I tested exactly 66 hours and 30 minutes after finishing my last drink. I urinated about 20 minutes prior to taking the test, in order to completely clear my bladder one last time before testing.

I drank approximately 20 drinks between 11 am and 9:30 pm. Never got drunk, just maintained a relaxed feeling. Prior to testing, I ran approximately 18 miles(over the 2 and 1/2 days between last drink and testing). I drank lots of coffee, lots of green tea, and took lots of vitamins, including niacin supplements. I eat healthy and take vitamins on a regular basis. I drink adequate amounts of water daily.

I am very active and healthy. 37 years old, muscular. I work out on a daily basis, lifting weights and usually running 5 to 7 miles per day. I've done the calculations, and with EtG levels as great as 10,000,000 (which, to my knowledge, is extremely high), I've calculated that I should be able to pass using a half-life of 4 hours (which is actually higher than the average of around 3 hours). DrBill100, do you think it's possible to pass the test?

Depending on amt consumed and metabolism, you may show positive. If that's a problem, be smarter about 20 drinks in 12 hours and stop for 4 days. It sounds like it is an issue of concern so think about the complications.

First, all the information is provided in the question. Amount consumed and metabolism is addressed. Second, if you don't have an answer, then why do you post anything. No one cares to hear your view on anything. I'm looking for the answer to a question. NOT your opinion. Unfortunately, there's not a delete button!

It's difficult to calculate. 1) the volume consumed alters first pass metabolism by irritating the gastrointestinal tract and shifting the burden to the liver. That creates more EtG but on the other hand accelerates metabolism; 2) EtG seems to be synthesized in some proportion to the dose but that ratio is unknown, because 3) EtG production varies from one individual to another, and 4) the rate at which you produce EtG is unknown.

The vast majority of the studies relative to heavy alcohol consumption use a 100 cutoff so there is little guidance available.

Additionally, I note that you mention time of last drink but EtG is still being created until you reach 0 BAC. As example, using one drink example, the Ethanol will peak at one point while the EtG will follow a nearly parallel profile offset by 4-5 hours... down to a certain point... and then trails off. So rather than time of last drink the important factor was BAC at time of last drink.

Here is a graph that demonstrates (using about 3 drinks) in a 165 lb, 6'1" 42 year old male, cut-off 100 ng/l: Helander and Beck 2004

While you view this profile check the 500 level on the graph and by changing the cut off to that point cuts detection time in half. It also changes and greatly simplifies the kinetic model used to determine elimination time.

I'm currently reviewing those studies where specific data is available to determine the actual impact of the 500 cut off.

Whether you pass at the volume and time span provided has no definitive data available. In your favor is the 500 cut off and the fact that EtG is water soluble.

How did you figure elimination time using half-life?

I see that you have done all of the right things to assure that you are testing the latest urine produced. I assume that you were well hydrated the day of your test. Many of the tests measure grams of alcohol per KG of body weight. You may want to check your ratio as well. I would suspect that you passed. When you find your results, please post.

I saw a previous post, indicating that 33oz of beer could produce up to 67,000 ng/ml. In order to assure I am covering any metabolic increase in production of EtG, I simply assumed that I would produce 500,000 ng/ml (which I'm thinking would be high, but I may be incorrect on this assumption? ). If I had 20 drinks, then my EtG level would be 10,000,000 ng/ml. To reach a level below 500 would take between 15 and 16 half-life's. From research, I learned that the half-life is around 3 hours on average. So, to be safe, I calculate the half-life at 4 hours. For 15, that would be approximately 60 hours. For 16, that would be approximately 64 hours. I realize this is a very simple way to look at it, but I figure it would give me a general idea. I used http://www.fsijournal.org/article/S0379-0738(09)00132-7/abstract to assume I'd have a half-life of no more than 4 hours. I figure the exercise and my general fitness would have to play a part in the outcome. Do you agree?

Also, I'm assuming that my body would have been eliminating the alcohol and EtG as the day progressed. It averaged out to about 2 drinks per hour (and actually less, but I'm hitting the high to be safe) over approximately 10 hours. After 3 pm, I only drank about 10 drinks till I stopped at 9:30 pm... and this is measuring 4 oz of 11% white wine as being one drink, mixed with sierra mist.

I was hydrated. Earlier in the day I was over hydrated due to forcing water after my morning workout. After my urinary output was back to a more normal rate, I drank just enough to keep my urine slightly colored. Pretty sure I wasn't dilute, but should have been pretty well hydrated. I will post when I find out the results. Not sure when that will be.

One last comment... I read an EtG guidance document posted online from the company that oversees the testing. In that document it indicates that the third party administrator encourages monitoring programs to view anything less than 1500 ng/ml as possibly being caused by incidental exposure and that drinking relapse should only be considered in levels over 1500 ng/ml. So, I assume that 500 is the cutoff, but that there is room to "maneuver" up to 1500. The form indicated that they encourage programs to not use cutoff's below 500.

In response to the BAC, for various reasons I will not get into here, I am pretty confident that my metabolism of ethanol is quite elevated. Further, I am positive my BAC wouldn't have been above .10 to .15. I feel confident that my BAC was down to or close to 0 by 2:00 am. That would make my total time for EtG excretion approximately 61 hours. However, most of the research I've read uses time from last drink as compared to BAC being 0. In heavier drinking episodes, there seems to be a reduction of about 8 to 10 hours if time to test is measured from a 0 BAC as compared to time of last drink.

Quote:

---

Originally Posted by ;

I figure the exercise and my general fitness would have to play a part in the outcome. Do you agree?

---

These factors are in your favor. So is the water consumption and especially the fact that you generally drink and stay hydrated.

You have vastly over-estimated the EtG. It isn't cumulative. So EtG production begins with metabolism. As you are drinking the second drink you are already metabolizing the first drink... so it goes with the EtG. So as you were drinking, then urinating, you were already eliminating EtG.

But, on the other hand you have over estimated the time. Because you were still producing EtG for at least 10 hours after you stopped drinking, while you were metabolizing the alcohol (based on your rate of consumption).

I'm still not certain how you calculated elimination time, but it requires use of enzyme (Michaelis-Menten) kinetics. That isn't important however as it simply isn't useful without an absolute quantity.

Little attention has been paid to the processes of EtG production. No one can tell you how much EtG is produced in relation to X amount of alcohol. We know that this amount may vary by 200 fold from one individual to another. No one knows why although it seems to be related to a genetic disposition to create a specific liver enzyme. Maybe. To date, every major initial claim in relation to this test has proven inaccurate.

Basically what remains is the number of drinks versus elapsed time. At the conclusion of drinking you would have had approximately 10 drinks (alc. Equiv) left to metabolize. During that metabolism you were creating EtG. Here I'm using a 1-drink = 1 hour formula. Based on maximum elimination times for that volume of alcohol clearance could run as high as 130 hours @100 cut-off. At 500 that should be reduced by 40% or around 70 hours. However mean average elimination time would be about 78 hours at @100 and @500 should come out to about 47 hours. That is right at the number of hours you have remaining after deducting metabolism (56). There are too many variables to call it one way or another.

Any way its figured you are close. That makes your metabolism, exercise and water consumption important. Keep your fingers crossed and good luck.

ADDED: I didn't see your posts on previous page. Who is the program administrator you're referring to? Certainly anything under 1500 should be reviewed for environmental origin. The various agencies and testing labs that use this test have no uniform standards however.

Thanks for the information. Hopefully, my activity level will pay off. I'm not feeling to encouraged at the minute. Not that it matters, but I was calculating half-life by dividing the EtG level in half until I reached the closest point under 500. I multiplied the number of times I divided the half-life by 4.

Starting with 10,000,000
1- 5,000,000
2- 2,500,000
3- 1,250,000
4- 625,000
5- 312,500
6- 78,125
7- 39,063
8- 19,532
9- 9,766
10- 4,883
11- 2,441
12- 1,221
13- 610
14- 305
In the above, it took 14 times to get below 500. So 14 multiplied by a half life of 4 hours would be approximately 56 hours. In my thought, it meant that it would take 56 hours to reach a level of 305 in the above example.

In regards to the program administrator question, I'd rather not name the agency, but it is a third party administrator of random drug screens for a monitoring board. It is a national company. In a document I found online from that company, providing EtG Guidance, it strongly encourages monitoring boards to never use levels less than 500 and that anything up to 1500 should be evaluated for possible incidental exposure. The document actually encourages monitoring boards to use 1500 as the level for considering drinking relapse. I also read a document from a monitoring board in Maryland that cited this document in the review of a practitioners multiple EtG infractions. The person had EtG over 2000 in all cases, and the board's review indicated that since the levels were over 1500, there was no chance that it was incidental exposure. Not sure if that's good or bad, especually since this test seemingly needs much more research completed and uniformity in its standards.

The reason I inquired is that most testing labs push for lower limit tests. Pair that with the fact that any agency that uses this test is necessarily ignorant of how it works, that is a prescription for disaster.

Switch to the 500 limit was only recently recommended by Greg Skipper and the American Society of Addiction Medicine These recommendations are usually ignored. Glad to hear some agency has listened.

In re to your earlier post it is quite possible that your metabolic rate may exceed the norm for male (.16 ph). Heavy drinkers can actually double that rate. But with all the unknown factors figuring at .20 is safer. Also your method for calculating elimination just might be accurate at the 500 level while enzyme kinetics is applicable at lower levels.

Well EXCUSE my attitude!

Thanks for all your input. I truly appreciate it. I feel confident that my metabolic rate for ethanol excretion is closer to .20. I guess I'm paranoid, and rightfully so. I will definitely not put myself through this stress, worry and anxiety again. I didn't know that I'm being EtG tested till now, and never have been for almost 2 years. Regardless, only time will tell. My prayer is that I can pass this one, and then NEVER get myself in this situation again.

In your opinion, do you think I can be relatively assured that I have a high probability of having a level between 500 and 1000? I'm pretty confident I can work with the program if it is less than 1500, and more so confident if my level is 1000 or less. That is especially true since I have documentation from the actual third party administrator my program uses.

Again, thanks for all your time. I'll let you know the results when I find out. The waiting is killing me!

One last question, DrBill100. I overestimated the number of drinks I had on purpose just to be safe. If I actually only drank 15 - 16 drinks, how would that affect the time? Would there be that great of change with a reduction of 4 or 5 drinks?

Anything that reduces ethanol reduces EtG. Each standard drink (5 oz of wine @12%) contains .06 oz of pure ethanol. Approx .02% of the EtOH dose is ultimately converted to EtG.

As to your question about being under 1500 ng I simply don't know. As you will note by the elimination graph I provided earlier EtG is rapidly eliminated down to a level in the 100-400 range. (That's one of the reasons for the low elimination half-life).

Also this early rapid elimination was noted by Wojcik and Hawthorne (you might want to read this) one of the few tests conducted by US researchers.

I know neither answers your question but when dealing in parts-per-billion beginning with an unknown quantity it's all guess work.

In conclusion, I think the most influential action you took was the water consumption prior to the test. Given that EtG is miscible in water (a glaring problem with the test) that should turn to benefit if anything will.

As of this evening, I have not been contacted by an MRO. The test was imported into the system as being completed 6 business days ago. I took it late in the day 10 business days ago. It would have been transported to for testing 9 business days ago.

Unfortunately, the test only shows up as being completed. It doesn't provide the results in the system. Regardless, I assume the MRO would surely have contacted me by now if the test were positive? I'm relieved, but still cautious. Apparently, the hydration, working out, and vitamin supplements worked. I don't intend to press my luck, though. It's not worth the stress! Clean slate going forward...

Just as a follow-up since you (RNBSN) asked for results... It has been 15 days since I took the test and I have not been contacted by an MRO. I assume I am in the clear. Apparently, the hydration, vitamins, coffee, and working out works to assist in clearing ETG faster...