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Clinical Trial
. 2015 Jul;39(7):1120-7.
doi: 10.1111/acer.12750. Epub 2015 May 18.

Using Transdermal Alcohol Monitoring to Detect Low-Level Drinking

Free PMC article
Clinical Trial

Using Transdermal Alcohol Monitoring to Detect Low-Level Drinking

John D Roache et al. Alcohol Clin Exp Res. .
Free PMC article


Background: Several studies demonstrate the utility of Alcohol Monitoring Systems' (AMS) transdermal alcohol concentration (TAC) monitor to objectively quantify drinking. AMS standard criteria (i.e., TAC >0.02 g/dl) used for drinking detection are deliberately conservative, but consequently only detect drinking equivalent to 5 or more standard drinks. Our study sought to characterize the sensitivity of TAC measurement to detect low-level drinking defined as the consumption of 1 to 3 beers.

Methods: Data were pooled from 3 studies giving controlled doses of 1, 2, 3, 4, and 5 Corona© beers (12 oz = 0.92 standard units) to 32 male and 29 female research volunteers wearing TAC monitors under controlled conditions. Analyses describe the sensitivity to detect drinking at various peak TAC thresholds beginning with any positive reading >0 g/dl, and then using TAC thresholds of 0.02 and 0.03 g/dl.

Results: Nearly 40% of participants drinking 1 beer did not have a positive TAC reading. However, positive TAC readings were observed in more than 95 and in 100% of participants drinking 2 and 3 or more beers, respectively. The probability of peak TAC detection was a positive function of the number of beers consumed and a negative function of the minimum TAC threshold for detection. Drinking was somewhat more likely to be detected in females than males drinking 2 to 5 beers, but not after 1 beer. Use of AMS standard criteria only reliably detected the consumption of 5 beers, and 45.9% of all occasions of drinking 1 to 3 beers were undetected using 0.02 g/dl as a threshold.

Conclusions: Peak TAC levels between 0 and 0.02 g/dl must be considered to detect the low-level drinking of 1 to 3 standard drinks, and such thresholds are necessary when researchers and clinicians want to detect low-level drinking.

Keywords: Alcohol Consumption; Heavy Drinking; Low-Level Drinking; Transdermal Alcohol Concentration; Transdermal Alcohol Monitoring.


Figure 1
Figure 1. Relationship between Peak Breath Alcohol and peak TAC
Scatter-plots of individual observations of peak breath alcohol concentrations (pkBrAC, in % blood alcohol concentration) and transdermal alcohol concentration (pkTAC) readings (in g/dl) for Female and Male Participants. Data include all observations of drinking 1-5 beers for each of 29 Female and 32 Male participants. The Diagonal line represents unity, and the vertical boxes highlight those observations occurring with pkBrAC ≤ 0.06 %.
Figure 2
Figure 2. Peak TAC Levels as a Function of the Number of Beers Consumed
Individual observations of peak TAC readings (in g/dl) expressed as a function of the number of beers consumed. Horizontal lines are drawn at the 0.03 and 0.02 g/dl TAC levels to highlight those threshold criteria. The linear trend line is also plotted to highlight the effect of number of beers consumed. Other details are the same as Figure 1.

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