Cocaethylene as a Biomarker in Human Hair of Concomitant Alcohol and Cocaine Use in a High-risk Population

Cocaethylene (CE) is a cocaine metabolite formed during alcohol and cocaine co-consumption. To our knowledge, no previous studies were conducted assessing CE as a biomarker indicating chronic excessive alcohol consumption in a suspected high-risk population. In this study, we hypothesized that hair CE can be an effective marker for alcohol consumption in a high-risk population. We recorded cocaine, benzoylecgonine, and CE levels in hair samples from individuals, establishing the predictive value of CE by comparing it to hair levels of the widely used hair fatty acid ethyl esters (FAEE), direct markers of chronic excessive alcohol consumption. CE had 14.04% sensitivity and 95.18% specificity in samples separating FAEE positive/negative results. The positive predictive value was 0.66, showing that the results for individuals with CE positive results were more than likely to be FAEE positive, but not conclusively. Thus, CE cannot be used as a definitive marker, indicating chronic excessive alcohol consumption.MAS