title: Measurement of direct ethanol metabolites in a case of a former driving under the influence (DUI) of alcohol offender, now claiming abstinence.
abstract: A 37-year-old female subject had been convicted of driving under the influence of alcohol, and 19 months later, claimed abstinence after supervised disulfiram treatment. Our aim was to elucidate the value of direct ethanol metabolites as measures of abstinence. Ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEE) in hair, phosphatidylethanol in whole blood and EtG and ethyl sulphate in urine were measured. The results were compared with self-report of alcohol consumption and traditional blood biomarkers for chronically elevated alcohol consumption as carbohydrate deficient transferrin (CDT), gamma glutamyl transpeptidase, mean corpuscular erythrocyte volume, aspartate aminotransferase and alanine aminotransferase. EtG was found in distal parts of hair only, whereas the proximal parts were negative. Furthermore, FAEE concentrations were found in the typical distribution over the hair length and showed values typical for either moderate social drinking or abstinence. CDT was above cut-off in 9 out of 16 analyses with a decreasing tendency and the lowest values in the last 2 months before the end of sampling. The data suggest that in addition to traditional markers, a combination of direct ethanol metabolites can be useful in the expert assessment of judging driving ability. A careful individual interpretation of the results for the different markers, however, is an absolute necessity.
authors.affiliation: Psychiatric University Hospital, University of Basel, Basel, Switzerland.
authors.forename: Friedrich M
authors.initials: FM
authors.lastname: Wurst
authors.forename: Michel
authors.initials: M
authors.lastname: Yegles
authors.forename: Christer
authors.initials: C
authors.lastname: Alling
authors.forename: Steina
authors.initials: S
authors.lastname: Aradottir
authors.forename: Jutta
authors.initials: J
authors.lastname: Dierkes
authors.forename: Gerhard A
authors.initials: GA
authors.lastname: Wiesbeck
authors.forename: Claudia C
authors.initials: CC
authors.lastname: Halter
authors.forename: Fritz
authors.initials: F
authors.lastname: Pragst
authors.forename: Volker
authors.initials: V
authors.lastname: Auwaerter
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000032:analysis; D000428:Alcohol Drinking; D000437:Alcoholism / Q000175:diagnosis; D001219:Aspartate Aminotransferases / Q000032:analysis; D001334:Automobile Driving / Q000331:legislation & jurisprudence*; D015415:Biomarkers / Q000032:analysis; D004909:Erythrocyte Indices; D004952:Esters; D005227:Fatty Acids / Q000032:analysis; D005260:Female; D053593:Forensic Toxicology; D005965:Glucuronates / Q000032:analysis; D020404:Glycerophospholipids / Q000097:blood; D006197:Hair / Q000737:chemistry; D006801:Humans; D015813:Substance Abuse Detection / Q000379:methods*; D013463:Sulfuric Acid Esters / Q000652:urine; D014168:Transferrin / Q000031:analogs & derivatives / Q000032:analysis; D005723:gamma-Glutamyltransferase / Q000032:analysis
chemical_list: D015415:Biomarkers; D004952:Esters; D005227:Fatty Acids; D005965:Glucuronates; D020404:Glycerophospholipids; D013463:Sulfuric Acid Esters; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C051521:phosphatidylethanol; C093924:ethyl glucuronide; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase