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How do we differentiate excessive from acceptable drinking
The testing used to identify excessive alcohol consumption depends on the application or purpose of the testing. For example, whether we are assessing levels that would impact on health, safety or social responsibility, although clearly these are all interrelated. There are two types of test that can be used.
Direct markers: These are produced as a direct result of exposure to alcohol and are therefore very specific to alcohol use. The two routine direct tests provided by FTS are EtG and FAEE, measured in hair to cover a 3 or 6 month history. For certain circumstances, which would be advised as required by FTS, alcohol and / or EtG can also be tested in urine to cover from 1 and up to a 4 day history.
Indirect markers: These are produced as a response to the toxicity of alcohol, causing impairment of normal body functions, particularly impairment of the liver. The routine indirect tests recommended by FTS are Blood tests for LFT’s, CDT, GGT-CDT ratio and MCV, generally to cover a 3 to 8 week history. However these markers can be influenced by other factors and are therefore not specific to alcohol and do not always respond to excessive alcohol use.
Importantly there is no single test that can provide all the answers, the results of any one of these tests independently are generally quite poor at differentiating normal from excessive alcohol use.