This refers to the uptake of a drug (e.g. alcohol) from the site of administration into the blood-stream. The absorption of alcohol occurs by passive diffusion and begins immediately after drinking. For ethanol, absorption starts in the stomach but occurs more rapidly from the upper part of the small intestine (duodenum). When the alcohol molecules reach the portal blood they are transported to the liver and thereafter the heart and peripheral circulation. The rate of absorption depends on many factors, e.g. food in the stomach, type of beverage consumed, anatomy of the gut, gastric emptying rate, concomitant drug use, smoking, time of day etc.

Accreditation of a laboratory is formal recognition by an authorized agency that the analytical laboratory is competent to perform certain measurements or tests.

Is a measure of the closeness of agreement between the result of analysis and the true value of the quantity being measured.

The first product of ethanol metabolism by all known pathways. Acetaldehyde (CH3CHO) is produced in the liver and is a highly toxic and chemically reactive substance.

Too much acid in the blood and body fluids (opposite = alkalosis).

The development of tolerance within the course of a single exposure to a drug.

Refers to both the physical craving for a chemical and to the psychologically learned behavior in which the person develops a primary relationship with a chemical (i.e., it comes before everything else).

The name given to a drug or chemical agent often self-administered usually without a medical prescription, repeatedly and compulsively.

Means to contaminate by addition of another substance or to make impure but still maintain the same appearance as the original, e.g. dilution of drug concentrations in urine by adding another liquid such as water. In connection with the illegal manufacture and sale of illicit drugs, the pure drug e.g., cocaine or heroin is often blended with some other cheap inert substances a process known as “cutting” before being distributed and sold to consumers.

An agonist is a chemical substance, drug or other molecule that binds to a receptor to produce an effect or start a sequence of events leading to a physiological response.

The extent to which two different tests or two different observers agree with each other when measuring the same thing.

The enzyme (actually class I ADH) catalyzing the conversion of primary alcohols into aldehydes and secondary alcohols into ketones. Thus, ethanol is oxidized into acetaldehyde and isopropanol becomes acetone.

Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal -or- A primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations..

A collective name for a class of organic compounds containing carbon, hydrogen and oxygen and the hydroxyl (-OH) group.

The mitochondrial enzyme (very low km) that converts acetaldehyde to acetate.

One or two or more variants of a gene or other DNA sequence. Different alleles of a gene generally serve the same function e.g. code for proteins that determine eye color, but may produce different phenotypes (e.g. blue, green or brown eyes). Some alleles may be defective and produce a protein (e.g. an enzyme) that has no function at all or an abnormal function.

Pertaining to the alveolar sac - the air cells - the site of gas exchange in the lungs.

Alveolar or end-expired air represents that fraction of the exhaled breath remaining after the deadspace region has been ventilated. For determination of alcohol in breath at least 1.5 liters of a prolonged exhalation should be discarded prior to sampling.

The alveoli are situated at the extreme ends of the branches of bronchial tree and are the air sacs at the base of the bronchioles where gases and volatile substances such as oxygen and carbon dioxide can enter and leave the pulmonary circulation.

Organic compounds containing both an acid and amino group, e.g. carboxylic acid (-COOH) and amine (-NH2) groups. Twenty amino acids are important in human nutrition and biology and they are the building blocks of proteins.

An enzyme produced in the pancreas to catalyze the digestion of carbohydrates (sugars).

A biological process not requiring oxygen.

A drug or substance that lessens or eliminates pain.

The specific component or substance measured in a chemical analysis.

A set of measurements carried out successively by one analyst using the same measuring system, at the same location, under the same conditions, and during the same short period of time.

The ability of a method or instrument to discriminate between samples with different concentrations of substance or containing different amounts of the analyte. The slope of the analytical calibration function (plot) is one index of the methods sensitivity.

Ability of a measurement procedure to determine solely the desired substance it purports to measure without responding to any others.

Any wavelength at which an absorbance measurement is made for the purpose of the determination of a constituent of a sample.

A deficiency of hemoglobin in the blood which can result from a decrease in the proportion of erythrocytes - an abnormally low number of red blood cells.

A chemical substance (drug) that binds to a receptor to block or reverse the action of another drug or chemical substance; Naloxone is an opiate antagonist that blocks the action of morphine at its receptor.

Are physical measurements (height, weight, age) that provide an indirect assessment of body composition and development.

An antibody is a large protein molecule produced by the body’s immune system to recognise and bind foreign molecules such as viruses.

A chemical substance that delays or counteracts blood clotting. Heparin is a natural anticoagulant in the body. Potassium oxalate, EDTA, and sodium fluoride are other examples of chemicals added to Vacutainer tubes to prevent clotting.

A hormone produced in the posterior pituitary gland that promotes the conservation of body water by its effect on the kidney thus influencing the production of urine.

A molecule that binds to an antibody.

An artery is a blood vessel that carries oxygenated blood from the heart and lungs to the rest of the body.

Is the pathologic accumulation of fluid in the peritoneal cavity. This condition is often associated with alcoholism and develops as one consequence of chronic liver disease (cirrhosis). The volume of ascites fluid might reach 10 liters or more.

A chronic inflammatory disorder of the airways which causes airflow obstruction and forced expiratory volumes are markedly reduced. Those suffering from asthma might not be able to fulfill the sampling requirements (time-pressure-volume) of some breath-alcohol analyzers.

Inability to coordinate voluntary muscle movements owing to various influences (drugs or diseases) on the cerebellum.

Means the wasting away or shrinkage of tissue caused by cell death.

The word autopsy derives from the Greek word meaning “to see for oneself.” In UK necropsy is used instead of autopsy also from Greek, which means “seeing a dead body.” In USA autopsy is synonymous with postmortem examination by a medical examiner.

Percentage of alcohol in a person's bloodstream

Bariatric comes from the Greek words baros, which means weight and iatric which means treatment. Hence bariatric surgery is an operation for treatment of being severely overweight (obesity) and usually involves making the stomach smaller by gastric banding or a gastric bypass.

The total energy output of the body at rest after a 12 h fast amounting to 1.0 kcal/kg/h for men (0.9 for women). For a 150 lb (68 kg) man the energy requirement for basal metabolism is 1632 kcal/day.

An observation or quantitative measurement made before administration of a drug or an experimental treatment. When evaluating results, the post-treatment measures are usually compared with the baseline measure.

The absorbance of a homogeneous sample containing an absorbing substance is directly proportional to the concentration of the absorbing substance.

A systematic error of measurement expressed as the difference between the expected result of a measurement and a true value (compare with accuracy).

The quantitative study of published articles and books and evaluation of these in terms of authorship, readership and citation practices.

A greenish-yellow secretion produced in the liver and collected and stored in the gallbladder until needed. Bile is an emulsifier which promotes mixing and digestion of fatty foods.

A material of human or animal origin commonly used for identification of the individual (DNA) or forensic or clinical laboratory analysis of endogenous or exogenous substances.

Removal and laboratory examination of tissue from a living body, e.g. liver biopsy is the gold standard for investigating liver cirrhosis.

A proficiency test sample for which the analyst or laboratory is unaware of the test nature of the sample at the time of analysis. Thus an undeclared proficiency trial entails submitting samples for analysis blinded or masked.

Permeable barrier controlling the passage of substances from the blood into the brain tissue and cerebrospinal fluid.

Stands for body mass index and is the most widely used definition of an individual’s degree of obesity. The index is derived by dividing the person’s weight in kg by the square of the height in meters, hence the units (kg/m2). Normal BMI is from 18.5 to 24.9, overweight is from 25-29.9, obesity (grade 1) is from 30-34.9, obesity (grade II) is 35-39.9 and obesity grade III is > 40.

The amount of drug swallowed at one time.

The large air-tubes or conducting airways of the lungs (one such tube is a bronchus).

Small subdivisions and tiny branches of air tubes within the bronchi.

A yeast or fungi sometimes found in living humans (skin, mouth, gut, vagina), that can utilize glucose to produce ethanol.

A small blood vessel that branches from an artery; capillaries connect arteries to veins. Exchange of oxygen, nutrients and waste material takes place across capillary walls.

Transferrin is a glycoprotein normally present in serum which helps to transport and delivery iron to the body. The analysis of CDT (a carbohydrate deficient form) has proven to be a sensitive and specific biological marker of heavy continuous drinking. After drinking about 80 g ethanol per day for men and 60 g per day for women for 7 continuous days CDT levels are elevated.

The central part of the nervous system consisting of the brain and spinal cord.

The structure at the base of the brain involved in the control of muscle tone, balance, and sensorimotor coordination.

This is the outer layer of gray matter covering the cerebellum. The cerebral cortex processes sensory information for controlling motor functions, speech, higher cognitive functions, emotions, behavior, and memory.

The clear fluid that fills the cavities (ventricles) that surround the brain and spinal cord.

The procedure used to document how laboratories receive and handle specimens from the moment of collection, during transport, arrival at the laboratory, and during the testing process.

As it relates to DUI, a test of the alcohol or drug concentration in a person's blood. A breathalyzer, blood analysis, or urinalysis can be used as chemical tests for alcohol. If other drugs are suspected, a blood test or urine test is used.

Microscopic rod-shaped structures composed of double stranded DNA and proteins and located within the cell nucleus. There are normally 46 chromosomes 23 inherited from each parent.

The gradual decrease in degree of intoxication at the same blood alcohol level in the course of repeated exposures.

Advanced liver disease in which the liver cells have died, hardened and turned an orange color.

A clandestine laboratory is a secret and unlawful facility for production of narcotic drugs. These labs take many forms and might be a kitchen, garage, bathroom, or out-house equipped with the necessary glassware, apparatus, chemicals, organic solvents, and other materials necessary for the synthesis, isolation, or purification of drugs of abuse.

This entails the examination of some part of the living patient – his excreta, or blood or secretions – to help the physician reach a diagnosis or provide a better treatment.

The term cognition involves all the mental functions through which information and knowledge is processed. It includes global functions such as consciousness, drive and attention as well as specific functions like memory, language and calculations.

The major protein of fibrous connective tissue e.g. tendons and ligament involve din the production of scar tissue produced in the liver.

The quantity of substance contained in a unit quantity of sample. When working with solutions, the recommended unit of concentration is grams of solute per liter of solution.

Substance or thing of the same kind or form, e.g. the other constituents of alcoholic beverages besides alcohol and water such as other higher alcohols, aldehydes and esters.

Tests performed in parallel with experimental samples and designed to demonstrate that a procedure worked correctly.

Chronic obstructive pulmonary disease is characterized by airflow limitations caused by chronic bronchitis and emphysema. Those suffering from COPD have reduced forced expiratory volumes and might be unable to satisfy the breath-sampling requirements with some breath-alcohol analyzers. ref. NEJM 343;269-279, 2000.

A statistic which measures the strength of the relation between two methods of measurements (association), but not whether two methods agree. It is important to note that high correlation does not necessarily mean good agreement.

Is a waste product derived from creatine a substance synthesized from amino acids mainly in muscle cells. Creatinine is excreted in the urine without being reabsorbed and U-creatinine analysis is therefore used as a test for impaired renal function. In connection with urine-drug testing, a creatinine concentration below 0.2 g/L indicates a highly dilute specimen.

This refers to the response in an assay caused by a substance other than the target drug being analysed. Usually an antibody for an immunoassay recognises only a part of the target drug by binding to a specific functional group or structure in the molecule.

A family of enzymes that can metabolize (detoxify) foreign chemical substances that enter the body as well as many endogenous species. The P450 enzymes are found in the microsome fraction of cells especially liver cells (hepatocytes). The particular P-450 enzyme that metabolizes ethanol is denoted P450IIE1.

Or cytosol is the soluble fraction or jelly-like substance within cells and outside the nucleus where many of the cell’s biochemical reactions take place.

These represent a class of psychoactive drugs, both licit and illicit, that relieve anxiety by depressing the central nervous system (CNS). Such drugs have a high abuse potential and ethyl alcohol is the prime example along with barbiturates and the sedative hypnotic chloral hydrate.

The organs responsible for getting food into and out of the body consisting of the esophagus, stomach, liver, gallbladder, pancreas, small intestine, colon and rectum.

Have a maximum alcohol concentration of 100%, though most are in the 40-50% range.

The moving of alcohol from the blood to the tissues.

The transport of absorbed drug or alcohol by the blood-stream to all parts of the body. The distribution of alcohol follows the distribution of body water and the rate of distribution depends on the rate of flow of blood to various organs and tissue.

A drug that promotes water excretion through an increase in the volume of urine.

Department of motor vehicles, also referred to as the licensing bureau.

Deoxyribonucleic acid, a family of large molecules within the cells of an organism that carry genetic information by specifying the structure of proteins. DNA is composed of a linear sequence of nucleotides.

The cancellation of driving privileges. The offender must reapply for a driver's license after a designated length of time.

The temporary withholding of driving privileges. An offender's license is withheld for a given period then returned.

Any chemical substance that influences body function.

Driving under the influence of alcohol or drugs. A crime that can result in fines, suspension or revocation of driver's license, or jail time.

The first part (~12 inches) of the small intestine from the pylorus to the jejunum.

Driving a vehicle while intoxicated.

Is the popular name for the drug 3,4-methylenedioxymethamphetamine (MDMA). Like amphetamine, MDMA is a derivative of phenethylamine.

Excess accumulation of fluid in body tissues usually resulting in swelling.

A spectrum of electromagnetic radiation or energy ranging from very high energy (short wavelength) such as gamma rays to very low energy (long wavelength) such as radio waves. X-rays, ultraviolet, visible, infrared, and microwaves are other examples of electromagnetic radiation.

The term used to denote removal of a drug (e.g. alcohol) from the body. The process of elimination involves both metabolic breakdown (biotransformation) and removal in an unchanged form in breath, urine, and sweat (excretion).

The removal of alcohol from the body.

Is an acronym for Enzyme Multiplied Immunoassay a modern technique of chemical analysis. This method of analysis is a homogenous assay which does not require a prior clean-up or extraction of analyte prior to analysis. EMIT involves an antibody-antigen reaction where a candidate drug in the biological specimen (urine or blood) and the same drug labelled with the enzyme e.g. glucose-6-phosphate dehydrogenase compete for binding sites on the antibody.

Ductless glands that secrete hormones into the bloodstream. The pituitary, adrenal, and thyroid glands are examples.

This is the study of hormones and their effects and the system of glands that produce hormones.

Produced or originating within the body by natural processes such as metabolism.

Membrane structure within the cytoplasm of cells.

Protein molecules that serve to speed-up chemical reactions in the body - An enzyme acts as a catalyst for promoting biochemical reactions.

Derived from the Greek epidemia or prevalence of disease. The branch of medical science concerned with the incidence and distribution of disease.

The term epilepsy applies to a group of central nervous system disorders characterized by recurrent seizures, which are sometimes called convulsions. Seizures can affect vision, speech or movement and can affect only part of the brain.

The name given to the red blood cells.

A tube connecting the pharynx with the stomach.

The alcohol found in alcoholic beverages is ethyl alcohol (ethanol).

Elimination of alcohol from the body in an unchanged state.

Is the removal of a drug or alcohol in an unchanged form in body excreta - urine, breath, sweat, stools, and saliva (if not swallowed).

These are glands that secrete their product out of the gland through a duct and into a cavity; the enzyme producing glands of the pancreas are typical examples.

Produced or originating outside the body.

A test programs whose design and management are outside the control of the participating laboratory.

Fluid outside the cells (interstitial fluid and plasma) amounting to about 20% of body weight.

The process of computing BAC at a given time using physical characteristics of the drinker, the quantity of alcohol consumed and the period of time over which alcohol is consumed and when alcohol was last consumed. Sometimes referred to as retro-grade extrapolation.

Outside of the blood stream.

This is the proportion of subjects with the disease but who give a negative test result.

This represents the proportion of healthy subjects who give a positive test result when screened for a certain disease state.

A compound made up of a hydrocarbon chain (either saturated or unsaturated) terminating in a carboxylic acid group.

An accumulation of fat in the liver representing the first stage of deterioration of the organ often the result of a period of heavy drinking. Fatty liver is reversible after a period of abstinence.

An enzymatically controlled anaerobic decomposition of carbohydrates to carbon dioxide and ethanol.

The formation of fibrous (scar) tissue another intermediate stage of liver deterioration.

This refers to the metabolism (removal) of part of the dose of a drug such as alcohol when administered orally before it reaches the systemic circulation. First-pass metabolism can occur either in the stomach or in the liver and for some substances also in the lung.

From the Latin word forensis meaning of the forum. In ancient Rome the forum was where debates took place and as such served as the courtroom.

Molecular intermediates that have a single unpaired electron and often arise during oxidation reactions. They are highly reactive and readily attack other molecules.

G-proteins are involved in signal transduction through the cell membrane and have the ability to activate different cellular amplifier systems. They get their name because they bind guanosine triphosphate (GTP). Various aspects of alcohol addiction such as development of tolerance and dependence may depend on altered signals through G-proteins. The discovery of G-proteins and the elucidation of their function by the US scientists Gilman and Rodbell was recognized by the award of the Nobel prize in Medicine or Physiology for 1994.

Gamma aminobutyric acid a major inhibitory neurotransmitter within the brain and is involved in the mechanism of alcohol’s effects on behavior.

An analytical technique for separating volatile substances on the basis of their solubility and volatility.

Surgery to remove part of the stomach.

A surgical operation to treat grossly obese individuals. The operation involves dramatically reducing the size of the stomach.

A combination of DNA segments that together constitute a unit capable of expressing one or more functional gene products.

An agent (drug) that renders a person unconscious and oblivious to pain.

A nonproprietary drug name usually describing the drug’s chemical structure and which is not protected by a trademark.

Abbreviation for gastroesophageal reflux disease which is a clinical syndrome that manifests as heartburn and regurgitation owing to reflux of gastric contents into the esophagus.

A hormone secreted by cells of the pancreas in response to low blood sugar. This hormone promotes an increase in blood sugar levels by initiating the breakdown of liver glycogen to produce glucose.

The synthesis of glucose molecules from non-carbohydrates such as protein and fat. This process begins when blood glucose levels are diminished and cellular levels of carbohydrates are depleted.

An amino acid that serves as the major excitatory neurotransmitter in the brain.

An antioxidant molecule found naturally in the body, composed of three amino acids, glutamate, cysteine and glycine.

A polysaccharide and the principle carbohydrate reserve in the body. Excess glucose is converted to glycogen and is stored in the liver and muscle. Glycogen can be converted easily into glucose when more energy is required.

Formation of glycogen from glucose molecules.

Hydrolysis of glycogen to glucose.

The metabolic breakdown of glucose to pyruvic acid.

A painful metabolic disorder characterized by accumulation of urate (uric acid crystals) which deposit in the joints - often a side effect of heavy drinking.

Are substances that bring about a state of dreaming or wandering of the mind characterized by an altered perception of sight and hearing. Hallucinogens e.g. LSD (lysergic acid diethylamide) are psychoactive substances often occurring naturally in various plants or fungi and if taken alter mood and perceptions of reality.

The percentage of blood volume occupied by erythrocytes, 44-54% in men and 38-48% in women.

The bursting of red blood cells.

A law of physical chemistry which says that at a certain temperature (34°C) the concentration of a volatile substance (alcohol) in the air above a fluid is proportional to the concentration of the volatile substance in the fluid. Diffusion of blood alcohol into deep lung air is governed by this principle.

The vein that receives blood after it passes through the central veins of the liver and transports blood into the inferior vena cava of the heart.

Generalized inflammation of the liver, often accompanied by tissue death and fibrosis (scar tissue). Alcoholic hepatitis can prove fatal but is reversible with abstinence.

The name given to the principal cells within the liver responsible for most of the metabolic activity.

Distillers measured it by mixing equal amounts of gunpowder and whiskey in small amounts and then lit a match to the mixture. If it did not burn, the whiskey was too weak. If it burned with a steady blue flame then this was proof that the alcoholic content was right.

The maintenance of relatively constant internal body conditions; a state of equilibrium within the body with respect to functions, composition of fluids and tissues.

A chemical messenger produced in an organ or tissue and transported to another part of the organism where it produces a behavioral or physiological response (effect).

A class of organic compounds only containing hydrogen and carbon atoms in various proportions.

Attracts water - water liking

A condition resulting when an excessive amount of glucose is dissolved in the blood.

High blood pressure.

An abnormally low concentration of glucose in the circulating blood.

The term hypoventilation defines a condition in which alveolar ventilation is insufficient to meet the metabolic demands of the individual and this results in an inappropriate tension of carbon dioxide.

Lower than normal level of oxygen in the blood or tissue.

Operating any vehicle while one's faculties are affected by alcohol and/or other drugs, medications, or other substances.

The influence of alcohol or a drug manifested in the subject's decreased ability to perform a given task safely.

One Beer (12 oz, 4.5%) = One Glass of Wine (4.5 oz, 12%) = One Mixed Drink (1.5 oz, 40%)

From the Latin meaning in glass a term commonly used to signify experiments in a test tube or flask as opposed to in the living organism.