This is for Dr. Bill or whoever can help. I had 2 (literally) small sips of wine on Sunday night, it is now Thursday. I have to take a drug test today which includes an EtG test. This test can test up to 5 days back. Will I pass? I have been alcohol free for a little over one month.

Two sips of wine will not be detectable at that length of time.

Thank you. I did not think so, but I know that they can be very sensitive, and have heard of even communal wine, mouth wash, etc giving positives. It is as far as I know a test for around 500 ng/ml.

You are correct that the test can pick up incidental exposure to alcohol. Generally, that is time related. Mouthwash a couple of hours prior to testing, or prolonged use of hair care products, etc. One way to reduce that possibility is to stay well hydrated, at least two (8 oz) glasses of water 2 hours before test. The 500 cutoff is also helpful, but don't rely on that.

Hair care products? I just had my hair highlighted last night at a salon... That is scary.

Hair care products? I just had my hair highlighted last night at a salon... That is scary.

Hair care and cosmetic items usually contain alcohol. Check shampoo and conditioners in particular... the daily use products.

This is particularly problematic in hair alcohol testing but alcohol can get into your system via sebaceous and sweat glands as well and through inhalation during use.

Once again, the 500 cutoff is helpful. Maintaining hydration is helpful. But this test is erratic and unreliable. Don't take anything for granted.

Dr. Bill,

Thank you for your patience regarding this matter,I am slightly confused though if the test can be so sensitive as to pick up mouth wash and alcohol from food, communal wine, and even hair products, how could it not pick up two sips of wine? Is it the time frame? If I had had that Wednesday night and taken the test Thursday then perhaps it would have shown? I apologize, I am just worried and confused.

Dr. Bill,

Thank you for your patience regarding this matter,I am slightly confused though if the test can be so sensitive as to pick up mouth wash and alcohol from food, communal wine, and even hair products, how could it not pick up two sips of wine? Is it the time frame? If I had had that Wednesday night and taken the test Thursday then perhaps it owuld have shown? I apologize, I am just worried and confused.

Time.

EtG follows an elimination curve much like alcohol. If you have one drink it will be detectable for under 2 hours. Have 10 drinks and alcohol will be detectable 8-10 hours. It is eliminated at a steady rate. Same with EtG which is produced from the metabolism of alcohol.

Small amounts of alcohol will create small amounts of EtG and the EtG will be eliminated via your normal metabolism. Of course to detect EtG at all it must rise above the test cutoff level and in your case that is unlikely even if tested hours later.

Most of the false positives result from inadequate advice. If you use a mouthwash containing alcohol and are tested about 4 hours later there is a good chance of a false positive. 12 hours later the EtG will be gone.

While there is always a danger with this test due to incidental exposure, I can assure that the EtG from the alcohol won't be detected because it is no longer in your system. Already eliminated. Probably within 12-15 hours but no longer than 24 hours.

Then how does it pick up alcohol in the system up to 5 days later? The metabolites? Or ETS?

Then how does it pick up alcohol in the system up to 5 days later? The metabolites? Or ETS?

There is no research to support the 5 day claim.

The tests that have shown an extended detection period involved detox patients, following heavy and prolonged drinking. All of the literature dealing with consumption in the range 1-5 drinks show average detection times in the range of 18-48 hours.

Here is a link to a study that addresses the misinformation in relation to this test: Wojcik & Hawthorne (http://alcalc.oxfordjournals.org/cgi/content/full/agm014v1#T1)

The test that is given is Superior to urine alcohol because it is detectable in the urine longer and therefore has a longer time spectrum of detection (2-5 days)There is essentially no ethylglucuronide present in the urine unless alcohol has been present in vivo (in a person's body). There are virtually no false positive tests, however, an important issue is that must be considered is that there is much non-beverage alcohol in our environment (alcohol as a solvent (in OTC meds), in foods (i.e. vanilla extract), use in rituals (communion wine), etc.) and hand-sanitizers.
ï‚· Many labs are beginning to offer low cost screening by immunoassay now that a reliable cut-off at 500 ng/ml has been achieved. LC/MS/MS (Liquid Chromatography/ tandem Mass Spectrometry) is often used to confirm ethylgluronide and is highly accurate.Ethylglucuronide is proving to be particularly useful in numerous settings associated with monitoring individuals committed to abstinence: 1. Individuals who have had problems with alcohol abuse and have been allowed to return to work based on an abstinence agreement, 2. Methadone clinics, 3. Individuals with hepatitis C, 4. In criminal justice settings and 5. In school testing programs, and 6. To confirm other testing methods

"There is essentially no ethylglucuronide present in the urine unless alcohol has been present in vivo (in a person’s body)"

In fact there are many causes for endogenous EtG production:
Liver abnormality, intestinal infection, pylori infection, gastrointestinal infection or malformation, including surgery, carbohydrate intolerance, Small Bowel Bacterial Overgrowth (SBBO), Candidiasis (yeast overgrowth), Diabetes, Irritable Bowel Syndrome, Bacterial Dysbiosis, food allergies, yeast infection, dietary deficiency including but not limited to vitamin deficiency, urinary tract infection.

The presence of yeast and sugar in digestive tract will lead to fermentation of EtOH and syntheis of EtG/EtS See Thierauf 2010 (http://www.ncbi.nlm.nih.gov/pubmed/20655676).

"There are virtually no false positive tests"

The purpose of this test is to detect surreptitious consumption of alcohol. Any result that detects alcohol that entered the system by any means other than drinking is a per se false positive.

The test does indeed detect the presence of alcohol over a longer period than urine testing. The time span is dose dependent and there is no research supporting the 5 day claim for even 1 individual let alone an average period of detection as the test is represented. Frank Musshoff tested the detectable range for small amounts of alcohol such as might be found in food, and non-alcoholic beverages. As you will note none extended beyond 24 hours. Musshoff, 2010 (http://www.ncbi.nlm.nih.gov/pubmed/20838803) See also my previous reference to Wojcik & Hawthorne that also investigated smaller amounts of alcohol.

Not only can EtG be created in vivo, without alcohol consumption, it can be created in the urine sample post-collection. Helander, 2009 (http://www.ncbi.nlm.nih.gov/pubmed/19464830) and Rana & Ross, 2010, O-3 (http://www.gtfch.org/cms/images/stories/media/tk/tk77_3/abstractorals.pdf)

I passed my test, thank you.