Screening for drug abuse involving alcohol
For situations where chain of custody is required, a Chain of Custody Kit (T282) is available. For chain-of-custody testing, order ETGX / Ethyl Glucuronide Confirmation, Chain of Custody, Random, Urine.
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Collection Container/Tube: Plastic urine container
Submission Container/Tube: Plastic, 5-mL tube
Specimen Volume: 2 mL
1. Collect a random urine specimen.
2. No preservative.
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
|Specimen Type||Temperature||Time||Special Container|
|Urine||Refrigerated (preferred)||28 days|
Screening for drug abuse involving alcohol
Ethyl glucuronide is a direct metabolite of ethanol that is formed by enzymatic conjugation of ethanol with glucuronic acid. Alcohol in urine is normally detected for only a few hours, whereas ethyl glucuronide can be detected in the urine for 1 to 3 days.
This procedure uses immunoassay reagents that are designed to produce a negative result when no drugs are present in a natural (ie, unadulterated) specimen of urine; the assay is designed to have a high true-negative rate. Like all immunoassays, it can have a false-positive rate due to cross-reactivity with natural chemicals and drugs other than those they were designed to detect. The immunoassay also has a false-negative rate to the antibody's ability to cross-react with different drugs in the class being screened for.
Screening cutoff concentration: 500 ng/mL
This assay only provides a preliminary analytical test result. A more specific alternative method (ie, liquid chromatography-tandem mass spectrometry: LC-MS/MS) must be used to obtain a confirmed analytical result. A positive result using the ethyl glucuronide screen indicates only the potential presence of ethyl glucuronide and does not necessarily correlate with the extent of physiological and psychological effects.
Care should be taken when interpreting results since there are many factors (eg, fluid intake and other biologic factors) that may influence a urine test result. It is possible that substances other than those investigated in the specificity study may interfere with the test and cause false-positive or negative results.
1. Schmitt G, Aderjan R, Keller T, Wu M: Ethyl glucuronide: an unusual ethanol metabolite in humans. Synthesis, analytical data, and determination in serum and urine. J Anal Toxicol. 1995;19:91-94. doi: 10.1093/jat/19.2.91
2. Dahl H, Stephanson N, Beck O, Helander A: Comparison of urinary excretion characteristics of ethanol and ethyl glucuronide. J Anal Toxicol. 2002;26:201-104. doi: 10.1093/jat/26.4.201
3. Wurst FM, Skipper GE, Weinmann W: Ethyl glucuronide--the direct ethanol metabolite on the threshold from science to routine use. Addiction. 2003;98 (S2):51-61. doi: 10.1046/j.1359-6357.2003.00588
4. Zimmer H, Schmitt G, Aderjan R: Preliminary immunochemical test for the determination of ethyl glucuronide in serum and urine: comparison of screening method results with gas chromatography-mass spectrometry. J Anal Toxicol.2002;26:11-16. doi: 10.1093/jat/26.1.11
5. Weinmann W, Schaefer P, Thierauf A, et al: Confirmatory analysis of ethylglucuronide in urine by liquid chromatography/electrospray ionization/tandem mass spectrometry according to forensic guidelines. J Am Soc Mass Spectrom. 2004;15(2):188-193. doi: 10.1016/j.jasms.2003.10.010
6. Langman LJ, Bechtel LK, Meier BM, Holstege C: Clinical toxicology. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:832-887
This assay is a homogeneous enzyme immunoassay technique. The assay will be performed semiquantitatively. The assay is based on competition between free drug in the urine sample, and a drug labeled with the enzyme glucose-6-phosphate dehydrogenase for a fixed amount of specific antibody binding sites. Active enzyme converts nicotinamide adenine dinucleotide (NAD+) to NADH, which results in an absorbance change that can be measured spectrophotometrically at 340 nm.(Package insert: DRI Ethyl Glucuronide Assay. Microgenics Corporation; 09/2015)
Monday through Saturday
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
|Test Id||Test Order Name||Order LOINC Value|
|ETGS||Ethyl Glucuronide Screen, U||58375-7|
|Result Id||Test Result Name||
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|63420||Ethyl Glucuronide Screen, U||58375-7|