Alcohol Dependency Testing
Our service helps to determine whether or not the subject is a chronic user of alcohol.
We perform two distinct tests for the breakdown products of alcohol (also known as metabolites) using hair samples.
We report against scientifically determined levels of these metabolites, which are then used in support of clinical evidence for chronic alcohol usage, over a 3 month period of time.
This is conducted with due regard to the recent High Court Judgement; LB Richmond vs B & W and B & CB  EWHC 2903 (Fam) and the guidelines of the Society of Hair Testing.
The tests we use are for Ethyl Glucuronide (EtG) and the sum total of four Fatty Acid Ethyl Esters (FAEEs). For other tests, such as for liver function, please enquire for details.
Alcohol Dependency Test FAQs
Q. What is excessive (chronic) alcohol consumption?
A. Alcohol (Ethanol) is legally permitted in many countries and is both consumed in greater quantities than other drugs and also by a wider spectrum of the population. According to the World Health Organisation, excessive alcohol usage in an average individual equates to in excess of 60g of ethanol per day, over a period of several months.
Q. How do we test for alcohol consumption?
A. Ethanol is a volatile compound and it is not possible to detect it directly for the purpose of determination of usage. Instead, and because ethanol is metabolized (broken down) by the body, we assay for two types of compounds derived from ethanol and which have been proven to correlate with the extent of ethanol consumption. These are Ethyl Glucuronide (EtG) and Fatty Acid Ethyl Esters (FAEE).
EtG is measured in our laboratories using a technique called liquid chromatography tandem mass spectrometry, or LCMSMS. The sample we use is a 3cm section of hair taken as explained below. A chronic excess of alcohol consumption has been proposed by the Society of Hair Testing (www.soht.org) as greater than 30pg of EtG per mg of hair, taken from the 3cm section.
FAEE tests are performed by summing the total of four different compounds, which are; ethyl myristate, ethyl palmitate, ethyl oleate and ethyl stearate. The cut off level for a chronic excess of alcohol consumption with respect to this marker has been proposed by the Society of Hair Testing a total of 0.5 ng of FAEEs per mg of hair.
Q. Why do we test for both EtG and FAEE?
A. EtG and FAEE can be used independently for determination of a chronic excess of alcohol consumption, but to avoid the risk of false positives and false negatives, we prefer to carry out a second independent marker assay. Hence we will always attempt to provide data on both of these markers in order to give more confidence in the result, always providing we have sufficient hair sample for such an analysis.
Q. What does the result mean?
A. A positive result from our test data, which will state that the tested hair sample is above the recommended threshold for both markers, will help to indicate chronic alcohol consumption over an average 3 month period. A negative result in the test data we provide cannot be used for any other inference whatsoever and does not indicate that the person has been free of alcohol consumption, is an occasional drinker or indeed is a “binge’ drinker.
The particular metabolism of ethanol dictates that there is no single marker which we can detect in any biological sample and indeed no single test of any other type which can reliably indicate long term chronic consumption of alcohol. Our test must be used as part of a portfolio of tests, which taken in their entirety, will enable a more reliable assessment to be made.
Collection of the hair sample
As a matter of courtesy to the subject and where possible, we ask for you to obtain the consent of the provider of the hair and if a minor is involved, then the consent of the person with parental responsibility should be obtained.
Clearly, if a court order or other legal documentation/direction is in place, we adhere to the provisions therein.
Sample collection will be via either one of our own staff or by one of the trained medical professionals appointed for this purpose.
The sample taken will be a “tuft” of hair approximately 5mm in diameter and will be greater than 3 cm long, starting from the scalp at the back of the head. It will be collected into an appropriate evidence bag labelled according to our strict quality control procedures.
Since intensive bleaching or otherwise dying hair can affect the results by leaching and thus leading to false negatives, we will take a view on the applicability of the sample before sampling.
Please note that if there is no head hair available, we cannot use body hair for alcohol dependency testing.