Phosphatidylethanol levels and their association with withdrawal severity among individuals with severe alcohol use disorder seeking inpatient withdrawal management

IntroductionThis study aimed to determine if phosphatidylethanol (PEth) levels are associated with alcohol withdrawal severity among individuals seeking inpatient withdrawal management.MethodsA prospective study enrolled individuals undergoing alcohol withdrawal treatment at a ASAM level 4 inpatient...

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Main Authors: Jeong Hoo Lee, Veronica Szpak, Lisa W. Vercollone, Peter R. Chai, Charlotte E. Goldfine, Samuel Maddams, Joji Suzuki
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1567617/full
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author Jeong Hoo Lee
Jeong Hoo Lee
Veronica Szpak
Lisa W. Vercollone
Peter R. Chai
Peter R. Chai
Charlotte E. Goldfine
Charlotte E. Goldfine
Samuel Maddams
Joji Suzuki
Joji Suzuki
author_facet Jeong Hoo Lee
Jeong Hoo Lee
Veronica Szpak
Lisa W. Vercollone
Peter R. Chai
Peter R. Chai
Charlotte E. Goldfine
Charlotte E. Goldfine
Samuel Maddams
Joji Suzuki
Joji Suzuki
author_sort Jeong Hoo Lee
collection DOAJ
description IntroductionThis study aimed to determine if phosphatidylethanol (PEth) levels are associated with alcohol withdrawal severity among individuals seeking inpatient withdrawal management.MethodsA prospective study enrolled individuals undergoing alcohol withdrawal treatment at a ASAM level 4 inpatient unit. Primary outcome was the association between serum PEth levels with alcohol withdrawal medication requirements in diazepam equivalent (mg). Secondary objectives examined associations between PEth levels, Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scores, drinking history, Alcohol Use Disorders Identification Test (AUDIT), and Prediction of Alcohol Withdrawal Severity Scale (PAWSS) scores.ResultsThirty participants (mean age 48.7 years, SD 11.7; 67.7% white) reported average daily alcohol consumption of 14.2 drinks (SD 11.4, range 1.2-47.6) and percent heavy drinking days of 72% (SD 31.9, range 13.3-100). Nine (29%) reported history of withdrawal seizures and seven (22.6%) reported history of delirium tremens. Admission PEth (PO, ng/mL) levels (mean 934.9, SD 546.6; range 42 - 2000-) did not significantly associate with total medication requirements (r=0.05, p=0.78) or CIWA scores (r=0.09 to -0.14, p>0.05). PEth levels showed no significant correlations with AUDIT (r=0.17, p=0.35) or PAWSS scores (r=0.13, p=0.50). However, significant correlations were found between PEth levels and average drinks per day (r=0.54, p=0.002), as well as with the percentage of heavy drinking days (r=0.54, p=0.002).Discussion and conclusionsConsistent with prior reports, PEth levels appear to correlate with patients’ alcohol consumption including heavy drinking, but our results did not find that PEth levels predict alcohol withdrawal severity among heavy drinkers seeking inpatient withdrawal management. Further research is warranted to better understand the utility of PEth testing.
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spelling doaj-art-d6bc1eac20ca41de9226bd6d65df2f922025-08-20T03:25:40ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-06-011610.3389/fpsyt.2025.15676171567617Phosphatidylethanol levels and their association with withdrawal severity among individuals with severe alcohol use disorder seeking inpatient withdrawal managementJeong Hoo Lee0Jeong Hoo Lee1Veronica Szpak2Lisa W. Vercollone3Peter R. Chai4Peter R. Chai5Charlotte E. Goldfine6Charlotte E. Goldfine7Samuel Maddams8Joji Suzuki9Joji Suzuki10Department of Psychiatry, Brigham and Women’s Faulkner Hospital, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesDepartment of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Medicine, Dunedin Hospital, Southern Health New Zealand, Dunedin, New ZealandHarvard Medical School, Boston, MA, United StatesDepartment of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesDepartment of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesDepartment of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United StatesIntroductionThis study aimed to determine if phosphatidylethanol (PEth) levels are associated with alcohol withdrawal severity among individuals seeking inpatient withdrawal management.MethodsA prospective study enrolled individuals undergoing alcohol withdrawal treatment at a ASAM level 4 inpatient unit. Primary outcome was the association between serum PEth levels with alcohol withdrawal medication requirements in diazepam equivalent (mg). Secondary objectives examined associations between PEth levels, Clinical Institute Withdrawal Assessment for Alcohol (CIWA) scores, drinking history, Alcohol Use Disorders Identification Test (AUDIT), and Prediction of Alcohol Withdrawal Severity Scale (PAWSS) scores.ResultsThirty participants (mean age 48.7 years, SD 11.7; 67.7% white) reported average daily alcohol consumption of 14.2 drinks (SD 11.4, range 1.2-47.6) and percent heavy drinking days of 72% (SD 31.9, range 13.3-100). Nine (29%) reported history of withdrawal seizures and seven (22.6%) reported history of delirium tremens. Admission PEth (PO, ng/mL) levels (mean 934.9, SD 546.6; range 42 - 2000-) did not significantly associate with total medication requirements (r=0.05, p=0.78) or CIWA scores (r=0.09 to -0.14, p>0.05). PEth levels showed no significant correlations with AUDIT (r=0.17, p=0.35) or PAWSS scores (r=0.13, p=0.50). However, significant correlations were found between PEth levels and average drinks per day (r=0.54, p=0.002), as well as with the percentage of heavy drinking days (r=0.54, p=0.002).Discussion and conclusionsConsistent with prior reports, PEth levels appear to correlate with patients’ alcohol consumption including heavy drinking, but our results did not find that PEth levels predict alcohol withdrawal severity among heavy drinkers seeking inpatient withdrawal management. Further research is warranted to better understand the utility of PEth testing.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1567617/fullalcohol use disorderphosphatidylethanol (PEth)alcohol withdrawalwithdrawal severitydirect alcohol biomarkerbrief research report
spellingShingle Jeong Hoo Lee
Jeong Hoo Lee
Veronica Szpak
Lisa W. Vercollone
Peter R. Chai
Peter R. Chai
Charlotte E. Goldfine
Charlotte E. Goldfine
Samuel Maddams
Joji Suzuki
Joji Suzuki
Phosphatidylethanol levels and their association with withdrawal severity among individuals with severe alcohol use disorder seeking inpatient withdrawal management
Frontiers in Psychiatry
alcohol use disorder
phosphatidylethanol (PEth)
alcohol withdrawal
withdrawal severity
direct alcohol biomarker
brief research report
title Phosphatidylethanol levels and their association with withdrawal severity among individuals with severe alcohol use disorder seeking inpatient withdrawal management
title_full Phosphatidylethanol levels and their association with withdrawal severity among individuals with severe alcohol use disorder seeking inpatient withdrawal management
title_fullStr Phosphatidylethanol levels and their association with withdrawal severity among individuals with severe alcohol use disorder seeking inpatient withdrawal management
title_full_unstemmed Phosphatidylethanol levels and their association with withdrawal severity among individuals with severe alcohol use disorder seeking inpatient withdrawal management
title_short Phosphatidylethanol levels and their association with withdrawal severity among individuals with severe alcohol use disorder seeking inpatient withdrawal management
title_sort phosphatidylethanol levels and their association with withdrawal severity among individuals with severe alcohol use disorder seeking inpatient withdrawal management
topic alcohol use disorder
phosphatidylethanol (PEth)
alcohol withdrawal
withdrawal severity
direct alcohol biomarker
brief research report
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1567617/full
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