The direct ethanol metabolite ethyl glucuronide: A specific marker of recent alcohol consumption

In clinical as well as in forensic practice, occupational medicine, at court, for both traffic safety and safety at workplaces biological state markers of high sensitivity and specificity, capable of monitoring those in treatment for alcohol dependence or poly-drug-abusers as well as social drinkers in risky situations (driving, workplaces) are required. The known markers can not be considered to be satisfying with regard to these parameters. Furthermore, they do not cover the whole time axis for alcohol intake - i.e. there is a gap with regard to alcohol consumption of between 1 day and 1 - 2 weeks between short- and long-term-markers like ethanol, methanol, HTOL/HIAA ratio and CDT, GGT or MCV respectively. These traditional markers are in many cases besides alcohol influenced by age, gender and a variety of substances and non-alcohol-associated diseases. Ethyl 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, tissues and hair. With its specific time frame of detection intermediate between between short- and long term markers and a high sensitivity and specificity, ethyl glucuronide is a promising marker of alcohol consumption in general that can be detected for an extended time period after the complete elimination of alcohol from the body and a marker for relapse control that enables the therapist to intervene at an early stage of relapsing behaviour. This review highlights for what purposes and to what extent ethyl glucuronide could be a useful tool to enrich our clinical as well as forensic work. Furthermore the current methods of determination are discussed and future perspectives are given.