Transdermal Monitoring Systems

These types of technologies measure alcohol levels that are excreted through the skin. Earlier efforts focused on liquid sweat. Later methods measure alcohol vapor levels above the skin known as "insensible perspiration." This technology is not meant to replace BAC testing as its accuracy is not of the level of BAC testing. Transdermal measuring does indicate if there has been a drinking episode.

McKnight, A. Scott, et al., “Transdermal Alcohol Monitoring: Case Studies,” National Highway Transportation Safety Administration (2012).  This study surveys the use of transdermal alcohol monitoring as used in a wide variety of programs nationally.

Dougherty, Donal. M.,et al., "Comparing the Detection of Transdermal and Breath Alcohol Concentrations During Periods of Alcohol Consumption Ranging From Moderate Drinking to Binge Drinking," Experimental and Clinical Psychopharmacology (2012)  This research compares transdermal alcohol concentration and breath alcohol concentration readings during the consumption of alcohol ranging from moderate drinking to binge drinking in 22 adult regular drinkers in order to investigate the sensitivity and specificity of the transdermal alcohol concentration monitors.

Leffingwell , Thad R. et al.,  "Continuous Objective Monitoring of Alcohol Use: Twenty-First Century Measurement Using Transdermal Sensors," Alcoholism: Clinical and Experimental Research (2012)  This article describes the development and evaluation of currently available transdermal alcohol sensors, present the strengths and limitations of the technology, and gives examples of recent research using the sensors.

"Summary of Evidentiary & Probation Violation Hearings," Alcohol Monitoring Systems, Inc, (2012). Since 2003, AMS has been working with courts and ancillary agencies to provide comprehensive SCRAMx testimony, which has included the creation of nearly 2,000 formal court reports used to detail the monitoring results of offenders who denied a SCRAMx violation (either alcohol consumption, equipment tampering, or a combination).

Marques, Paul R. and A. Scott McKnight. "Evaluating Transdermal Alcohol Measuring Devices," NHTSA, (November 2011). This report is an evaluation study of two types of transdermal devices that detect alcohol at the skin surface representing two types of electrochemical sensing technology: the AMS SCRAM™ ankle device and the Giner WrisTAS™ wrist device. The report summarizes comments from research subjects, offenders, and vendors who manage transdermal detection programs.

Barnett, Nancy P, Jennifer Tidey, James G. Murphy, Robert Swift, and Suzanne M. Colby. "Contingency Management for Alcohol Use Reduction: A pilot study using a transdermal alcohol sensor," Drug and Alcohol Dependence 118, 2-3 (2011). The purpose of this study was to evaluate the efficacy of CM for reduction in alcohol use, using a transdermal alcohol sensor to provide a continuous measure of alcohol use. Results support the efficacy of CM for alcohol use reductions and the feasibility of using transdermal monitoring of alcohol use for clinical purposes.

"Secure Continuous Remote Alcohol Monitor: SCRAM," Alcohol Monitoring Systems, Inc, (2012). This slideshow provides information on how the SCRAM bracelet works and its overall success rate in a variety of studies.

Litten, Raye Z., Ann M. Bradley and Howard B. Moss. "Alcohol Biomarkers in Applied Settings: Recent advances and future research opportunities," Alcoholism: Clinical and Experimental Research 34, 6 (2010). While there have been several advances in the past decade in the identification, development, and application of alcohol biomarkers, more research is needed to validate biomarkers, especially the ones in humans.

Hlastala, Michael P. "Limitations in Transdermal Alcohol Monitoring," Law & Science 24, 8 (August 2009). One concern with transdermal alcohol monitoring is the impact of human variability of skin diffusion properties. In order to create a TAC plot so that the amplitude of the TAC plot resembles the amplitude of the BAC plot, AMS chooses to multiply the TAC values by an average of 1.4, the average reduction of TAC from the BAC after diffusion through the skin. However, this correction factor varies among individuals and can lead to inaccurate readings.

Piterbarg, Yuliya. "Population Modeling and Bayesian Estimation for the Deconvolution of Blood Alcohol Concentration from Transdermal Alcohol Biosensor Data," University of Southern California, Department of Philosophy, (2009). This study develops statistical methods to estimate blood alcohol concentration (BAC) from trans-dermal alcohol concentration (TAC) measurements supplied by a transdermal alcohol sensor (TAS). A study was conducted on 17 healthy volunteers and the results are recorded.

Marques, Paul R. and A. Scott McKnight. "Field and Laboratory Alcohol Detection with 2 Types of Transdermal Devices," Alcoholism: Clinical and Experimental Research 4, 33 (2009). Two types of transdermal electrochemical sensors that detect alcohol at the skin surface were evaluated: the AMS SCRAMTM device and a Giner WrisTASTM device. Each device had peculiarities that reduced performance, but both types are able to detect alcohol at the skin surface. With product improvements, transdermal sensing may become a valuable way to monitor the alcohol consumption of those who should be abstaining.

Ayala, Jessica, Kelsie Simons, and Sarah Kerrigan. "Quantitative Determination of Caffeine and Alcohol in Energy Drinks and the Potential to Produce Positive Transdermal Alcohol Concentrations in Human Subjects," Journal of Analytical Toxicology 33, 1 (2009). The purpose of this study was to determine whether non-alcoholic energy drinks could result in positive "alcohol alerts" based on transdermal alcohol concentration (TAC) using a commercially available electrochemical monitoring device. Based on these results, it appears that energy drink consumption is an unlikely explanation for elevated TACs that might be identified as potential drinking episodes or "alcohol alerts" using this device.

State of South Dakota v. Neal J Lemler , Supreme Court of the State of South Dakota, (September 2009). The court ruled that the mythology utilized in Lemler's alcohol monitoring bracelet met the Daubert standard for admissibility of scientific evidence.

State of Indiana v. Jennifer L. Mogg , Court of Appeals of Indiana, (December 2009). Mogg appealed the revocation of her probation because she believed the trial court abused its discretion in admitting evidence of her alcohol consumption generated by the SCRAM system. The appellate court concluded that the trial court did not abuse its discretion in determining the SCRAM readings were sufficiently reliable to be admissible as evidence in this case.

Pollard, John K, Eric D. Nadler and Mary D. Stearns. "Review of Technology to Prevent Alcohol-Impaired Crashes," NHTSA, (September 2007). This report assesses the ability of technologies, existing and anticipated, to detect driver impairment from alcohol and identifies international state-of-the-art vehicle-based technology options to prevent alcohol-impaired automotive crashes.

Compton, Richard P. and James Hedlund. "Reducing Impaired-Driving Recidivism Using Advanced Vehicle-Based Alcohol Detection Systems: A Report to Congress," NHTSA, (December 2007). Several alcohol detection technologies were reviewed in the report: Breath sample analysis, tissue spectroscopy, transdermal perspiration measurement, eye movements, detecting alcohol vapor in the vehicle, driver and driving performance measurement. The report offers suggestions for potential next steps including increasing the use of breath alcohol ignition interlocks among DWI offenders and continuing research and development on tissue spectroscopy and other transparent and non-invasive methods of measuring alcohol in drivers.

Hawthorne, J.S. and M.H. Wojcik. "Transdermal Alcohol Measurement: A Review of the Literature," Canadian Society of Forensic Science Journal 39, 2 (2006). The body of scientific literature on transdermal alcohol testing dates back almost 70 years. Based on published research in this field, one can conclude that measuring alcohol transdermally on a constant basis provides an effective screen for alcohol consumption and a reasonable approximation of the magnitude of that consumption.

Sakai, Joseph T, Susan K. Mikulich-Gilbertson, Robert J. Long, and Thomas J. Crowley. "Validity of Transdermal Alcohol Monitoring: Fixed and Self-Regulated Dosing," Alcoholism: Clinical and Experimental Research 30, 1 (2006). To purpose of this laboratory study was to test the validity of transdermal assessment of alcohol concentration measured by a lightweight, noninvasive device. The results concluded that the device consistently detected consumption of approximately 2 standard drinks. On average, the device shows discriminative validity as a semi-quantitative measure of alcohol consumption but individual readings often are not equivalent to simultaneous BrACs.