Urinary ethyl glucuronide and ethyl sulfate testing for detection of recent drinking in an outpatient treatment...

This study determined the information about recent alcohol consumption obtained when urinary ethyl glucuronide (EtG) and ethyl sulfate (EtS) were introduced as a routine test in outpatient treatment programs for alcohol and drug dependence.

Outpatients (21 men and 3 women) undergoing treatment for alcohol (N = 8) or drug (N = 10) dependence, or in methadone maintenance therapy (N = 6) volunteered for the study. Twice weekly in connection with return visits to the unit, patients gave a urine sample and completed an anonymous single-question form about any drinking in the past 3 days. Urinary EtG and EtS were determined by liquid chromatography-mass spectrometry.

Totally, 214 urine samples (4-14 samples/patient; mean 9) and 211 self-reports were collected over a 2-8-week period. Altogether 26% of the urine samples from 12 of 24 patients tested positive for EtG (0.5-434 mg/l) and/or EtS (0.1-87 mg/l). In one patient, samples were only positive for EtS. In 21% of 211 self-reports from 11 patients, alcohol ingestion was admitted in the past 3 days. In 87% of the 211 complete cases, the self-report information agreed with the EtG/EtS results (i.e. true positives and true negatives). The highest frequency of drinking was seen in the drug-dependent group with only 20% of the patients being abstinent according to both measures. This compares with 62.5% abstinence in the alcohol-dependent group and 50% in the methadone maintenance therapy group.

Although based on a limited number of subjects, these results indicated that urinary EtG and EtS testing is a useful tool for objective identification of recent drinking in outpatients treated for alcohol and drug dependence.