[taft12]

You have previously posted that hair EtG tests remain relatively uncommon in the US. I was wondering if you know whether these are also Lab Developed Tests, as PethStat from USDTL is, or if they are commercially available. Specifically, do commercial labs such as Quest, LabCorp, and/or Concentra offer hair (or fingernail, as USDTL also advertises) EtG tests? The USDTL website states: "NailStat and HairStat EtG tests are the first and only tests to reliably report a donor’s alcohol exposure for the past 90 days," yet there are advertisements from random labs offering these all over the web. I can't find any information that they are offered by the big commercial labs. Thanks for your help. I've learned a lot about EtG and PEth from your and others' responses and I am interested in and increasingly disturbed by the growing popularity of these tests without the corresponding hard science data to support the interpretation of results.

[DrBill100]

I assume you are familiar with the term "laboratory developed test (LDT)" since you mentioned it. If not let me know.

PEthStat is definitely LDT and offered I believe only by USDTL. Dried Blood Spot.

Fingernail (a keratin based test) derives from the same assumptions as hair (also keratin based). Fingernail has no supporting data for rate of incorporation (ICR) nor, as you are probably aware, does scalp hair among the many drug metabolites.

There is nothing to prevent a laboratory from marketing an LDT to their clients. There are express provisions against such marketing through any other resource. In other words commercializing the process without FDA approval.

No form of EtG testing is approved by the FDA.

[taft12]

There is nothing to prevent a laboratory from marketing an LDT to their clients. There are express provisions against such marketing through any other resource.

So these labs who are third party administrators, or even service providers, for monitoring programs (professional boards or other agencies) can offer ANY of these tests to their clients and then interpret them based on weak science at best with basically a randomly chosen level of detection? Do you happen to know if LabCorp (which recently acquired MedTox as well) offers hair or nail EtG? Thanks so much for the help.

[DrBill100]

Let me be certain we are understanding each other.

A third party administrator (C/TPA) is not to be confused with a marketer. If the test is being promoted via a third party does not indicate that such third party is a TPA. Quite the contrary. TPA is clearly defined by federal statute and rule: See 49 CFR Part 40 http://www.dot.gov/odapc/NEW_DOCS/PART40.pdf If the third party is selling the test then it is commercialized and no longer LDT.

However the foregoing is irrelevant as if you were subject to federal drug testing rules (SAMHSA) neither EtG nor hair testing would be allowed.

Can the regulatory agencies (noted above) rely upon weak science? You bet! In fact a complete absence of science. An unregulated industry. If their clients will buy it... it's sold.

At the present time I have no knowledge of the LabCorp/MedTox transaction. However, I believe any test that contains "EtG" should be scrutinized.

[taft12]

.

Thanks for clarifying the exact definition of "commercialized." I wondered about that. I'm with you on what the TPAs do. I am trying to figure out if LabCorp could add-on hair EtG to their hair test. They're pretty vague on the website and don't even mention urine EtG except under the actual test menu, even though it's often added to their Health Professionals' panel. Just to be clear, I am NOT trying to cheat a test or get away with anything. I just see so many people involved in a system that can ruin lives and, especially, careers based on often faulty results. Or at the very least, faulty interpretation.

Did you know that the Society of Hair Testing (which I'm assuming is a European organization but correct me if I'm wrong) has now published guidelines on levels of hair EtG that can be used as a marker of abstinence? They say less than 7ng/ml (http://www.soht.org/pdf/Use%20of%20Alcohol%20Markers%20in%20Hair%20for%20A bstinence%20Assessment%202012.pdf)

What scares me is that the same folks who promoted UEtG are now behind PEth and this hair test. It doesn't seem right.

Also, I'm not sure if you've cited this PEth article before but it has some interesting data. It's actually a Master's thesis from Switzerland. You probably already know it, but if not:

http://www.soht.org/pdf/Use%20of%20Alcohol%20Markers%20in%20Hair%20for%20A bstinence%20Assessment%202012.pdf