[Rusty22]

Tested positive for random hair test , med review officer ruled of no addiction to substances with me. Required a contract of abstinence to keep career. Did fine for a couple of months and tested pos for etoh . I have abided by rules thoroughly up to this slip up. Does anyone know what they will do to me? Will they extend contract of abstinence or make me go to meetings? Does anyone know? Job in med field, Please help

[DrBill100]

The contract you refer to above should clearly outline the range of actions available. There are hundreds of these programs and the rules, regulations and penalties are widely variant.

[Rusty22]

For a serum Peth, what is the average time for a result? When the lab collects it is it overnighted? Is overnight the standard ? Are health care workers given priority ?
Thanks

[DrBill100]

For a serum Peth, what is the average time for a result? When the lab collects it is it overnighted? Is overnight the standard ? Are health care workers given priority?
Thanks

How samples are handled is anyone's guess. Last I heard blood work for PEth was to be frozen from point of collection until test which would have course include shipment. Don't believe health care workers would even be specifically identified let alone given priority.

Did you drink enough or across a week or two cumulatively to show positive on PEth?

[Rusty22]

It's close, about 6 oz in 3 days, drew Peth on a thurs then no word on following thurs or Friday . No word is negative. 3 months ago same lab I submitted a hair test and had a five day result including weekend days.

[DrBill100]

What were they testing in hair? What do you mean 5-day result?

PEth research is all over the board. Seriously doubt there is anyone that can properly interpret results. Nonetheless they will claim they can.

What lab is doing the PEth

[Rusty22]

It was 14 panel hair test, had results in 5 days. The lab is us labs or us test labs.
They state on there web site 4-7 days for results, I think I should have heard by now.

[DrBill100]

It was 14 panel hair test, had results in 5 days. The lab is us labs or us test labs.
They state on there web site 4-7 days for results, I think I should have heard by now.

USDTL, Des Plaines, IL. They seem to be the prime mover in PEth testing. Just to confirm, this was by blood draw and not a finger prick. Right? This lab currently offers a dried blood spot test for PEth.

When they ran the 14-HDT was it a quantified result (LC/MS/MS) or simply denoted negative. Just curious as it sounds like you are getting some pretty intense attention. Are you on someone's list?

Or was that the random HDT you first mentioned that got the ball rolling? Still a 14 is unusual.

[Rusty22]

It was the random I first mentioned on this thread. The one that got ball rolling. Peth ?It was blood. A serums draw. But do the weekends count as days in a lab this size? Should I have heard by now? They have had the sample 7 full days and negative results we are not notified ?

[Rusty22]

Also on another note, EtG,ets are run using liquid chromatography. This test must be ultra sensitive ? Case managers are using low levels and taking them very seriously . How much longer does ets hang around compared to EtG ?

[Fr_Chuck]

Weekend seldom count for lab dayes, health care workers do not get any priority in testing.

Often at least in US, most employers will hold health care workers up to a higher standard, due to liabiltiy at the work place.

[DrBill100]

Also on another note, etg,ets are run using liquid chromatography. This test must be ultra sensitive ? case managers are using low levels and taking them very seriously . How much longer does ets hang around compared to etg ?

EtS has the same detection window as EtG. LC/MS/MS is extremely sensitive and reliable. Instrumental technology is far ahead of our knowledge of how to interpret the results.

[Rusty22]

peth was negative, whew!
Is ets run always with EtG or following a pos EtG ?
also, if one oz of etoh is consumed on Friday, at 80 hours what
would you expect EtG to be, likely well below 100, but some people
don't follow cut off values. That's the whole reason peth is recommended
by us labs.

rusty22

[DrBill100]

peth was negative, whew !!
1) Is ets run always with etg or following a pos etg ?
also, 2) if one oz of etoh is consumed on friday, at 80 hours what
would you expect etg to be, likely well below 100, but some people
dont follow cut off values. 3) Thats the whole reason peth is recommended
by us labs.

rusty22

1) EtS can only be tested for following a positive EtG if the EIA screen is being used, which in most cases it is. Why? Because there is currently no EIA available for EtS.

So the lab advertisements that offer the 2 for 1 test are simply playing on the purchasers ignorance of the 2-step testing process. If the screen is EtG negative then there was no test for EtS.

In fairness, if the purchaser is willing to pay for LC/MS, in other words skip the lower cost screen and go directly to the test usually used only in confirmation then both EtG and EtS can be detected simultaneously. That is seldom the case.

2) Regardless of the instrumental setting EtG synthesized from one (1) oz of alcohol will not be present (let alone detectable) at 80 hours... not even at 24 hours. EtG and EtS are eliminated from the body just as the parent analyte EtOH. They have the same hydrophilic characteristic. These metabolites do not accumulate or secret in tissue like THC for instance.

3) EtG, EtS and PEth do not operate on a comparable scale. The former are supposedly direct metabolites created concurrently and immediately upon presentation of EtOH in the liver. PEth is a delayed pathological response to alcohol that occurs in blood and "requires 'sustained' drinking" over a period. The use of one to confirm the other would depend on the confluence of very unlikely events.

EtG testing has become a very lucrative field but the supporting science[?] has collapsed around it. So they introduced EtS as an "additive" without admitting the fallibility of EtG. The theory being that if both are present one confirms the other. Of course since they are created concurrently that is a ridiculous claim. But it keeps the money flowing. EtS has all of the major flaws as EtG so now the industry is introducing a third direct biomarker PEth.

[Rusty22]

Quest diagnostics is performing the EtG . They only advertise it as etoh but I know it via EtG. Which method is being used for EtG through quest ? I can tell you the cost is 30 dollars for etoh via EtG with quest.

[DrBill100]

Quest diagnostics is performing the etg . They only advertise it as etoh but I know it via etg. Which method is being used for etg through quest ? I can tell you the cost is 30 dollars for etoh via etg with quest.

Not following. EtOH is a different test. EtG test cannot identify EtOH. If Quest is offering the test(s) they should be separately listed as I'm certain they charge separately. Do you have a test number? It's not difficult to add EtG to EtOH test but it is two separate processes.

Also, forgot to clarify the negative PEth. How much did you drink during the week leading up to that test? I'm trying to piece together the disparate findings that are emerging.

[Rusty22]

Found it, it's on there website, it is LC/ms/ms. They are running both EtG and ets. Wow ! This for 30 bucks ? Must be a volume price

[DrBill100]

Found it, it's on there website, it is LC/ms/ms. They are running both etg and ets. Wow ! This for 30 bucks ? Must be a volume price

LC/MS/MS is only run if there is a positive by EIA. They make some dandy deals if it is direct billing as opposed to insurance. If insurance is billed just the EIA w/o confirmation is 60.00 and as I recall 280.00 for both.

[Rusty22]

Thanks , on Peth 7 oz of etoh were consumed in two separate days 3 days apart. 5 oz was one of those days.
Here is what I found with quest :


Ethyl Glucuronide with Confirmation, Urine
90418
CPT Code(s): 80101
Includes
If EtG /EtS Screen is positive or equivocal, confirmation testing will be performed at an additional charge (CPT code(s): 83789).

Preferred Specimen(s)
1 mL random urine
Minimum Volume
0.5 mL
Instructions
Avoid contact with ethanol, disinfectants, swabs
Transport Container
Plastic urine container
Transport Temperature
Room temperature
Specimen Stability
Room temperature: 7 days
Refrigerated: 7 days
Frozen: 30 days
Reject Criteria
Preserved specimens
Methodology
Liquid Chromatography, Tandem Mass Spectrometry (LC/MS/MS)
Performing Laboratory
Quest Diagnostics Nichols Institute
27027 Tourney Road
Valencia, CA 91355-5386
Reference Range(s)
Ethyl Glucuronide <500 ng/mL
  Ethyl Glucuronide <500 ng/mL
  Ethyl Sulfate <100 ng/mLPlease note: These results are for medical treatment only. Analysis was performed as non-forensic testing.
(The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.)

[DrBill100]

Bit misleading isn't it? See (1) above. Confirmation is not automatic but must be separately ordered. Urine may be stable for 7 days but the metabolite EtG is not and may degrade or synthesize in container within 24 hours at room temperature.