A marker with a specific time spectrum of detection and both high sensitivi
ty and specificity is required to diminish the clinically as well as forens
ically important gap on the time axis between short- and long-term markers
of alcohol consumption like ethanol and CDT, GGT or MCV, respectively. Ethy
l glucuronide (EtG) is a non-volatile, water-soluble, stable upon storage,
direct metabolite of ethanol with a molecular weight of 222 g/mol that can
be detected in body fluids for an extended time period after the complete e
limination of alcohol from the body. We investigated 107 urine and 78 serum
samples of a total of 107 inpatients in 4 groups: (1) 33 inpatients in acu
te alcohol withdrawal and long term treatment; (2/3) 29 and 15 addicted for
ensic psychiatric inpatients (closed integral 64 StGB, penal code); (4) 30
recently detoxified inpatients of a station for long term treatment by LC/M
S-MS with the internal standard d5-EtG and additionally in the fourth group
of patients also by gas chromatography/mass spectrometry (GC/MS). In 2 out
of 33 inpatients of the first group, EtG could be determined 3 days after
hospitalization; in an other subject, a relapse could be detected. In 2 out
of 29 and in 1 out of 15 forensic inpatients of group 2 and 3, respectivel
y-where neither clinical impression nor routine laboratory findings gave an
indication for relapse-concentrations of EtG ranged between 0.1 and 18 mg/
l in urine. For the serum samples of the 30 inpatients of group 4, we could
demonstrate a total agreement for the results of the GC/MS and the LC/MS-M
S method as to whether a sample was found to be positive or negative for Et
G. We suggest that these results strengthen our earlier findings that ethyl
glucuronide is a marker of alcohol consumption, in general that can be det
ected for an extended time period after the complete elimination of alcohol
from the body and a marker for relapse control with a specific time frame
of detection intermediate between short- and long-term markers. (C) 2000 El
sevier Science Inc. All rights reserved.