Measuring alcohol in breath or body fluids is the principal means by which drunk-driving statutes are enforced and scores of reliable methods are available for forensic alcohol analysis. However, finding a punishable blood alcohol concentration (e.g. >1.0 g/L) is not a reliable indication of the person's drinking habits and whether there might be underlying alcohol problems. Indeed, treatment for dependence on alcohol instead of punishment for drunk driving might be a good strategy. Moreover, monitoring alcohol consumption of convicted drunk drivers during rehabilitation has proven effective to reduce recidivism rates after relicensing. For this purpose, sensitive and specific biochemical markers are needed to assess whether a person has recently consumed alcohol and to provide a rough estimate of the amounts consumed and the duration of ingestion. Markers based on abnormal blood and urinary chemistry or altered haematology have become available and new ones are being developed. Elevated concentrations of urinary methanol (>2 mg/L) and a raised ratio of serotonin metabolites, 5HTOL/5HIAA (>1.5%), give a strong indication of recent drinking even if the associated urinary ethanol concentration is zero. Carbohydrate-deficient transferrin (CDT) and G-glutamyltransferase (GGT) are examples of clinical tests used as indicators of prolonged overconsumption of alcohol (>60 g per day) and damage to organs and tissue, respectively. This paper gives a survey of biochemical markers of alcohol use and abuse and highlights some applications in traffic medicine.
Abstract