[chosen52782]

HI DrBill100,

I drank on 7/2 and will possibly have an EtG urine test on 7/12. Any chance of me failing after almost 10 days of no drinking?

Thank you in advance!

[DrBill100]

The longest elimination period on record is 130 hours. That was in detox setting with liver and kidney problems. There is, in my opinion, no possibility of any alcohol from the 7/2 session showing up 10 days later.

Prior to an EtG test you are always well advised to be well hydrated, 4 (8-oz) glasses of water on the day before the test and on the day of the test (not excessive amounts). This prevents concentrated urine which increases EtG that can result from environmental sources.

[chosen52782]

What is the usual standard time for elimination of etg/ets from the body?

[chosen52782]

What is the usual standard time for elimination of etg/ets from the body?

[DrBill100]

It's dose dependent. One drink ranges between 3-21 hours. There is really no way to determine individually as everyone synthsizes EtG at different rates. It is also dependent on the cutoff of the test as well. So the only way to be safe is review the averages and shoot high.

I calculate it by number of drinks as compared to published research. The time span you are dealing with doesn't require any calculation.

[chosen52782]

The research I've done online is that it could be anywhere from 80-120 hrs. I also believe that ETG is still produced until the BAC has reached 0. And I did see the study where it took 130 hours, but as you said that was on the extreme side. I believe that was an oxford journal study if I'm not mistaken. Is this sound right to you?

[DrBill100]

As EtG is a late stage metabolite of EtOH it is definitely created until all EtOH has been eliminated from system: 0 BAC.

Yet elimination research uses varying standards. Some calculations are based on completion of last drink (Wojcik & Hawthorne) while others have used time of first drink (Halter, etal). Some have used time of admission (Beck, etal) and yet others “0” BAC. The studies are also skewed by the interval between urine sampling (sometimes up to 12 hr variance).

Adding to the confusion is the fact that researchers use no standard cut-off. One may use 100 ng/ml, (see Borucki 2005) another 250 and yet another 500 (Helander, etal)

Most seem to agree that there is an alcohol/EtG dose relationship. The more alcohol consumed the higher peak level of EtG. This dose-dependent relationship is weak. Individuals administered measured amount of alcohol normalized to weight have widely varying amounts of EtG. The stronger relationship is between waiting time between drinking and the test. (see Wojcik, above)

As a final blow, there is some evidence to indicate that EtG is being created in everyone, all of the time (Rosano & Lin, 2008).

When just the above factors are considered it becomes apparent that statements about elimination time are wild guesses, at best. Arbitrarily pulled from the context of a study to exaggerate the effectiveness of the test.

[chosen52782]

I want to thank you for all of your insight. These studies show the 80 hour slogan means absolutely nothing! I know with my situation 9.5-10 days it's impossible to have EtG from alcohol in your system unless there is some type of metabolism deficiency. The funny thing is, even at the low cut off level tests, according to one of the studies were coming back less than the so called 80 hr.

[RNBSN]

Great job Dr Bill! I especially like (Rosano & Lin, 2008). Doesn't the 24g drink represent about 2+ standard drinks?

[DrBill100]

Great job Dr Bill! I especially like (Rosano & Lin, 2008). Doesn't the 24g drink represent about 2+ standard drinks?

In very rough terms. Depending on where you're standing... in which direction you're looking. The problem with converting grams to standard drinks is definition of same by country. Examples:

Standard drink (grams of pure ethanol)*

UK = 8
Netherlands = 9.9
Australia, Ireland etal = 10
Finland = 11
France, Italy etal = 12
Canada = 13.6
US = 14
Japan = 19.75

In the mass media where the term "standard drink" or "drink" is used this can lead to some very different impressions or guidelines as relates to volume of alcohol consumption. Good to remember when reading an article that originated in another country.

In studies, most designed for international publication, the use of specific dosage and/or dosage by weight is used to overcome this cross-cultural inconsistency and standardize methods.

*International Center for Alcohol Policy.

[RNBSN]

Yes, I see from the CDC site that the amount in 1.5oz of 80 Proof is about 13.7g. I know that different drinks (especially the mixed drinks like Long Island Teas etc.) have more ETOH in them than 1.5oz, but the 1.5 oz is the amount in a mini-bottle sold in the US. With all of that being said, it appears that the 24g alcohol dose would represent a little less that 2 mini-bottles or 2 beers.

I see that the dose of alcohol was also put in 10 oz of liquid and consumed in 20 minutes. Any thoughts or information about the effects of consuming slowly versus quickly. I know that a person's maximum BAC is higher if they consume 4 drinks over 20 minutes versus 4 drinks over 3 hours. To restate, I am wondering if more EtG is produced from consuming the same amount of alcohol in a shorter amount of time due to a higher BAC level.

[DrBill100]

There are several factors operative in your question. First, assuming that EtG is exclusive to metabolism in the liver, then extra-hepatic metabolism comes into play, particularly in the GI tract with focus on the stomach. It is estimated that 20% give or take, of metabolism occurs in the stomach by Alcohol Dehydrogenase (ADH). (This would not create EtG, according to current knowledge).

Of course metabolism is rate limited at this, and all, levels. ADH is diminished by the concentration of alcohol (above 30%) and continuing exposure (GI perturbation). In addition women have substantially less GI ADH than men thereby reducing first pass metabolism and placing a greater load on the liver.

When these factors are joined, the greater the volume of alcohol that ultimately reaches the liver then more EtG that would be created. The concentration of alcohol would play a role during first-pass metabolism, by putting more or less ethanol into the circulatory system ultimately to be metabolized by the liver.

Please note, that following this theory it is likely that women synthesize more EtG by volume consumed than men. Female metabolism (EtOH) is more liver dependent and females have a slightly larger liver in relation to body muscle (storage capacity). There are no studies comparing gender differences in EtG. Although volumes of gender comparison EtOH metabolic studies exist. Another strange oversight in EtG research. Compounded by the established fact that women metabolize alcohol faster than men despite the ADH deficiency.

This information derives from current EtG research and depends on accepting the premise of EtG being exclusive to the liver. I'm not entirely convinced of that based on some limited studies that point to an intracellular capacity to metabolize EtOH present in all cells including neurons.

Directly related to your question is also that small amounts of alcohol are metabolized slightly different that larger amounts. Lower concentrations in infrequent drinkers are ADH dependent whereas larger amounts and/or continued exposure induces the MEOS system. There are a couple of studies that claim infrequent and frequent drinkers are similar for EtG. But this subject is rife with short-sighted, poorly designed studies that seem to be directed to affirming the process and expanding commercial use as opposed to elucidating the physiologic mechanisms involved.

[RNBSN]

Thanks Dr Bill for that information. I guess that ADH plays a role in the reduced level of EtG in persons that consume food while drinking due to alcohol remaining in the stomach longer before being absorbed into the bloodstream. I can't believe, with how much is unknown about EtG, that the test is used as a first line test to prove alcohol consumption.

[DrBill100]

I guess that ADH plays a role in the reduced level of EtG in persons that consume food while drinking due to alcohol remaining in the stomach longer before being absorbed into the bloodstream.

That would be consistent with what is known of EtG to this point. Bear in mind however that all of the initial claims about this metabolite have now been disproven: 1) that it is produced only following alcohol consumption, 2) that it is stable, will not increase or degrade, in urine samples, 3) that it cannot be produced via gastrointestinal fermentation.

[looking4?]

DrBill100: I Tested 66 hours 30 minutes after last drink. I urinated 20 minutes prior to test to clear bladder. I drank 20 drinks between 11 am and 9:30 pm. Never drunk but maintained a relaxed feeling. Prior to test, I ran 18 miles(over the 2 days). I drank lots of coffee, lots of green tea, lots of vitamins, & 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. Lift weights & run 5 to 7 miles/ day. I've done the calculations. 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). Do you think the amount of vigorous exercise I do would make a difference in me passing the test? I feel that the exercise would have to increase my chances quite a bit? The cut off is 500. Thanks!