery through direct ethanol biomarker testing
As opposed to the limited sensitivity and specificity of indirect ethanol biomarker testing, direct biomarker testing offers heightened sensitivity and specificity to identify alcohol use disorder (AUD), which is estimated to affect 300 million people worldwide.1
Our menu of 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 Because these direct alcohol biomarkers have a longer half-life and extended detection window, alcohol consumption over a period of several days can be more accurately assessed.
14.8 million
14.8 million Americans have AUD3
140,000
140,000 deaths in the U.S. each year caused by excessive alcohol use5
$249 billion
Annual financial burden of AUD was $249 billion in 20106
Improved analysis of the specific role alcohol plays on an individual’s health.3
Test results clarify actual amounts of recent consumption, which, combined with questionnaires, can support initiating clinical interventions.
Optimized testing
Because hazardous drinking practices and associated morbidity remain underdiagnosed, routine screening for unhealthy use is recommended by the U.S. Preventive Services Task Force as a cost-effective, clinical preventive service. Incorporating alcohol biomarker testing is recommended by the American Society of Addiction Medicine and the American Psychiatric Association to help diagnose AUD and support patient recovery.4
Our blood biomarker testing to evaluate for PEth provides an expanded window of detection to identify ethanol consumption. PEths, a group of phospholipids formed in the presence of ethanol, phospholipase D, and phosphatidylcholine, are incorporated into the phospholipid membrane of red blood cells. Based on blood concentrations of PEth, it is possible to determine recent alcohol consumption and how much has been taken for several weeks following the last use.
Uses liquid chromatography/tandem mass spectrometry (LC/MS-MS) to measure PEth concentrations in blood.
Measures and reports the two most common PEth homologues: PEth 16:0/18:1 (POPEth) and PEth 16:0/18:2 (PLPEth), which, combined, account for over 60% of all the observed PEth homologues in the blood.
Identifies relapse, especially to heavy ethanol consumption.
Helps monitor ethanol abstinence over time.
Offers a detection window of two to four weeks in the blood. Among individuals who chronically or excessively consume alcohol, the detection window can be longer.
Paul Jannetto, Ph.D., describes Mayo Clinic Laboratories' new direct biomarker test for alcohol consumption. PETH is a blood test with a window of detection of about two to four weeks — compared with five days for urine-based screening for alcohol use.
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Direct urine alcohol biomarker testing
Our urine alcohol testing offers clinical specificity to evaluate for alcohol use through the detection of EtG and EtS. These assays offer an extended window of detection that can reliably identify alcohol consumption in urine up to five days, which helps facilitate diagnosis and assists in monitoring ethanol abstinence or relapse in outpatients treated for alcohol-related problems.
Uses liquid chromatography/tandem mass spectrometry (LC-MS/MS) to quantify levels of both EtG and EtS in urine.
A positive interpretation will be given if either the EtG result is greater than or equal to 250 ng/mL, and/or EtS is greater than or equal to 100 ng/mL.
Combined testing provides sensitivity and specificity to low levels of ethanol.
When screening for only EtG, false positives may occur.
Detects EtG, which is a direct metabolite of alcohol formed by enzymatic conjugation of ethanol with glucuronic acid. Alcohol in urine is normally detected for only a few hours, whereas EtG can be detected in the urine for up to five days.
Testing begins with a screening assay. If positive, then the liquid chromatography-tandem mass spectrometry confirmation with quantification (Mayo ID: ETGC) will be performed at an additional charge.
Care should be taken when interpreting results, since there are many factors (e.g., fluid intake) that might influence the urine test result. It is possible that substances other than those investigated in the specific study may interfere with the test and cause false-positive or false-negative results.
Jarvis M., Williams J., Hurford M., et al. Appropriate use of drug testing in clinical addiction medicine. J Addict Med. 2017 May/Jun;11(3):163-173. doi:10.1097/ADM.0000000000000323
Centers for Disease Control and Prevention. Alcohol-Related Disease Impact (ARDI) website. Accessed April 19, 2022.
Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD. 2010 National and state costs of excessive alcohol consumption. Am J Prev Med. 2015;49(5):e73–e79
Kapur B, Aleksa K., What the lab can and cannot do: clinical interpretation of drug testing results. Crit Rev Clin Lab Sci. 57:8, 548-585. doi:10.1080/10408363.2020.1774493
Niemela, O. Biomarker-based approaches for assessing alcohol use disorders. Int J Environ Res Public Health. 2016 Jan 27;13(2):166. doi:10.3390/ijerph13020166
Hakim F, Wiart JF, Ménard O, Allorge D, Gaulier JM. Dosage sanguin du phosphatidyléthanol [Phosphatidylethanol blood analysis]. Ann Biol Clin (Paris). 2019 Dec 1;77(6):638-644. French. doi:10.1684/abc.2019.1499. PMID: 31859640
Ulwelling W, Smith K. The PEth blood test in the security environment: what it is; why it is important; and interpretative guidelines. J Forensic Sci. 2018 Nov;63(6):1634-1640. PMID: 30005144
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