Thursday, July 22, 2010

The Science Behind Drinking: Testing for Alcohol Consumption and Abuse

Health News Digest

As actress Lindsay Lohan now knows, there are a variety of ways to test a person’s bodily fluids for alcohol consumption, both before and after an arrest for driving under the influence and to monitor adherence during rehabilitation. During her recent probation for DUI, Ms. Lohan found herself in a special ankle bracelet that uses Breathalyzer technology to sample the sweat on the skin every half hour to determine if an individual violates probation by drinking alcohol. In Ms. Lohan’s case, the device was triggered several times, prompting the judge to consider these violations when sentencing her to 90 days in jail.

In most cases where individuals are suspected of driving under the influence, breath analyzers are used to determine blood alcohol concentration, but according to Dr. Amitava Dasgupta, Director of Clinical Chemistry, Toxicology and Point-of-Care Services at Memorial-Hermann Hospital, Texas Medical Center in Houston, not all breath analyzers are created equal. ”Most people don’t know that there are two types of blood alcohol breath analyzers and the results from only evidentiary breath analyzers can be used to prosecute people accused of driving under the influence,” he said. Additionally, interferents such as mouthwash, hand sanitizers and energy drinks can skew the results of a breath analyzer, and test administrators must take these factors into consideration.

Measuring alcohol use and abuse goes far beyond just testing DUI suspects, and during a morning presentation titled “Role of the Laboratory in the Science of Drinking: From Blood Alcohol Levels and Markers of Alcohol Abuse to Pharmacogenomics,” on Monday, July 26, both Dr. Dasgupta and Dr. Loralie Langman, Associate Professor of Pathology and Laboratory Medicine at the Mayo Clinic in Rochester, will outline the complex and changing role labs are playing not only in measuring and interpreting blood alcohol levels, but also in measuring biomarkers of alcohol abuse and researching genetic variations that can provide insight into why individuals metabolize alcohol in different ways. These presentations will be offered during AACC’s 2010 Annual Meeting, which is being held at the Anaheim Convention Center.

Both Dasgupta and Langman point out that monitoring alcohol consumption and alcohol abuse long-term is much more complicated than taking snapshots of blood alcohol concentrations. In such a scenario, clinicians need to continue measuring traditional biomarkers for alcohol consumption and abuse, such as liver enzymes, mean corpuscular volume (MCV) and carbohydrate-deficient transferrin, mainly because these markers stay elevated for a longer period of time and have the potential to help determine recent alcohol intake versus chronic alcohol consumption, as well as alcohol abuse versus moderate drinking.

Genetic researchers have discovered that there are some genetic factors that cause alcohol sensitivity in people of certain ethnic origins. “Certain populations are genetically predisposed to be more sensitive to alcohol than others,” explains Langman. “Individuals who are sensitive to alcohol can be drunk with a blood alcohol level of .03, and these are the people who should probably not drink.” However, testing individuals for certain genetic polymorphisms related to alcohol abuse or addiction is complicated and there is still much research that must be done before such tests can be offered clinically.

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