Our reports on the reliability of the new EtG alcohol urinalysis test focused on two women who faced terrible hardship after EtG tests showed they had been drinking when they insist they had not.
In the world of addiction medicine and monitoring this is known as a "false positive."
Critics of the EtG test say it produces false positives too easily, especially when results are not read by experts.
The EtG test detects Ethyl Glucuronide -- a byproduct of alcohol present in the urine of drinkers -- was introduced to the United States about five years ago by Dr. Gregory Skipper of Montgomery, Alabama. He worked with European scientists to develop the test for use in substance abuse monitoring programs.
Dr. Skipper stands by the science of the test, but is highly critical of the way it is being used in drug courts and by professional licensing boards around the nation. He says alcohol-laced lotions and potions like perfumes, personal hygiene products, and hand sanitizer gels can produce EtG in the body and in turn can create false positive test results.
The women on whom we focused live in Franklin County, Mo. and in Wichita, Kan. But the controversy and debate over the test and how it is being used is raging across the nation. In the course of our research we spoke with a Minnesota doctor and a California Nurse who both say they have suffered due to false positive EtG tests. They have agreed to let us share their stories here.
Rona Cristiano is a registered nurse in Southern California. She voluntarily entered the California Nursing Board's diversion program when she realized she had a problem with pain pills. She admits she has abused alcohol in the past.
While on the diversion program, she twice tested positive on EtG tests, but with a reading of under 500. (Dr. Skipper recommends of cut-off level of at least 1,000, though he admits that may still be too low to be reliable and 1,500 or 2,000 might be appropriate.)
Each time she was prohibited from returning to work. And each time, she swears she had not been drinking.
When Cristiano learned that perfumes and other products can cause positive EtG tests -- especially vapors from hand sanitizer gells -- she says she became "afraid to breathe."
Cristiano has reason to be fearful.
Nurses can use hand sanitizer gels 50 to 100 times a day. Dr Skipper's research shows that kind of exposure can create EtG levels as high as 600.
"I am suspect of everything around me," she tells us.
"I am so tired emotionally and mentally of this hanging over my head. I pray this test is abolished, and I can feel whole again. And then, I can breathe deep."
Cristiano is now leading the fight to eliminate the use of the EtG test by the California Board of Nursing, or at least change the way test results are viewed. She says she is joining with other licensed professionals including doctors, pharmacists and lawyers to officially petition the board.
Dr. Daniel Ramquist
Dr. Daniel Ramquist is a 50-something physician from Minnesota. In 2005 he was in the state's physician substance abuse monitoring program while recoving from an admitted addiction to pain medications.
He submitted two samples for EtG tests. Both came back positive, one with a result higher than 4,000. The other, taken just two weeks later, was 320.
Despite the high first reading, Dr. Ramquist insisted both tests had to be wrong. The board rejected his appeal and Ramquist was told he could no longer practice medicine.
"I really believe this EtG test is evil and does more harm than good," Ramquist said in a telephone interview. "I value my sobriety and to have that called into question is terrible."
Dr. Ramquist began researching the EtG test and the biochemistry of Ethyl Glucuronide.
He discovered evidence that he believes supports his claim that his sample may have become contaminated and degraded due to environmental and chemical factors. He presented this evidence to the Minnesota Board Complaint Committee and was allowed to keep his medical license.
Questions about EtG's reliability has led licensing boards in some states to ban use of the EtG test.
North Dakota is one. The director of the state nursing board tells us "we have studied it and were concerned about the validity of the test."
In New Mexico, the director of the state's diversion program for nurses tells us "there's too much controversy around (the test)... because people can test positive if they use hand creams."