PROCEDURE



Ethanol (Alcohol)

Drug Class: Alcohols

Street Names: Hootch, Booze, Grog, Juice, Sauce

Detection Time: Generally 4 to 8 hours after ingestion. Can be up to 12-24 hours. Excretion in the urine starts in about 40 minutes, but might not be at a detectable level for at least two hours.

Screening Cut-off: 25 mg/dl Linearity: up to 600 mg/dl

Confirmation Cut-off: 20 mg/dl Confirmation LOD:

Confirmation Identifies:

Due to possible evaporation of the alcohol upon standing at room temperature, the confirmation results might be lower than the screening results. If a sufficient amount of alcohol remains in the sample for confirmation, the testing will differentiate between ethanol, methanol, isopropyl and acetone. Methanol and acetone are by-products of alcohol metabolism. Their presence may indicate alcohol abuse. Isopropyl is the main component in rubbing alcohol, is poisonous and not normally seen in confirmation results. If it does appear, it is likely due to contamination of the sample.

TASC-Arizona: Ethanol

Quest Diagnostics: Ethanol

Expectations: The test is different from the customary “breath” tests in that the amount of alcohol that can appear in the urine is 30-50% higher than is present in the blood. Whereas the “breath” test more closely matches the blood levels. About 95% of alcohol is metabolized in the liver and the remainder excreted unchanged in the urine. Detection is subject to how much is consumed and how soon after consumption the sample is obtained.

Effects:

Intoxication can cause loss of alertness, stupor, coma and death. It is the primary cause of liver disease, nutritional deficiencies and is related to about half of all traffic fatalities and homicides in the United States. Heavy use during pregnancy can lead to birth defects or fetal alcohol syndrome.

Medical Uses:

Ethanol can be used as an antiseptic and as a solvent for certain drugs (cough medicines).

Notes:

If a positive alcohol result is obtained, TASCLabs will also perform a Keto Diastix® screening. The test checks for the presence of Glucose and Ketones in the urine. The presence of Glucose typically indicates diabetes. Glucose in the urine will be converted to alcohol by yeast or bacteria and cause a false positive Alcohol result. Ketones may appear in the urine primarily from diabetes, but also starvation, anorexia, high protein or low carb diets, hyperthyroidism or pregnancy.

In addition to beverages, alcohol can be found in many products such as mouthwashes, colognes, and candies. NyQuil® contains about 10% alcohol (20 proof) as compared to a normal cocktail drink containing 1.5 oz of 80-proof liquor. This means a person needs to drink four times the amount of NyQuil to produce the effects of one cocktail. Therefore, the use of NyQuil is not a valid excuse for a positive alcohol test as the client would need to consume more than 6 oz in about two hours before the collection.

▪ All of the following are equal to 0.6 ounces of 100% alcohol:

o 12 oz of beer @ 5% alcohol

o 5 oz of wine @ 12% alcohol

o 1.5 oz of 80-proof liquor (40% alcohol)

o 6 oz of NyQuil™ @ 10% alcohol

The Specimen should be tightly capped to prevent evaporation of alcohol. Refrigerate if possible.

Urine concentrations can be used to estimate the blood alcohol level. Physiologically, the blood alcohol level will peak before the urine level. Over the past 50 years, various studies have shown there is a 1.3-1.5 to 1.0 ratio between the Urine and Blood levels. Generally, the ratio of 1.5:1 is used to be on the conservative side, to give the benefit of the doubt to the client. This ratio means that there is about 50% more alcohol in the urine than will likely be found in the blood. Thus, if the urine shows a level of 30 mg/dl, the blood level is likely to be 20 mg/dl. The following table is a general guideline of the approximate blood alcohol level, its effects and what the urine alcohol level might be expected.

|Approx. Blood Level |Sporadic Drinkers |Chronic Drinkers |Urine Alcohol Level (TASC estimate) |

|10 - 80 mg/dl |Below or at Illinois & Indiana legal |Below or at Illinois & Indiana legal |15 - 120 mg/dl |

|or 0.01 - 0.08% (BAC) |limits |limits | |

|100 mg/dl |Legally Intoxicated |Legally Intoxicated, but minimal |150 mg/dl |

|or 0.1% (BAC) | |signs | |

|200-250 mg/dl |Alertness loss and/or lethargic |Effort needed to maintain control |300 - 375 mg/dl |

|or 0.2 -0.25% (BAC) | | | |

|300 - 350 mg/dl |Stupor or coma |Drowsy and slow |450 - 525 mg/dl |

|or 0.3 - 0.35% | | | |

|Over 500 mg/dl |Death possible |Coma |Over 525 mg/dl |

|Or 0.50% | | | |

Ref: Heise HA, Concentrations of Alcohol in Samples of Blood and Urine Taken at the Same Time. J. Forensic Science 12, 454 (1967)

Substances That Cause Positive Results:

Ethanol (alcoholic beverages and some OTC medicines)

NyQuil Liquid (contains 10% alcohol)

N-Butanol (solvent used in resins and lacquers)

N-Proponol (solvent used in inks and cosmetic preparations)

Diabetes – Excessive sugar in the urine can be metabolized by bacteria or yeast to create alcohol in the sample.

Ethanol (Alcohol)

(Breath and Saliva Tests)

Street Names: (See Ethanol – Urine)

Detection Times:

Breath: It depends upon how much is consumed and how long of a time has passed since the last drink. A person’s body eliminates alcohol at a constant rate, which lowers intoxication levels by 0.015% BAC per hour. If an averaged size person had only one drink, the maximum intoxication might be about 0.02% BAC. In less than two hours all the alcohol will be eliminated and their BAC will be zero. On the other hand, if a person drinks enough to have an alcohol level of 0.2%, which is well over the legal limit of 0.08%, it will take over 13 hours after they stop drinking for their alcohol level to reach zero. (ref: Alcopro News – January 2011)

Screening Cutoff: 0.08% Linearity:

Confirmation Cutoff: None

Note: Collection of a urine sample is suggested for a secondary test of alcohol. It allows checking the positive result for the presence of sugar, indicating possible diabetes.

Saliva: Can detect presence from immediately after consumption and up to 24 hours.

Screening Cut-Off: 0.08%

Confirmation Cut-off: None

Expectations:

Breath Alcohol Concentration (BAC):

Hand-held units provide an easy and reproducible means of detecting alcohol. Generally, the test is accepted in most traffic courts as being a reliable indicator of intoxication. False positives can occur if mouth is not cleared of excess fluids, such as blood or vomit, or if the individual recently smoked. If the person administering the test fails to use it properly or if the unit itself has not been maintained or re-calibrated when necessary.

Saliva / Oral Fluid:

Typically, these are screening devices that show an approximate level of any alcohol present. They tend to be a little more accurate than the BAC as saliva more closely compare to blood levels than expired air. These too are subject to error caused by contamination of the mouth. Like most saliva tests, nothing should be taken by mouth for at least 15 minutes prior to the test.

Effects: (See Ethanol – Urine)

Medical Uses: (See Ethanol – Urine)

Substances That Cause Positive Results:

▪ Alcoholic Drinks

▪ OTC products containing alcohol (NyQuil or cough medicines)

Ethanol (Alcohol)

EtG (Ethylglucuronide)

Street Names: None

Detection Times:

It is excreted in the urine and is detectable up to 5 days after heavy alcohol use.

Screening Cut-Off: 500 ng/ml

Confirmation Cut-off: 100 ng/ml

Expectations: EtG is one of the minor metabolites of alcohol. Since EtG is only created during the metabolism of alcohol, there is little change of outside contamination. Ingestion of alcohol containing products, such as listed below, may cause readings below the cut-off. The cut-off level of 500 ng/ml is designed to avoid false readings due to such products.

Effects: (See Ethanol – Urine)

Medical Uses: (See Ethanol – Urine)

Substances That Cause Positive Results:

▪ balsamic vinegar

▪ beauty product that contains SD Alcohol 40

▪ breath drops

▪ cooking Vanilla (30% alcohol by volume)

▪ extra sour dough bread

▪ fake alcohol such as O'Doull's, Near beer, and Fre' wine products

▪ hair dye

▪ mouthwash

▪ soy sauce

▪ teriaki sauce

▪ waterless hand soap. (Proven by recent clinical study)

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