Excessive alcohol use kills 140,000 Americans each year and is the leading risk for premature death and disability for adults under 50. Most alcohol use disorder (AUD) care is directed toward drinking-related consequences (e.g., motor vehicle injuries, cirrhosis, heart disease, stroke, HIV/AIDs, cancer, violence, acts of self-harm and overdose) while AUD frequently goes
unaddressed. Here, addiction psychiatrists can play a vital role using a sensitive and specific biomarker detecting recent alcohol use: phosphatidylethanol (PEth).
PEth is analogous to Hemoglobin A1c (HgbA1c) in that it forms in red blood cells, is obtained via serum, and provides a quantitative estimate of recent ethanol exposure (e.g., <20=minimal alcohol use; 20-200=moderate; >200=heavy). PEth has a narrower detection window (2-4 weeks) than HgbA1c (8-12 weeks). PEth's clinical use has expanded. It is now recognized as a gold standard for alcohol detection in forensics and for safety assurance among high-stakes service personnel (e.g., airline pilots, physicians).
Addiction psychiatrists may order the assay or be asked to interpret it during patient care. Its sensitivity is 70-100%, outperforming other alcohol biomarkers. For example, in pre- and post-transplant liver patients use of PEth doubled the alcohol detection rate of drinking within the last week. PEth has been validated in cirrhotic patients with or without kidney disease, and no sources of false positives have been identified, which may broaden its use and clinical implications. In this 90-minute workshop, 3 psychiatrists from different institutions address pertinent and practical aspects of this biomarker relevant to all addiction clinicians.