Alcohol is one of the leading drivers of harm worldwide. Its consequences affect both individuals and societies as a whole. Individuals causing the greatest part of this harm are those who are dependent on it. Therefore, alcohol dependence should be considered as a top priority from a public health perspective.
The proper management of alcohol dependence requires the use of several strategies, from psychosocial to pharmacological ones. One frequently used element, especially in abstinence oriented settings, is regular alcohol urine screening.1
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Share of people drinking alcohol daily
In 2019, 8.4% of the European Union adult population consumed alcohol daily, 28.8% weekly, 22.8% monthly and 26.2% never consumed or hadn’t consumed any in the last 12 months.
Daily consumption of alcohol was found to increase with age. The lowest share of those who consumed alcohol the most frequently (i.e. every day) was recorded among those aged 15 to 24 (1.0%) while the highest share in people of 75 or over (16.0%). However, the latter age group also accounted for the highest share that never consumed alcohol or had not consumed any in the past 12 months (40.3%).2
Metabolism
80 to 90% of the consumed ethanol is absorbed in the intestine, 94 to 98% of which is broken down in the liver. Here, the ethanol is metabolized by alcohol dehydrogenase to produce acetaldehyde, which in turn is metabolized into acetic acid by aldehyde dehydrogenase. The final products are CO2 and H2O. Ethanol can also be metabolized in the liver by the inducible cytochrome P450 (CYP2E1). Further metabolism (0.1 to 0.2%) into ethyl glucuronide, phosphatidylethanol or fatty acid
ethyl ester, for example, is due to non-oxidative causes.
Alcohol markers
Determining direct alcohol biomarkers is therefore the gold standard. These direct alcohol biomarkers are compounds that are formed after ethanol is absorbed by conjugating with alcohol in the body. Determination of ethyl alcohol concentration is commonly used for measuring legal impairment, investigating forensic evidence, diagnosing and/or treating alcohol dependency, as well as detecting alcohol poisoning.
How can alcohol biomarkers be used in practice?
What is the correct use of biomarkers in practice and how is it possible to implement a multidisciplinary approach to the patient? Download flyer here.
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1. Pablo Barrio, Silvia Mondon, Lídia Teixidor, Lluisa Ortega, Eduard Vieta, Antoni Gual, One Year Clinical Correlates of EtG Positive Urine Screening in Alcohol-Dependent Patients: A Survival Analysis, Alcohol and Alcoholism, Volume 52, Issue 4, July 2017, Pages 460–465
2.One in twelve adults in the EU consumes alcohol every day. One in twelve adults in the EU consumes alcohol every day - Products Eurostat News - Eurostat. (n.d.). Retrieved March 28, 2023, from https://ec.europa.eu/eurostat/web/products-eurostat-news/-/edn-20210806-1