Understanding Ethyl Glucuronide (EtG) Testing for Alcohol Use

For those in the medical, legal, and clinical fields, having a solid understanding of Ethyl Glucuronide (EtG) testing is fundamental for addressing various alcohol-related issues.

An EtG urine alcohol test detects recent alcohol consumption through the analysis of a urine sample. Since this test could cover various scenarios, healthcare professionals must familiarize themselves with its accuracy and efficacy to obtain reliable results.

What is an EtG Test?

An ethyl glucuronide (EtG) test is a drug test that indicates if you’ve recently had alcohol. EtG is the result of the body breaking down ethanol and causes intoxication. 

EtG tests most commonly test urine but also detect ethanol in hair, blood, or nails. Although the test can’t determine if you’re currently sober, it can determine if you’ve consumed alcohol in the last 80 hours.

EtG testing is used in a variety of circumstances, including:

• Court-ordered DWI or DUI programs
• Alcohol treatment programs
• Court cases
• Probation programs
• Schools
• Military
• Professional monitoring
• Liver transplants

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How Does an EtG Test Work?

The EtG test uses a sample to detect the presence of EtG in your body. Tests can detect relatively low levels (100 ng/ml) of EtG in urine. 

If you drink more alcohol, raising your blood alcohol concentration, an EtG test will likely show positive results. Even light drinking can trigger a positive EtG result.

These tests will likely show signs of very light drinking if administered within 12 hours of consuming alcohol. Although it’s a decent method of monitoring alcohol, it’s not perfect.

How to Prepare for an EtG Test

The best way to prepare for an EtG test if you need a negative result is to not drink for several days before the test. Even a single drink can cause a positive result on an EtG test.

Remember that several things can affect the results of an EtG test. It’s possible to get both false negative and false positive results depending on the amount of water you drink. The substances you’re exposed to can also affect the test results.

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How Long Before an EtG Test Should You Stop Drinking?

If you want a negative result, you should avoid drinking for at least three days before taking the test. If you’re a heavy drinker, you should stop drinking five days before taking the test.

A positive EtG test could indicate a need for professional support if you struggle with substance use, including drug and alcohol dependence. However, you should consider abstinence for more than just avoiding a positive test.

Abstaining from alcohol could reduce your risk of alcohol-related health issues. It can also allow you to manage your alcohol use better.

Is an EtG Test Accurate?

According to SAMHSA, EtG tests have high accuracy rates.¹ But there are several things unrelated to alcohol consumption that can affect the test results.

A variety of substances can contaminate the test results, including:

• Aftershave
• Cosmetics
• Breath spray
• Cleaning products
• Hair dye
• Mouthwash
• Hand sanitizer
• Foods containing alcohol flavoring
• Antiperspirant and other hygiene products

One may question, 'Can you dilute an EtG test?' It's possible to influence the results of an EtG test by drinking a lot of water. The more someone urinates after drinking, the faster they'll excrete EtG from their bodies.

What are the Limitations of an EtG Test? 

The primary limitation of the EtG test is that it can only detect alcohol in your system for about 72 to 80 hours after drinking. If you want to be constantly monitored, you’ll need to take the test at least twice a week. Additionally, false positive and false negative results are possible. 

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How to Interpret EtG Test Results 

EtG tests are easy to interpret. A positive result means you’ve recently consumed alcohol. A negative result indicates that you haven’t been drinking alcohol in the past few days.

Additionally, results can be divided into high and low positive results. 

High positive results could indicate:

• Heavy drinking on the same day or previously (i.e., the previous day or 2)
• Light drinking the same day

Low positive results could indicate:

• Previous heavy drinking (in the last 1 to 3 days)
• Recent light drinking (past 24 hours)
• Recent intense "extraneous" exposure (within 24 hours or less)

Very low positive results could indicate:

• Previous heavy drinking (in the last 1 to 3 days)
• Previous light drinking (past 12 to 36 hours)
• Recent "extraneous" exposure (within 24 hours or less)

Summary

If you've had problems with alcohol, medical professionals can monitor you for alcohol abstinence. Joining a sobriety program to help you avoid drinking alcohol is a good idea. 

‘Gaming the system’ by figuring out how to continue to drink alcohol isn't helpful. It isn’t a good long-term solution for alcohol-related problems. 

EtG tests are a specific type of drug test that indicates if you’ve consumed alcohol in the past 2 to 3 days. The test typically uses urine samples but can also detect alcohol in hair, blood, or nails.

If you want a negative test result, avoid alcohol for 2 to 3 days. If you’re a heavy drinker, you should stop drinking for longer.

The EtG test is fairly accurate at detecting alcohol in your system. However, there are ways to contaminate or manipulate the results.

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