Alcohol

Ethyl Glucuronide (EtG) and Ethylsulfate (EtS) are metabolites of alcohol (ethanol).

Measurement of EtG and EtS in urine are useful tests to detect recent ingestion of ethanol. These metabolites have long detection window and remain positive after ethanol is eliminated from the body. In cases where surveillance of an alcohol slip or relapse drinking is needed, EtG and EtS in urine offer very sensitive alternatives, or complements, to ethanol testing.

Although the presence of EtG in a urine sample is a specific and sensitive indicator of recent alcohol ingestion, it may indicate the possibility of casual, inadvertent, or extreme environmental exposure to alcohol when ETS is negative or below the cutoff. Conversely, a positive urine ETS test indicates alcohol consumption within detection window when EtG is not detected. The negative EtG may be the result of bacterial degradation causing ETG concentration drop below the cutoff.

After primarily screening samples for presumptive positives, Kashi Labs then confirms the EtG/EtS results by liquid chromatography – tandem mass spectrometry (LC-MS). The screen and confirmatory EtG/EtS testing allow for faster and more accurate testing compared to standard testing methods for alcohol.

Compound
Lower Limit of Detection

40% cutoff (ng/mL)

SCREEN CUTOFF(NG/ML)
Confirmatory Cutoff (ng/mL)
Upper Limit of Detection

50x cutoff (ng/mL)

Et Glucuronide

200

1000

500

25000

Et Sulfate

40

N/A

250

12500

EtG or EtS can be detected in urine at low levels after intensive use of hand sanitizer or alcohol based mouthwash, as well as certain foods. Due to this overlap between true positives & positives associated with foods or cosmetics, it is hard to distinguish the source of EtG/EtS at low levels. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommendations are: If the EtG concentration is 100-1000ng/ml indicates unintentional exposure OR alcohol consumption, if EtG is > 1000ng/ml is a confirmation of alcohol consumption.

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