Booze tests reveal all about your drinking

[johnny861]

Booze tests reveal all about your drinking

If you tend to be a little less than honest when your doctor asks you how much you drink, beware. A battery of new tests on blood, urine and hair can reveal how much someone has drunk not only in the past days, but also in the past weeks and months.

Doctors are likely to be the first to employ some or all of the new tests, to monitor patients with alcohol problems. But they are also likely to attract the interest of employers, insurance companies and forensic scientists.

Airlines could, for instance, identify pilots who are heavy drinkers by testing their hair. A urine test might allow police to prove many hours or even days after an accident that someone had been drinking.

Used together, the set of tests could provide a comprehensive picture of someone's drinking habits, revealing when they had last been drinking and whether they are heavy or light drinkers. "It covers the whole time spectrum following alcohol consumption," says Friedrich Wurst of the University of Basel in Switzerland, head of one of the multinational teams developing and validating the tests.


Indirect evidence


Alcohol itself vanishes from the body within hours. After this point there are a number of existing methods of telling whether someone has been drinking, but almost all of them rely on indirect evidence, such as levels of liver enzymes in the blood. Because other toxins or even pregnancy can cause similar changes, none of these tests is very reliable.

In the past decade, however, various groups worldwide have been studying breakdown products unique to alcohol. One of these indicators, ethyl glucuronide (EtG), starts accumulating in blood as alcohol levels decline.

"Ethyl glucuronide, plus the absence of alcohol itself, indicates a potential hangover state," says Wurst. The presence of EtG could show whether drivers or workers who have been involved in an accident were drunk at the time, even if they are not tested until hours or days later. EtG lasts for up to five days in urine, and confirms beyond all doubt that someone has had a drink in that time.

Another test that looks for phosphatidyl ethanol (PEth) provides an intermediate measure. PEth lasts for up to three weeks in the blood of people who consume more than around three beers a day, or the equivalent. Wurst's team has shown it is a far more reliable indicator than liver enzymes. "We found no false negatives," he says.

Looking at the combined levels of four fatty acid ethyl esters (FAEEs) in hair provides an even longer-term measure of alcohol consumption. FAEEs appear in blood within 12 to 18 hours of alcohol being consumed, but end up stored in hair.

In the latest study, Wurst's team monitored around 40 drinkers and teetotallers, and showed that FAEE levels in hair can distinguish between light and heavy drinkers (Alcohol and Alcoholism, vol 39, p 33). "The only way to remove the evidence is to shave all body hair," says Wurst.

Prolonged intake
Other researchers say the work could greatly extend the power of testing. "We don't really have comparable tests for prolonged intake," says Charles Lieber of Mount Sinai School of Medicine in New York and the Bronx Veterans Affairs Medical Center. "We don't have anything similar in place, and there is potential there. But it is important that it is duplicated by other investigators."

"It's a great start, and the first paper of its kind," says Christine Moore, lab director at US Drug Testing Laboratories, a private company in Chicago. "In the US, I don't know of anyone who tests EtG yet, and only one lab that does PEth," she says.

But she thinks the hair test could be widened to include more than the existing four ethyl esters: at least 10 have already been unequivocally linked to ethanol. "It would extend it and make it even better," she says.

Moore is investigating whether it is possible to find out if mothers have been drinking excessively during pregnancy by looking at the levels of FAEEs in meconium, the first faeces of a newborn. If they had, it would be too late to help that child, but any future pregnancies could be monitored more closely.

[Johnny Funk]

Why would you lie to your doctor?

[Funkenstein]

Originally Posted by Johnny Funk

Why would you lie to your doctor?

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I have heard stranger tales than these.