EtG testing - seems impossible?

Nurses Recovery

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Eeeh. Might as well post this under my real username. I'm about to enter into the Kansas Nurse Assistance Program which requires monthly urine screens for three years. One false positive will get me reported to the BON. I know there are further gold standard tests that can be done but I don't think my program does these if you have a positive UA.

I've been doing some research on EtG testing and am wondering if it's even possible to go three years without getting a false positive? I can obviously abstain from alcohol. And I know about the obvious alcohol containing products like mouthwash, cold medicine, make-up and skin creams, hair dyes, hand sanitizer, fermented products like soy sauce, baked goods and flavored lattes...but my research seems to show that there are literally thousands of products that could possibly cause a false EtG reading. At least deodorants, toothpaste, and shampoos have to list ingredients -- I have no idea what's in my cleaning supplies or laundry detergent. (All of which are on various lists of products that could possibly cause a false EtG reading.) Apparently, yeast infections and UTIs can also cause false positives.

KNAP has been no help. They tell me to refer to the materials that they sent me but those materials are literally three small paragraphs on cold medicine and mouthwash, hemp products, and poppy seeds. I might call the testing facility tomorrow to see if they have anything more comprehensive.

But, like...this does get done, right? People have to pass these tests for all sorts of monitoring programs, probation, and to get jobs...but it seems like the internet (and even this board) is filled with people complaining about false EtG positives.

Specializes in PDN; Burn; Phone triage.

Oh man. My thread! I ended up with a false positive for PCP of all things a couple of months ago. What a headache.

Specializes in LTC, Psych, Med/Surg.

I do not have an anxiety disorder and I think it is absolutely NORMAL to be terrified when starting a monitoring contract. I was a basket case when my first UDS was questioned because it was ever so slightly dilute.

I had no issues with urines after that first one and I successfully completed SIX YEARS of monitoring that would have been five, but I couldn't find a nursing job. License is now unencumbered.

Catmom :paw:

So sorry about the false positive thing--did they do a split specimen and did they test both bottles? Do they allow a hair test, or do you want to even go that route? I know false positives are treated like real ones, so I feel for you. Unfortunately, that's why they give us these extensive, exhaustive lists of prohibited substances--sometimes they're just being overly concerned about "triggering" your addiction, and sometimes they are really trying to help by preventing false positives. Wow...that really is awful...well, keep on keeping on, all you can do! Check online about any herb or drug you put in your mouth--false positives can be sparked by the strangest things. Good luck!

Specializes in PDN; Burn; Phone triage.

^My false positive was due to lamictal -- script was current with the program. It is a pretty well known false positive causing drug but was also the medication that saved my life. The nurse who essentially runs the program flipped out, saying that no one in the history of the program had ever had a false positive for PCP while taking lamictal. You can Google it. The warning is on the drug insert.

I had a huge spiel written out but it just occurred to me that she might read this forum and could identify me. lol

Specializes in Impaired Nurse Advocate, CRNA, ER,.

Here's a good guide to medications and other products to avoid. It's from Talbott Recovery Campus in Atlanta. I provide this to all of my clients when they enter treatment.

http://www.talbottcampus.com/pdf/MedGuide.pdf

Hang in there!

Jack

For those of you who don't know Jack (LOL at the unintended pun!!)- you can always believe anything he says. I LOVE it when i see him on here- he is an old-timer on this board, who has a wealth of info & excellent advise- in long-time recovery himself. You can always believe it, if he says it! :yes:

Specializes in LTC, Psych, Med/Surg.
For those of you who don't know Jack (LOL at the unintended pun!!)- you can always believe anything he says. I LOVE it when i see him on here- he is an old-timer on this board, who has a wealth of info & excellent advise- in long-time recovery himself. You can always believe it, if he says it! :yes:

Put me down for a ditto to what TXRN2 said. I have known Jack for years (lol) and am always delighted when he graces this forum with his posts.

:yelclap:

Catmom :paw:

Specializes in Impaired Nurse Advocate, CRNA, ER,.

Awww shucks...thanks! Been awhile...very busy between work, peer assistance advisor, and my daughter in early recovery (and struggling...a chip off the old block!). The urine drug screens done on site can show false positives or negatives due to non-specificity of the test (immunoassay). All positive results on the immunoassay screening should be verified by gas chromatography/mass spectroscopy. Here's a link discussing drug testing and cutoff limits for ETG/ETS. The National Association of Drug Court Professionals recommend a cutoff of 500 ng/ml for ETG (ethyl glucuronide) and 100 ng/ml for ETS (ethyl sulfate). This means levels below those numbers can't be ruled out for "incidental" exposure to alcohol through mouthwash certain medications (including OTC cough cold and sleep aids), and possibly food cooked with alcohol. It's a myth that all alcohol is cooked off. I tell my clients if there is the name of an alcohol on the title of the food you're considering ordering, then don't order the food (bourbon chicken, Jack Daniels ribs, beer batter fish, etc.) The chance you'll test positive is low, but with the way the monitoring programs are, why take the risk.

Jack

Do they actually test EtG? Or just urine ethanol?

Most programs wont tell you what they are testing for. My program has different number assigned to different panels so I never know what I am taking. I do know that they can choose to test for anything at anytime (that includes etg) and I won't ever know the difference!

Specializes in PDN; Burn; Phone triage.
Do they actually test EtG? Or just urine ethanol?

My program definitely tests for EtG. It is probably the only specific chemical/drug that they spell out that they test for.

I had read that EtG isn't normally used anymore because of the erroneous results. Seems scary if they do test for that, I need to really double check all my skin care products.

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