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Mon, Feb 10 1:39am · Other causes of failed PEth test for alcohol abuse? in Mental Health

So common that the only explanation is these are being done deliberately. This makes sense as those who introduced and promulgated the mythology that these biomarkers differentiate incidental exposure from drinking did so for opportunistically for profit and out of greed. These labs are not FDA approved and have no accountability as there is no agency that has the ability to both investigate false tests and impose these labs for wrongdoing. That is why they are able to misleadingly market tests these tests as indicative of proof of alcohol ingestion. As they are unregulated they can basically say whatever they want. The only agency that is able to investigate false or fraudulent tests is the College of American Pathologists and all they can do is force the labs to correct an erroneous test and "educate" them to do better next time no matter how serious the misconduct or how often it occurs. Likewise the agencies ordering these tests and the "approved" assessment and treatment centers that profit from the referrals generated by these tests when they return positive had no real accountability-particularly when no insurers are involved and the victim is responsible for payment. Giving someone a positive test near the end of the monitoring contract typically resets the contract and guarantees another windfall of cash for more assessments, more unneeded "treatment" and more costly testing which lining their pockets with cash and virtually no chance of getting caught for it and that is what these low-lives do.

Thu, Feb 6 2:48pm · Other causes of failed PEth test for alcohol abuse? in Mental Health

PEth was discovered to be a minor metabolite of alcohol in the 1980s so nobody developed anything here it was merely identified. EtG was discovered in the 1950s. As minor alcohol metabolites these assays have no clinical significance so there would be no reason to use the tests in clinical care and therefore no reason a lab would go through the time consuming and costly FDA approval process to market it as a stand alone lab test to be ordered in patient care OR a forensic lab test used for testing a biological matrix for substances of abuse. Instead it was developed through the fast track laboratory developed test (lLDT) pathway which was designed as an avenue to develop stand alone tests for rare diseases in which the cost of developing through usual channels would far exceed its potential profitability or in emergent situations ( such as coronavirus). FDA approval of forensic tests require arduous validity and specificity testing including “forensic ingestion trials” which I’m the case of ethanol would require transdermal and vaporized exposures of any potential substances that could interfere with the concentration of the substance being tested. The EtG was introduced as a stand alone LDT to completely bypass the research required through the FDA approval process including determining sensitivity and specificity in 2003 and it was proposed by Dr Greg Skipper and NMS labs marketed it as 100% accurate and specific for ethanol to mislead others into believing it was a test for drinking. The same thing was done with EtS and then PEth. These were developed out of profit and greed only and it is despicably evil they were even introduced. As this is the third time they’ve done it with utter disregard for the consequences a reckoning is coming and we need to make sure those responsIble are held accountable publicly , civilly and criminally. The jig is up!

Tue, Feb 4 5:04pm · Other causes of failed PEth test for alcohol abuse? in Mental Health

That depends on what you mean by Skipper "seems to realize this and is at least helping now"? Are you referring to his availability as a paid expert witness or something more? Is this change in perspective presented as genuine mea culpa resulting from a sincere epiphany or is was it written as click bait for his medico-legal services. The specificity of any drug or alcohol test being used for forensic purposes needs to be as close to zero as possible to prevent false-positive tests. False positive tests should be non-existent to very rare. This requires extensive,and detailed research looking at multiple variables including metabolic and genetic differences, validity, cross-reactivity, cutoff levels, etc. etc. These issues need to be known well BEFORE the test is actually used for forensic purposes. The only research done on the EtG when it was introduced in 2003 and the PEth when it was introduced in 2013 was the research concerned with detecting and quantifying and the specificity of these tests is being determined post-market by trial and error. These consequences were predictable and avoidable.

Sun, Feb 2 9:33am · Other causes of failed PEth test for alcohol abuse? in Mental Health

"In conclusion, new tests for monitoring alcohol or drug use, such as the blood PEth test, can be useful even though a low positive test (<112ng/ml) by itself may not be proof of relapse. It is unlikely that the specificity of the blood PEth test will be 100%. There are essentially no tests that are perfect. Until adequate studies are performed to document more accurately the specificity of the blood PEth test it seems reasonable that a low positive blood PEth level should not be used by itself as proof of intentional alcoholic beverage consumption."

In 2003 Skipper claimed that a urine EtG > 100 ng/ml was proof of intentional alcoholic beverage consumption. From 2006 to 2012 the cutoff level proving drinking was raised from 250 then to 500 and then to 1000 ng/ml as the number of people getting positive tests who did not in fact drink continued to rise. As it was becoming more and more clear there was no cutoff level proving drinking Skipper claimed that proof of intentional alcoholic beverage consumption could be proved by testing for EtS. And when EtS was found to have the same problems as EtG the blood test phosphatidylethanol (PEth) was recommended as a confirmatory. In 2013 Skipper et al. claimed that a positive PEth test (> 20 ng/ml) could only be caused by heavy drinking and for the past 7-years it has been promoted and marketed as a highly specific test that reliable differentiates between incidental/extraneous exposure and drinking. In state physician health programs the consequences of a positive PEth test are fairly straightforward. At minimum, a positive test will require a 5-day evaluation at an out-of-state cash-only "approved" assessment center costing an average of 5K. These assessment centers typically recommend treatment lasting from 1-3 months and costing another 25-80K out-of-pocket and when discharged from treatment the PHP typically recommends a new monitoring contract for 5-years starting from scratch. It is at this point many of these doctors simply say "f*%k it" and kill themselves. In fact getting a positive PEth test near the end of a 5-year monitoring contract seems to be a common pattern -it occurs so frequently that it appears to be by design and when you consider the profit motive, opportunism and greed here it is highly probable.

The EtG, EtS and PEth were introduced as forensic tests with zero evidence base. All 3-were introduced and promoted as reliable, accurate and valid tests with high sensitivity and specificity and all 3 were subsequently found to be unreliable, inaccurate and invalid tests with very high sensitivity but poor specificity. These should never have been put out on the market and they now need to be removed. It is time to call bulls#*t on this charade.

Skipper GE, Thon N, Dupont RL, Baxter L, Wurst FM (2013) Phosphatidylethanol: The potential role in further evaluating low positive urinary ethyl glucuronide and ethyl sulfate results. Alcohol Clin Exp Res 37: 1582-1586.

Oct 29, 2019 · Other causes of failed PEth test for alcohol abuse? in Mental Health

It is an”laboratory developed test” (LDT)- clinical tests have more oversight. Accountable to no one.

https://disruptedphysician.com/category/laboratory-developed-tests/

May 31, 2019 · Other causes of failed PEth test for alcohol abuse? in Mental Health

Documents sent to Massachusetts State Auditor Suzanne Bump pertaining to misuse and abuse of these tests by professional monitoring programs and licensing boards: bit.ly/2HMnAgN and bit.ly/2JPzubQ

May 13, 2019 · Other causes of failed PEth test for alcohol abuse? in Mental Health

Mine was 365 so I must have been engaging in 7-binge sessions per day ( breakfast, lunch, dinner, mid-way between each and a nightcap to boot). Where has common sense gone,!

https://mllangan1.files.wordpress.com/2019/05/ma-borim-board-counsel-robert-harveys-misconduct-part-1.pdf