title: Urinary ethyl glucuronide and ethyl sulfate testing for detection of recent drinking in an outpatient treatment program for alcohol and drug dependence.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden. helen.dahl@karolinska.se
authors.forename: Helen
authors.initials: H
authors.lastname: Dahl
authors.forename: Annette
authors.initials: A
authors.lastname: Voltaire Carlsson
authors.forename: Kristina
authors.initials: K
authors.lastname: Hillgren
authors.forename: Anders
authors.initials: A
authors.lastname: Helander
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000652:urine*; D000437:Alcoholism / Q000175:diagnosis / Q000652:urine; D000553:Ambulatory Care; D000431:Ethanol / Q000652:urine; D005260:Female; D005965:Glucuronates / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D015813:Substance Abuse Detection / Q000379:methods*; D013463:Sulfuric Acid Esters / Q000652:urine*; D013695:Temperance; D013997:Time Factors; D055815:Young Adult
chemical_list: D005965:Glucuronates; D013463:Sulfuric Acid Esters; C093924:ethyl glucuronide; D000431:Ethanol; C011612:diethyl sulfate