EtG Test: What It Is and How It Works

Get Answers on EtG Tests and Alcohol Treatment Options at Icarus

EtG tests are one of the most common ways to verify recent alcohol consumption, but not a lot of people know what it is or how it works.

There are various tests that medical professionals and government officials use to determine how much alcohol a person has consumed and their degree of alcohol impairment. These tests are also helpful for substance abuse treatment programs.

The breath alcohol test and blood alcohol test, in particular, are widely known and depicted in the media. Moreover, most adults have had at least one encounter with either of these two tests, either for work requirements or after getting pulled over after a night of celebration.

Among the different alcohol tests, one that is less well-known yet potentially more effective is the EtG test. Keep reading to find out the full details on EtG testing and how it works!

What Is An EtG Test?

An EtG test is an advanced screening method used to measure alcohol level or how much alcohol is present in the body. It has two major differences between a breathalyzer test and a blood alcohol test. First, is that the test measures EtG levels, not the alcohol itself. Instead, it screens for the presence of EtG, a known intoxicating agent in alcoholic beverages. Second is that the test can determine alcohol present in your body for the past 80 hours or even up to 90 hours.

Instead of simply measuring the amount of alcohol consumed within the last couple of hours, an EtG test gives you the power to check for alcohol intake over a longer period of time. Due to this, EtG alcohol testing is a valuable tool for alcohol addiction recovery or treatment centers. It allows them to verify and document alcohol abstinence or whether they drank even a small amount of alcohol.

However, an EtG test cannot tell us exactly how much alcohol you or anyone else drank over a period of time. Moreover, due to our inherent physical or biological differences, it is possible for people to convert alcohol into EtG differently. Some may convert more alcohol into EtG, while others may excrete it faster, for example, if they urinate more frequently.

What Is EtG?

EtG stands for ethyl glucuronide. It is a non-volatile and water-soluble by-product of ethanol and glucuronide. Ethanol or ethyl alcohol is the intoxicating agent in alcohol while glucuronide is a biological compound made after alcohol passes through the liver. In other words, ethyl glucuronide is a form of ethanol after it was broken down and the alcohol we drank was processed by our body.

EtG is primarily found in our hair and body fluids, including blood and urine. Whenever we drink alcohol, no matter how little the amount, EtG is formed in our body. This can be detected in and excreted in our urine.

How Do EtG Tests Work?

An EtG alcohol test is usually done using a urine sample. However, it can also be done using a hair specimen. EtG is formed quickly after drinking alcohol and can be present in urine for up to 48 hours. In some cases, it can still be detected even after 72 hours or more, especially in cases of prolonged or heavy drinking. There are studies that suggest it is possible to detect EtG in urine even up to 120 hours after the alcohol was processed by the body.

With a urine sample, an EtG alcohol test can show whether you drank any amount of alcohol over a maximum of about three days. In comparison, a hair specimen can show your alcohol consumption over a 90-day or three-month period.

For an EtG urine test, small strips are used to test for the presence of EtG in the urine. These strips typically have various colored squares. They would either be dipped into the collected urine or have a small amount of pee dropped onto them.

EtG Test Cutoffs and Results

Since people can process alcohol and EtG differently, EtG test results can vary by a large margin. A positive EtG test can have three levels or ranges and corresponding cut-offs for each. These test result ranges and cutoffs are based on the estimated amount of alcohol drank and the hypothetical time frame.

Some testing facilities report two different EtG levels and cut-offs.  This is done to maintain a “margin of safety” within which they can be certain that EtG is present, even at the smallest possible amount.

High Positive

A high positive EtG test result is usually those with levels upwards of 1,000 ng/mL. It indicates that the individual tested has either indulged in:

• Heavy drinking earlier during that day or the day before
• Light drinking on the day of the test

Low Positive

A low positive EtG test result typically comes from test cutoff values between 500 ng/mL to 1,000 ng/mL. A low positive result within these values suggest:

• Heavy drinking within a maximum of three days prior
• Light drinking within 24 hours before the test
• Recent intense exposure to other products that may contain alcohol in the last 24 hours

Very Low Positive

A very low positive EtG test can result from low cutoff ranges between 100 to 500 ng/mL. These low values indicate any of the following:

• Heavy drinking within a maximum of three days prior
• Light drinking within the past 12 to 36 hours or up to a day and a half
• Recent intense exposure to other products that may contain alcohol in the last 24 hours

Accuracy and Limitations of EtG Testing

An EtG test does not always guarantee accuracy. Despite its usefulness and remarkable lookback period for the consumption of alcohol, it still has its limitations.

First is the sensitivity of the EtG test strips. On one hand, the high sensitivity allows them to detect even very low levels of EtG in the urine. On the other hand, the same sensitivity can cause false positives. There are hundreds of common household or environmental products we use in our daily life that contain alcohol, specifically ethanol.

Exposure to any of the following products, especially in high amounts, can result in false positives:

• Mouthwash
• Breath spray
• Hand sanitizer
• Cleaning products, including disinfecting wipes
• Food cooked or flavored with alcohol
• Antiperspirants and other hygiene products
• Cosmetics or skin care products
• Hair dye

Improper storage of urine can also affect the EtG levels. If the sample is kept at room temperature for an extended time, it can develop bacterial growth that can raise the EtG levels, thus resulting in false positives. It is imperative that urine intended for EtG testing is kept in cool or refrigerated storage if not used or shipped within a certain time frame.

Lastly, individuals who are diagnosed with both diabetes and a urinary tract infection are likely to produce erroneous EtG test results, too. However, false positives can only result if both conditions are present. A person who only has diabetes and not a urinary tract infection, or vice-versa, will still produce accurate EtG test results.

Is EtG Testing Better Than Blood and Breath Alcohol Tests?

In some cases, yes. The best types of alcohol tests will depend on the situation and intention behind the test or what it will be used for.

For example, an EtG test is better than screening for breath or blood alcohol level if you are undergoing treatment for alcohol addiction or are recovering from a drinking problem. This is because the test will be able to detect alcohol for up to three days or more. It can prove that a person dutifully followed their treatment program and restrained themselves from drinking any alcoholic beverages.

However, it’s different for situations like workplace testing or vehicular accidents due to suspected drunk driving. In such cases, screening for blood alcohol content or concentration (BAC) using a breathalyzer test is more appropriate. This is because this type of test can accurately detect alcohol in your blood and provide results on the spot.

Situations that require knowing how much alcohol a person drank or their current level of inebriation or impairment will not benefit from EtG testing. An EtG test essentially answers the question of whether or not a person consumed alcohol but not the amount they drank.

Where Are EtG Tests Used?

An EtG alcohol screen is the go-to test for alcohol abstinence and alcohol monitoring, whether in DUI rehab programs or for other alcohol testing situations. Alcohol dependence or addiction treatment facilities use EtG tests, to ensure their clients follow their treatment program. An EtG test is especially useful for people who choose to enroll in an intensive outpatient program, rather than admit themselves to an inpatient facility.

Courts may also order an EtG test to serve as supporting evidence or proof in various cases, including:

• Child custody cases
• DWI, DUI, or similar driving while intoxicated cases
• Drug court cases

Hospitals and medical care facilities may also request or require an EtG test for patients who are planning to undergo a liver transplant. Many liver transplant centers impose a mandatory six-month period of sobriety on alcoholic hepatitis patients before they can receive a liver transplant. This is to allay concerns and lessen the risk of the person going back to indulging in alcohol and resulting in a recurrent problem.

An EtG test may also be used in the military, in schools, and in probation programs.

EtG Testing at Icarus Behavioral Health

Icarus Behavioral Health is one of the many addiction treatment specialists today that use EtG testing to enhance and ensure the recovery journey of their clients. The Albuquerque facility offers comprehensive and compassionate care for all New Mexico patients.

Whether you are looking for an intensive outpatient program or inpatient treatment, Icarus Behavioral Health will ensure you receive a personalized treatment plan catered to your needs.

Contact the Admissions team at Icarus Behavioral Health and get your recovery started (or renewed) today!