Ethyl glucuronide

Walsham, Natalie E; Sherwood, Roy

doi:10.1258/acb.2011.011115

Cited by 65 publications

(34 citation statements)

References 87 publications

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“…Alcohol in urine can be detected by assaying ethanol as well as alcohol metabolites, specifically EtG and EtS (Figure 12). 76,79 An advantage of EtG/EtS testing over traditional ethanol testing is its extended window of detection (Table 3), which better allows identification of recent alcohol use and relapse. Even after complete elimination of alcohol from the body, EtG and EtS are still detectable for up to 4 days.…”

Section: Clinical Managementmentioning

confidence: 99%

Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use

Gudin

Mogali

Jones

et al. 2013

Postgraduate Medicine

204

122

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The concurrent use of opioids, benzodiazepines (BZDs), and/or alcohol poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs and/or alcohol are at higher risk for fatal/nonfatal overdose and have more aberrant behaviors. Few practice guidelines for BZD treatment are readily available, especially when they are combined clinically with opioid analgesics and other central nervous system–depressant agents. However, coadministration of these agents produces a defined increase in rates of adverse events, overdose, and death, warranting close monitoring and consideration when treating patients with pain. To improve patient outcomes, ongoing screening for aberrant behavior, monitoring of treatment compliance, documentation of medical necessity, and the adjustment of treatment to clinical changes are essential. In this article, we review the prevalence and pharmacologic consequences of BZDs and/or alcohol use among patients with pain on chronic opioid therapy, as well as the importance of urine drug testing, an indispensable tool for therapeutic drug monitoring, which helps to ensure the continued safety of patients. Regardless of risk or known aberrant drug-related behaviors, patients on chronic opioid therapy should periodically undergo urine drug testing to confirm adherence to the treatment plan.

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Section: Clinical Managementmentioning

confidence: 99%

Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use

Gudin

Mogali

Jones

et al. 2013

Postgraduate Medicine

204

122

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“…Ethyl glucuronide (EtG), a direct metabolite of ethanol, has well been established as a powerful biomarker for detecting alcohol abuse and for monitoring alcohol abstinence [1][2][3][4]. Depending on the time period to be investigated, EtG can be determined in blood, urine, or hair samples.…”

Section: Introductionmentioning

confidence: 99%

“…Chromatograms of negatively(1) and positively (2) tested hair samples analyzed in cut (a) and pulverized (b) form. Determined concentrations: cut hair, 30 pg/mg; pulverized hair, 42 pg/mg…”

mentioning

confidence: 99%

Investigations on the influence of different grinding procedures on measured ethyl glucuronide concentrations in hair determined with an optimized and validated LC-MS/MS method

et al. 2012

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Ethyl glucuronide (EtG) analysis in hair is a suitable method for the retrospective determination of previous alcohol consumption. According to the German guidelines, EtG abstinence is improbable at c(EtG) > 7 pg/mg in the proximal 3 cm of scalp hair. The chromatography of the routinely used liquid chromatography-tandem mass spectrometry procedure was optimized by replacing the stationary phase. To simplify sample preparation, two different mills were tested, and an optimized grinding process was developed. The new method was successfully validated according to the guidelines of the German Society of Toxicological and Forensic Chemistry. Despite a simple extraction procedure without any cleaning steps, a very high sensitivity (limit of detection, 1.7 pg/mg; limit of quantitation, 2.3 pg/mg) could be achieved. Competitive analysis showed significantly higher EtG concentrations in pulverized versus cut hair samples. The strong impact of sample preparation on the determined EtG concentrations suggests the introduction of a standardized sample preparation method to produce comparable results.

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“…They are advantageous as compared to traditional biological state markers, such as liver enzymes or mean corpuscular volume, since those are indirect measures of ethanol intake. Therefore, they are limited with regard to the time period for previous drinking and/or are confounded due to age, gender, other ingested substance intake and non-alcohol-associated diseases [2,3,4,5]. On this background, direct ethanol metabolites have gained interest during the last two decades.…”

Section: Introductionmentioning

confidence: 99%

“…Ethyl glucuronide (EtG), a promising marker of alcohol intake, is a direct metabolite of alcohol formed as a conjugate of alcohol with glucuronic acid in the liver, catalyzed by the enzyme uridine diphosphate glucuronyltransferase [3,5,6,7]. EtG is measureable in tissue, blood, hair, and, most commonly, in urine [6].…”

Section: Introductionmentioning

confidence: 99%

Cellular Photo Digital Breathalyzer for Monitoring Alcohol Use: A Pilot Study

Skipper¹,

Thon

DuPont

et al. 2013

Eur Addict Res

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Background: Monitoring alcohol use is important in numerous situations. Direct ethanol metabolites, such as ethyl glucuronide (EtG), have been shown to be useful tools in detecting alcohol use and documenting abstinence. For very frequent or continuous control of abstinence, they lack practicability. Therefore, devices measuring ethanol itself might be of interest. This pilot study aims at elucidating the usability and accuracy of the cellular photo digital breathalyzer (CPDB) compared to self-reports in a naturalistic setting. Method: 12 social drinkers were included. Subjects used a CPDB 4 times daily, kept diaries of alcohol use and submitted urine for EtG testing over a period of 5 weeks. Results: In total, the 12 subjects reported 84 drinking episodes. 1,609 breath tests were performed and 55 urine EtG tests were collected. Of 84 drinking episodes, CPDB detected 98.8%. The compliance rate for breath testing was 96%. Of the 55 EtG tests submitted, 1 (1.8%) was positive. Conclusions: The data suggest that the CPDB device holds promise in detecting high, moderate, and low alcohol intake. It seems to have advantages compared to biomarkers and other monitoring devices. The preference for CPDB by the participants might explain the high compliance. Further studies including comparison with biomarkers and transdermal devices are needed.

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Ethyl glucuronide

Cited by 65 publications

References 87 publications

Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use

Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use

Investigations on the influence of different grinding procedures on measured ethyl glucuronide concentrations in hair determined with an optimized and validated LC-MS/MS method

Cellular Photo Digital Breathalyzer for Monitoring Alcohol Use: A Pilot Study

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