BRIEF RESEARCH REPORT article
Front. Psychiatry
Sec. Addictive Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1567617
Phosphatidylethanol levels and their association with withdrawal severity among individuals with severe alcohol use disorder seeking inpatient withdrawal management
Provisionally accepted
Jeong Hoo Lee1*
Veronica Szpak1
Lisa W. Vercollone2
Peter R. Chai1
Charlotte E. Goldfine1
Samuel Maddams1
Joji Suzuki1- 1Brigham and Women's Hospital, Harvard Medical School, Boston, United States
- 2Dunedin Hospital, Dunedin, Otago, New Zealand
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Introduction: This study aimed to determine if phosphatidylethanol (PEth) levels are associated with alcohol withdrawal severity among individuals seeking inpatient withdrawal management. Methods: A 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, CIWA scores, drinking history, AUDIT, PAWSS scores. Results: Thirty 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 Conclusions: Consistent 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.
Keywords: alcohol use disorder, Phosphatidylethanol (PEth), Alcohol withdrawal, withdrawal severity, direct alcohol biomarker Brief Research Report
Received: 27 Jan 2025; Accepted: 26 May 2025.
Copyright: © 2025 Lee, Szpak, Vercollone, Chai, Goldfine, Maddams and Suzuki. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jeong Hoo Lee, Brigham and Women's Hospital, Harvard Medical School, Boston, United States
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