title: Ethyl glucuronide (EtG): better than breathalyser or self-reports to detect covert short-term relapses into drinking.
abstract: OBJECTIVE
  The assessment of relapses is widely used as an outcome measure of alcohol dependence treatment. However, the methods of assessing relapses range from questionnaires to biological markers of alcohol for different time spans. The aim of this study was to compare the relapse rates of weekend home stays during long-term alcohol dependence treatment, assessed by ethyl glucuronide (EtG), breath alcohol tests and self-reports.
  
  
  METHODS
  Two hundred and ninety-seven alcohol-dependent patients receiving a long-term inpatient treatment programme participated. After a weekend at home (Friday to Sunday) they were evaluated for relapse by personal interviews and with breath alcohol tests. A concomitantly collected urine sample was later assessed for EtG with liquid chromatography-tandem mass spectrometry (LC-MS/MS analysis).
  
  
  RESULTS
  Of the total, 37.7% of the patients were positive for EtG at least once. Breath alcohol tests had been positive in only 4.4% and in personal interviews only 5.7% of the patients had admitted relapse. 15.6% of EtG tests were positive, but breath alcohol tests were negative (Cohen's kappa = 0.056). Ninety-three per cent of the relapses were only detected by EtG.
  
  
  CONCLUSIONS
  In addition to breath alcohol tests and interviews, urinary EtG can clearly improve the verification of relapse in inpatient treatment programmes allowing for weekend stays at home. Without EtG testing, a high amount of relapses will stay undetected.
authors.affiliation: Corresponding author: Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany. klaus.junghanns@uksh.de.
authors.forename: T
authors.initials: T
authors.lastname: Wetterling
authors.forename: L
authors.initials: L
authors.lastname: Dibbelt
authors.forename: G
authors.initials: G
authors.lastname: Wetterling
authors.forename: R
authors.initials: R
authors.lastname: Göder
authors.forename: F
authors.initials: F
authors.lastname: Wurst
authors.forename: M
authors.initials: M
authors.lastname: Margraf
authors.forename: K
authors.initials: K
authors.lastname: Junghanns
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000652:urine*; D000437:Alcoholism / Q000175:diagnosis / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D001944:Breath Tests / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005965:Glucuronates / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report / Q000592:standards*; D016320:Substance Abuse Treatment Centers / Q000639:trends; D013695:Temperance; D013997:Time Factors
chemical_list: D015415:Biomarkers; D005965:Glucuronates; C093924:ethyl glucuronide