Evaluation and application of a urinary diethylamine method to measure compliance with disulfiram therapy.

Abstract

The detection of a disulfiram (DS) metabolite in urine can be used to monitor alcoholics'' complicance with DS therapy. The metabolite, diethylamine (DEA), was detected after derivation with 3,5-dinitrobenzoyl chloride and TLC of the product. Urine specimens were positive for DEA for an average of 34 h after a single 500-mg dose of DS and for 73.5 h after the last of 3 daily doses. Among urine specimens from 52 hospitalized alcoholics (30 receiving DS) tested for DEA, there were no false-positives or false-negatives. An additional group of 21 men (10 receiving DS) were followed-up for 1 yr, urine samples being collected at each office visit. Of the 149 urine samples obtained from men given DS, 51% were positive for DEA, a complicance rate similar to that of outpatients prescribed other drugs. Abstinence correlated significantly with compliance: 4 men abstinent throughout the year had 66% of their urine samples positive, while among 6 nonabstinent men, only 32% of the urines contained DEA.