We all have had this scenario...a patient comes to the ED or is getting admitted for a medical complaint...and you notice a few findings on their lab tests that make you wonder if they have an alcohol use disorder. An elevated MCV. An elevated AST. Have you ever asked yourself - how accurate are these tests are detecting and diagnosing an alcohol use disorder? Or on the flip side - how often do we see a patient presents to the ED requesting help with alcohol after years of heavy drinking and has essentially normal labs? In this episode we dig into the limited literature on this topic and try to answer the question - how accurate are lab tests in determining if a person is consuming alcohol, and if so how much?