Relapse is the term addiction specialists use to describe the reinitiation of substance intake after a drug or alcohol user begins the recovery process. Generally speaking, people who relapse repeatedly have significantly reduced chances of ultimately achieving long-term substance abstinence. In a study published in January 2014 in the journal Alcohol and Alcoholism, a team of German and Austrian researchers compared the effectiveness of three potential methods of detecting a relapse during ongoing alcoholism treatment. These researchers concluded that a new urine testing technique produces superior accuracy in detecting recent alcohol use.
Alcoholism Relapse Basics
The risk for a relapse back into the use of alcohol occurs because people affected by alcoholism experience long-term changes inside their brains that support continued alcohol intake. One of the prime examples of these changes is a constant or recurring desire to keep drinking, commonly known as an alcohol craving. Another prime example is the onset of withdrawal symptoms when alcohol use ceases or drops off rapidly. Essentially all alcoholics experience cravings while actively drinking and the vast majority also experience strong cravings during the recovery process. All alcoholics also experience withdrawal symptoms in the span of time when alcohol levels inside the brain and body start to fall. According to findings compiled by the National Institute on Alcohol Abuse and Alcoholism, individuals who repeatedly go through cycles of alcohol withdrawal and relapse can ultimately increase their sensitivity to withdrawal symptoms, and can therefore boost their chances of relapsing again in the future.
A New Urine Testing Procedure
When you consume alcohol, it passes into your bloodstream and starts to break down. One of alcohol’s breakdown products, called acetaldehyde, plays a major part in producing the symptoms of a hangover. Another breakdown product, called ethyl glucuronide or EtG, forms in the liver and ultimately leaves the body when you urinate. In the last few years, researchers and doctors have learned how to detect the EtG content of urine, even when a person has consumed only a relatively small amount of alcohol. In fact, the urine test for this breakdown product is so sensitive that doctors can tell if an individual unaffected by alcoholism has consumed any alcohol within the past 24 to 48 hours. Doctors using the test can sometimes tell if an active or recently recovering alcoholic has consumed any alcohol over a span of three-plus days.
In the study published in Alcohol and Alcoholism, researchers from five German institutions and one Austrian institution compared the results of EtG testing for alcoholism relapse detection to the results of two other common measures of relapse: breathalyzer results and self-reports from the drinkers. They conducted this comparison with the help of 297 individuals receiving treatment for alcoholism in a long-term program that allowed its participants to spend weekends by themselves or with their families. After returning from a free weekend, each of these individuals self-reported his or her level of involvement in alcohol use, took a breathalyzer test designed to detect the amount of alcohol circulating in their bloodstreams, and also took an EtG urine test.
The researchers found that 5.7 percent of the program participants admitted to drinking alcohol while on their weekend break. Breathalyzer results for the group indicated that 4.4 percent of the participants had relapsed back into alcohol use. However, fully 37.7 percent of the participants tested positive for alcohol consumption on their EtG tests. This total included more than 15 percent of the people who tested negative for alcohol consumption on their breathalyzer tests. In fact, the researchers concluded that EtG urine testing was responsible for detecting well over 90 percent of all cases of weekend alcoholism relapse in the program.
Significance and Considerations
The Substance Abuse and Mental Health Services Administration notes that the EtG urine test is so sensitive that it can easily fail to distinguish between a relapse back into drinking and the incidental use of common alcohol-containing products such as certain brands of mouthwash or sanitizer. This is important, since the inaccurate detection of drinking can lead to serious misunderstandings or even to legal repercussions. However, keeping this consideration in mind, the authors of the study published in Alcohol and Alcoholism believe that EtG testing can play an important role in identifying cases of relapse in recovering alcoholics that would otherwise go unnoticed and could potentially substantially decrease the long-term chances for alcoholism recovery.