I am a substance abuse counselor working with the Juvenile Drug Court Program in Las Cruces, New Mexico. One of our many policies is to administer random urinalysis on all of our clients. We have one female client, age 15, with type 2 diabetes. Almost all of her results have been positive for alcohol. Some of the levels have had alarmingly high levels of alcohol. Can you give me any information on why this may be so? Is this related to her diabetes? We are positive that she has not ingested alcohol.

I think there are two possible explanations for the finding of alcohol in the test urine samples. The first is that your vigilance over alcohol ingestion may have been eluded, but, in view of the occasional ‘alarmingly high level’, I think it more likely that alcohol was added directly to the specimen, possibly as a plea for continuing help.

The other possibility, in someone who has diabetes, is that acetone is being incorrectly identified as alcohol. Acetone in this instance may be due to insufficient nutrition or to insufficient insulin and needs to be investigated. Leaving aside the possibility of test interpretation error, identifying acetone in urine can easily be done in a few seconds by one of the dipstick tests which would be available in any doctor’s office, but the test would still be best done by someone who uses it routinely.

DOB