Blood alcohol testing in the clinical laboratory: problems and suggested remedies

Laboratory directors or others responsible for blood alcohol testing are advised to reevaluate their procedures for alcohol tests. The demand for better traffic safety has resulted in a large increase in the number of arrests for drinking and driving violations and in a concomitant increase in the litigation of alcohol-related cases. My experience in the last 20 years indicates that many difficulties in the forensic aspects of these cases and many miscarriages of justice could have been reduced or even avoided if laboratories doing alcohol analyses had followed established guidelines. The most frequently encountered problems involve the physician-patient privilege ("the test was done for medical purposes only") and the fact that alcohol results were frequently reported as blood alcohol concentrations when they were, in fact, serum alcohol concentrations. Here I discuss these problems and suggest some solutions.