The direct ethanol metabolite ethyl glucuronide: Its significance as an alcohol consumption and relapse marker - Identification methods and outlook

In clinical as well as in forensic practice biological state markers of hig h sensitivity and specificity capable of monitoring alcohol consumption of those in treatment for alcohol dependence or poly-drug abusers are required . The known markers cannot be considered satisfactory in respect of these p arameters. Furthermore, they do not cover the entire time axis for alcohol consumption. These traditional markers are often influenced besides by alco hol, by age, gender and various of substances and non-alcohol-associated di seases. Ethyl glucuronide (Etc) is a non volatile, water soluble, stab re u pon storage, direct metabolite of ethanol with a molecular weight of 222 g/ mol that was determined by our group in more than 1200 samples of body flui ds, tissues and hair from over 200 patients, almost 200 drivers and postmor tem with different GC/MS and ESI-LC/MS-MS methods using deuterium-labelled Etc as internal standard. With its specific time frame of detection interme diate between short-term and long-term markers and a particularly high sens itivity and specificity, ethyl glucuronide is a promising marker of alcohol consumption in general that can be detected for an extended time period af ter the complete elimination of alcohol from the body (up tp 80 h) and a ma rker for relapse control enabling the therapist to intervene at an early st age of relapsing behaviour. The complementary use of EtG together with othe r upcoming markers of alcohol consumption like phosphatidyl ethanol should lead to an improvement in treatment outcome, quality of life and cost reduc tion.