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the microsampling blog

VAMS meets PEth: changing the conversation around alcohol abuse

alcoholism, disease

There are many situations or settings where it is necessary to screen people for alcohol consumption, including among organ transplant patients, those applying for a return of their suspended driver’s license, or those involved in child custody cases, and more.

Traditional alcohol screening methods involving hair or urine sampling have obvious and subtle drawbacks. Aside from the issue of a lack of specific or accurate results with these types of screens, traditional alcohol biomarkers can't always be used to make finer distinctions between social drinkers, heavy drinkers or alcoholics.

Phosphatidylethanol (PEth) is a more sensitive alcohol biomarker that can be detected in blood and is currently being studied by toxicology researcher Christophe Stove, PhD, and his team at Ghent University. PEth is already known to be a more advanced and specific way to measure alcohol use as compared to urine testing or other methods. Dr. Stove is investigating the variation at which PEth decreases in the bloodstream over the course of a month, to help improve and fine-tune this type of screening.

"We wanted to gain more insight into the behavior of PEth in people who normally drink alcohol, but at some point decide not to drink," says Stove. "Setting up a large-scale study like that is not very easy as it's quite complicated to find a large number of people that normally drink and then spontaneously decide not to drink for a month."

For that, he needed to recruit a large group of people who normally drink but were willing to abstain for a month. Dr. Stove made two decisions which made this much simpler.

He joined forces with Tournee Minerale, a month-long sobriety challenge well known in Belgium. He also took advantage of volumetric absorptive microsampling technology, in the form of Mitra® microsampling devices. The Mitra devices feature a special VAMS® tip that absorbs a precise volume of blood sufficient for lab analysis. Participants received Mitra devices at home in self-sampling kits. They were shown how to use the kits to easily collect their own dried specimens at different time points over the course of the month.

at-home-blood-collection-micro-sampling-dried-bloodWithout VAMS, “there's no way that we would be able to recruit 800 study participants that would all need to come in for a blood draw at three time points in one month. That's huge. The recruitment of the participants definitely would not have been so easy. With VAMS, we could just tell them that they didn't need to leave their homes to participate. We sent the kits via regular mail and instructed them to sample themselves.”

The benefits of finger-prick capillary blood collection aren’t exclusive to research study participants.

“We have collaborated with centers that do follow-up for people who have had their driver's license suspended and need to get it back,” Stove said. “We asked the centers if they would consider a finger prick blood test as a possible option [for tracking a driver's sobriety.]  They were quite enthusiastic about it. They considered [finger-stick blood sampling] more feasible because they could do that without the requirement of medically trained staff.”

Dr. Stove and his team are currently determining the results of the study. “The vast majority of the remote blood samples that we got back look good from a technical perspective,” Stove says. “We are busy with the analysis of these thousands of samples that we got back. In the next few months, we'll finish those analyses, and then we'll come out with the actual outcome of the study.”

Structural-formulas-of-ethyl-glucuronide-EtG-and-phosphatidylethanol-PEth-R1-and-R2Even then, some issues around introducing PEth in the driving license regranting process must be overcome. For PEth measurement to gain widespread usage, a large majority of testing centers would need to agree to adopt microsampling and PEth analysis more or less simultaneously. If some centers start using PEth and others don't, "you would have some centers that are better at catching people that keep on drinking excessively, whereas other centers that would not use this alcohol biomarker would be worse at catching people that drink," Stove says.

"The centers that would not use PEth would be, let's say, the interesting centers for the people that need to undergo testing."

Such are the challenges of process improvement for those working ahead of the curve.

As part of the work of cutting-edge organizations such as Ghent University, microsampling technologies are helping to advance health, wellness, and alcohol testing programs forward.

Review resources for toxicology labs on analyzing microsamples to screen for drugs, alcohol, and other substances!

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Image credits: Trajan, iStock

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