RNRhachet

https://www.centerforprofessionalrecovery.com/specificity-of-phosphatidylethanol-as-a-marker-for-alcoholic-beverage-consumption Prior perspective of 100% specificity for drinking reversed. He now claims no known cutoff for drinking and the previously marketed "confirmatory" test for drinking heavy amounts of alcohol is of unknown validity or reliability. What this means is that all of the biomarker testing they have used in the past 19 years in monitoring programs has absolutely no value and should be removed from the equation. A blood test of unknown specificity does not confirm urine urine tests of unknown specificity. Without a known cutoff the values reported are meaningless

https://www.centerforprofessionalrecovery.com/specificity-of-phosphatidylethanol-as-a-marker-for-alcoholic-beverage-consumption See attached 2013 paper which is the primar "research" relied on by the commercial labs that are marketing the PEth test as 100% specific for drinking. Greg Skipper is the primary author and this is the 3rd biomarker he introduced and promoted as a reliable indicator for drinking and it is also the 3rd time that the test has proven to be unreliable. On January 14, 2020 he posted an analysis of the specificity of PEth that is diametrically opposite what he has been saying for the past 7-years noting this is a "relatively new test" of unknown specificity, there is no known cutoff that differentiates incidental exposure to alcohol from drinking and that until the proper studies have been done the PEth test should not be relied on as the sole basis for disciplinary action. As Skipper introduced PEth as a CONFIRMATORY blood test for positive EtG/EtS in the urine in 2013 and claimed 100% specificity for drinking at a cutoff level of 20 ng/ml because only HEAVY drinking would result in a level above the cutoff this is despicable. He is also acting as an expert witness supporting his new perspective and this is the 3rd alcohol biomarker test he introduced and and promoted as confirming drinking at a precise cutoff that was subsequently found to be unreliable and of unknown validity. EtG from 2001 > 2006 then EtS from 2006 > 2013 and now PEth from 2013 > 2020. How many have been harmed in the past 7-years? A positive PEth test near the end of a contract is common and this is when those in monitoring programs are most vulnerable to suicide given the choice between "voluntary agreement" for a re-evaluation (knowing it will result in unneeded treatment followed by a new monitoring contract) or a refusal which with absolute certainty results in disciplinary action. I am looking for as many cases as possible in which the PEth test led to unneeded referrals for assessment, false diagnosis of AUD (the diagnostic criteria for "unspecified" "mild" and "moderate" AUD is typically arrived at by using the +biomarker test and whatever complaint led to the referral or the referral itself making these tests the proximate cause of the diagnosis or that led to disciplinary action (suspension, revocation, limitations) placed on licenses. The specific questions I have are: 1. What was the reason for your referral to the agency that ordered the test? 2. What other tests were done by the agency (EtG, EtS, BAC, breathalyzer, CDT, MCV, GGT AST/ALT, etc.) and did you get independent testing to support your position? If so did the agency acknowledge and address these tests in your evaluation? Did the board address these tests at your hearing? Did the statement of reasons for the decision contain any of these test results? 3. What was the Peth level used in the decision making process and who made the determinations and decisions? 4. What weight did the PEth test play in each decision and what was the outcome? You can e-mail me at [email protected]. If you feel comfortable using your real name please do but if you do not please send some sort of unique identifier in order to be able to communicate at some point in the future. Additionally if there is a board order or other document showing the weight of this test in the decision making process that would be helpful. PEth-Article-in-ACER.pdf

Why the silence? We need to question this "authority"! Do we speak up or accept the status quo? https://www.linkedin.com/pulse/overdue-need-critical-analysis-impact-illegitimate-langan-m-d-?published=t

Good grief! Everyone gets a positive EtG 3-6 months prior to graduation in this system. It is a racket. Whether you kiss their ass or speak your mind makes no difference. You are ****** either way people. This needs to be named, exposed and reformed. Activism is needed and the boards are part of the problem. The same thing is happening with doctors and we need to communicate, collaborate and address this directly. It is a scam! Greg Skipper – Disrupted Physician

Getting a positive EtG in the three months before a contract is ending is reportedly very common and seems to be intentional to force people into another evaluation and another 5 year contract. This is all a scam.

I disagree with TwoYearNurse. I just looked at the blog that zzzz50 referenced and it is one blogpost of many. Perhaps TwoYearNurse did not bother to look any further than the one blogpost but it has links to others and it is very well referenced. It appears to me what the author is getting at in this post is that physician monitoring programs have no meaningful oversight, regulation or transparency. What's wrong with that? He also notes that these programs were presented as an "alternative to discipline" and that this represents a "false-dichotomy" as "abuse can be hidden under a veil of benevolence." He also discusses at length the junk-science tests these physician programs introduced without FDA approval and gives a very credible argument that this "institutional injustice" is related to the marked rise in physician suicide. I don't see anything "fear based" in any of this. Programs should be run by qualified experts and being an addict or alcoholic "in recovery" does not make an expert. It can help in certain cases but can also harm. I also don't see where he is saying that anyone who "diverts" should not be licensed. My take is that he is saying that some of the people who are actually running these programs (such as the one running the PRN in Florida) should not be licensed due to behavior that most people would not commit even under the influence. I agree. I think most people would. I think this should instill fear--it is those bearing gifts and saying nothing is wrong that are the danger here.