DVLA, driving and Screening for chronic alcohol misuse

The classic tests that doctors have used historically for screening for alcohol misuse namely the Gamma GT and MCV measurement are useless, being normal in 50% of subjects with alcohol used disorders. The DVLA have adopted measurement of carbohydrate deficient transferrin (CDT) in drivers who have lost their licence in the UK. CDT gives a time integrated index of alcohol consumption over the previous ten days or so, and has a specificity and sensitivity of 90% and 60%. In Germany they use measurement of urinary ethyl glucuronide/ethyl sulphate, which has a very high sensitivity (90%) and specificity (95%) and can detect alcohol consumption in the previous 72 hours.   There are other tests such as fatty acid ethyl esters, hair ethyl glucuronide which I can discuss with you. If you have lost your licence and need to prove continued abstinence from alcohol there are a number of approaches that I employ, including remote monitoring by breathalyser as well as CDT and urinary ethyl glucuronide testing.