Option of taking Peth, hair or nails on initial

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Have a colleague in Virginia who has just been "accepted" into the monitoring program due to alcohol use.  Already had an evaluation, etc.  But she they are making her choose either 1) Peth, 2)Hair ETG or 3) Nails ETG as part of a continuing evaluation.

What is the purpose of this if you are already into monitoring?  In SC where I am, I got accepted into monitoring after doing all of these tests.  Would they extend her monitoring time length or perhaps even the frequency of testing depending on the results of these tests?

She last had alcohol (moderately - heavy) 1 month ago.  I don't now the specific number of drinks.  Would Hair ETG be the best option for her to take?  I read even after 1 month of being sober, ETG washes out of hair even with normal shampoo and daily stress.  Peth is very sensitive (up to 30 days) but it's still risky even though she's been sober for 1 month.  If she drank heavily, even the peth might still be above 20.  Nails ETG I heard is more sensitive than Hair ETG because it's hard to wash ETG out of nails?  what's the best option to choose?

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If she last had alcohol 1 month ago, then do the PETH.  That's an obvious no brainer, but if she last had alcohol at multiple times over the past 3 or so weeks and even though she doesn't considerate it "moderate," if she had alcohol, for example, 2 or 3 drinks on 4 occasions or 5 occasions over the past 3 or 3.5 weeks, then she needs to do the Hair ETG.  Nail ETG is more sensitive than Hair.  Hair VARIES with Alcohol.  For some people, it sips out of the follicle and is washed out.  For some people, it sticks around.  For some people, it never hardly reaches the follicle in meaningful amounts, and for some others, a small amount goes straight to the follicle and they hold onto it.  Alcohol=Hair=ETG is not commonly done for alcohol because it is so variable among individuals.  But, if truly no alcohol in 30 days, then PETH is obviously the choice.

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Unfortunately, she had had multiple drinking episodes and stopped 30 days ago.  So I've heard of Peth staying positive for longer than 30 days depending on how much the person had drank even if 30 days passes.   

Hair ETG is still done commonly in many places btw.  Also for probation (used to be a nurse in detention center).  Fingernail ETG is not commonly used but monitoring agencies will do it.  

I'll suggest hair ETG then - she has thin hair.   I think thicker, coarse hair retains metabolites more.  That's where the variation among individuals comes in

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Tough choice. Really depends on how much she drank prior to the 30 days. If she drank alcohol 6 times in the previous 30 days, for example June 7 to July 7 she drank 6 times and averaged 3 drinks each of the 6 times and then stopped drinking July 7 through Aug 7 (today) , I would go PETH all the eay without question.

Remember this, alcohol is STILL detectable (ETG) MORE commonly that what you realize in the hair. We all here of the stories where someone beat the hair alcohol test and they make it known, put it on message boards, talk about it. We do not here of the ones who get nailed. They are too depressed to post about it. If you drink moderate amounts of alcohol and you test negative for a hair alcohol test, you are in the Minority. It's not like alcohol is not detected in hair. Most of the time, it IS detected, but the test is NOT as reliable as other drugs for hair testing, but that doesn't make the test completely unreliable either. It is just a lot less reliable.

Given the scenario and drinking rates I gave above, if those drinking rates are close or approximate, I would choose the PETH.

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It's difficult to say which test to do.  Peth is VERY sensitive, but if you have 30 days, not that much chance it's above 20.  It's gone through enough half lives.  

But the hair etg test is not that sensitive.  And given a 30 day of no drinking, that's 30 days of growing negative hair.  

Also, check this study - older or more distal hair lengths had just 50% of the etg that the proximal segments did.  This assumes regular hygiene and time washes etg out of hair.  Remember, etg is a very polar and hydrophilic molecule.

 

Hair EtG: Alterations in segment levels accompanying hair growth

https://pubmed.ncbi.nlm.nih.gov/30084156/

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