Biochemical markers of alcohol intake can be separated into two categories: direct markers of ethanol metabolism and indirect markers. The different alcohol markers have varying time windows of detection and are a useful additional tool to detect alcohol intake in alcohol-dependent clients.
Introduction
Alcohol dependence is characterized by craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences. The World Health Organization Alcohol Use Disorders Identification Test (AUDIT) is recommended for the identification of individuals that are dependent on alcohol [1]. The prevalence of alcohol use disorders (including dependence and harmful use of alcohol) is 11.1% in the UK compared to 7.5% across Europe [2]. In England, 250 000 people are believed to be moderately or severely dependent and require intensive treatment [3].
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| Figure 1. The metabolism and excretion of ethanol. The size of the arrow demonstrates the proportion of the ethanol consumed that is excreted via each mechanism. Over 95% is metabolized to acetaldehyde and acetic acid. Less than 0.1% is metabolized to ethyl glucuronide and ethyl sulphate. |
Alcohol use is the third leading risk factor contributing to the global burden of disease after high blood pressure and tobacco smoking [4]. In 2012, 3.3 million deaths (5.9% of all global deaths) were attributable to alcohol consumption [2]. It is estimated that the UK National Health Service (NHS) spends £3.5 billion/year in costs related to alcohol and the number of alcohol-related admissions has doubled over the last 15 years [3].
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| Table 1. Alcohol markers: time window of detection and limitations. GGT, gamma glutamyl transferase; MCV, mean corpuscular volume; PEth, phosphatidylethanol. |
Biochemical markers of alcohol consumption
