Alcohol test may be condemning the abstinent.(Practice Trends)(testing methods)

SAN DIEGO -- Nancy Clark, a registered nurse, had been drug free and sober for 3 years when she tested positive for alcohol on the new ethyl glucuronide test, the same one used for many chemically dependent physicians who are entered into monitoring programs and are on probation.

She kept her job the first time, but then she tested positive again--and lost it.

So Ms. Clark bought a plane ticket. She flew almost 3,000 miles from Pennsylvania to San Diego to meet with the one person she thought might be able to help her and others in her situation: Dr. Greg Skipper.

"When I tested positive, I looked on the Internet, and everything I saw said this test was perfect," said Ms. Clark of Fleetwood, Penn., at the meeting where she met with Dr. Skipper--the annual conference of the American Society of Addiction Medicine.

"I thought: How am I ever going to be able to protest this?" she said.

Recent evidence, however, suggests that while the test may be highly accurate and sensitive, it may also be fallible, said Dr. Skipper, who helped develop ethyl glucuronide (EtG) as a drug test to monitor whether a person has consumed alcohol. In essence, the evidence suggests the test may be too good, picking up people who are exposed to alcohol in any number of ways without drinking it, said Dr. Skipper of Montgomery, Ala., director of that state's physician health program.

The EtG test is used widely by physician monitoring programs. In a survey of physician health programs conducted this year, 29 of 31 responding programs reported that they use the test, compared with 17 of 46 programs that reported using it in 2004, said Dr. Michael Sucher, medical director of the physician health program in Scottsdale, Ariz. Some of those states use it routinely, others just for cause.