Author(s)

Troy A. Buck^*, Paul M. Borsuk, McKenna P. Sheridan, Jie Xie, Joseph R. Holtman

Department of Anesthesiology, Division of Pain Management and Pain Medicine, Loyola University Medical Center, Maywood, USA.

Background: Measurement of ethanol (EtOH) use in chronic pain patients has always been a challenge. Current biomarkers are easily confounded, giving unreliable results. Self-reporting is unreliable. Phosphatidylethanol (PEth) is a recent EtOH biomarker that shows promise as an alternative measure of EtOH. Methods: Twenty patients were included in this study. All were 21 years of age or older and had chronic pain for greater than 3 months. Patients took the Alcohol Use Disorders Identification Test (AUDIT) questionnaire. Blood was collected for PEth testing. Correlation between Audit score (0 - 40) and PEth level (ng/mL) was done with the Pearson Product-moment correlation coefficient (SPSS). Values are means ± S.E.M. Significance at p ≤ 0.05. Opioid use with EtOH use was also examined. Results: Twenty patients were enrolled, 17 (85%) males and 3 (15%) females. AUDIT scores were 8.1 ± 1.4. PEth levels were 178.3 ± 43.5. Eighty-five percent of patients had Audit scores indicating mild to moderate use of EtOH while 15% had severe use. PEth levels indicated 70% mild to moderate EtOH use and 30% heavy use. The correlation coefficient between the Audit score and PEth was 0.219 (p = 0.353) and not significant. Twenty-five percent of patients in the study were on opioids. The average PEth level in these patients was 273 ± 101.7. Conclusions: There is a poor correlation between self-reporting of EtOH use per AUDIT and PEth levels. Twenty-five percent of patients in the study were also on opioids, with PEth levels indicating high levels of EtOH consumption in this group. This suggests that self-reporting of EtOH use is inadequate in the chronic pain setting to detect actual EtOH use.

Chronic Pain, Alcohol, Phosphatidylethanol, PEth, EtOH

Buck, T.A., Borsuk, P.M., Sheridan, M.P., Xie, J. and Holtman, J.R. (2025) Measurement of Ethanol Use in a Chronic Pain Population Using the Biomarker Phosphatidylethanol. Open Journal of Anesthesiology, 15, 161-169. doi: 10.4236/ojanes.2025.156011.