Continuous Alcohol Monitoring Programs: ​

Challenges and Implications

From - Counterpoint Volume 8; Issue 4 - Article 5 (March 2025)

An article for participants in the myCAMprogram

Jan Semenoff, BA, EMA
​Forensic Criminalist

Article information:

Article - 800 words (approximately 4-6 minutes)
This is Part 2 of a series of articles on Continuous Alcohol Monitoring programs. CLICK HERE for Part 1
Continuous Alcohol Monitoring (CAM) is often used when a person is ordered by a court, probation officer, or parole board to stay alcohol-free. CAM can be ordered after an alcohol-related offense, like DUI, or as part of another court case. It can be part of pre-trial release, probation, or a treatment program. CAM is also used in family court cases.
Courts like CAM because it promises:
  • 24/7 monitoring
  • An alternative to jail
  • Greater accountability
There are three main types of CAM devices:
  • Transdermal ankle monitors: Worn on your ankle. They measure alcohol that leaves your skin. Most record data every 30 minutes.
  • Ignition interlock devices (IIDs): Installed in your car. You must pass a breath test before the car will start. They use fuel cell sensors and often take a photo or video to confirm your identity.
  • Handheld breath testers: You blow into them when prompted, often at random times. They may track your location and take a photo or video.
These devices send results to the monitoring agency, which may use them to decide if you are following the rules. But CAM systems are not perfect. They can give false positive results, the data can be hard to interpret, and devices can malfunction.
 

Why This Matters to You

If you are in a CAM program, your results can affect:
  • Your freedom
  • The length of your program
  • Your ability to keep a job or see your family
A single reading on your device could be misunderstood. Knowing about common problems with CAM devices can help you protect yourself.

False Positive Readings

CAM devices can give false positive results — readings that say you drank when you did not.
Why this can happen:
  • Transdermal monitors can detect alcohol from products like hand sanitizer, cologne, or cleaning solutions.
  • Fuel cell breath testers can react to chemicals like isopropanol or acetone. Your body can produce these naturally during fasting, dieting, or diabetes. They can also be found in many workplaces.
​Even when the devices use strict filters to screen results, false positives can still happen. And sometimes these filters hide problems in the data.
What this means for you:
  • If you get a positive result, it is not always proof you drank.
  • You need to know and follow rules to avoid contamination.
  • Keep your own records so you can show what happened if there is a dispute.

Understanding the Data

​CAM devices measure transdermal alcohol concentration (TAC). This is not the same as blood alcohol concentration (BAC).
Key points:
  • TAC readings lag behind BAC changes.
  • Results are affected by skin type, sweating, hydration, and metabolism.
  • Mathematical formulas are used to decide when TAC data becomes a reportable event — but these formulas can vary depending on where you are.
  • Gender, body mass, and health conditions can all change how the device reads your alcohol level.
Why this matters:
  • Your reading needs to be understood in context — when it happened, what you were doing, and any other factors.

Calibrations and Malfunctions: A Continuing Concern

CAM devices use fuel cell technology and must be calibrated regularly to stay accurate
​Problems that can occur:
  • Missed calibrations can cause wrong readings.
  • Software problems or sensor failures can create missing or inaccurate data.
  • Different device models have different maintenance needs. 
What you can do:
  • Ask about your device’s calibration schedule.
  • If there’s a problem, make a note of it and tell your lawyer or program supervisor.

Protecting Yourself in a CAM Program

​If you are in a CAM program, these steps can help you avoid or address problems:
1. Check Calibration Records
Find out when your device was last calibrated and if it has a history of problems.
2. Look at the Context
If you get a positive reading, think about what you were doing. Were you around products or environments with alcohol? Did you have a medical condition that could affect readings?
3. Understand the Limits of CAM Data
A single CAM reading is not the same as a police breath test result. Knowing the difference can help in your defense.
4. Watch for Device Problems
If the device stops working, acts strangely, or misses readings, record it.
5. Get Expert Help
Experts in alcohol testing can explain how CAM devices work and why readings may not always be accurate.

The Role of Education

Many CAM participants are never told:
  • How their device works
  • What products or conditions can trigger false positives
  • How to respond to alerts
  • How to keep records that can protect them
​The MyCAMprogram was created to fill this gap. It teaches:
  • How to avoid false positives
  • How to substitute safe products
  • How to document your activities and health issues
Participants who are educated about their devices are less likely to have problems — and more prepared to handle them if they occur.

Key Takeaways

  • CAM results are not always right — false positives and errors happen.
  • TAC and BAC are different, and TAC readings can be affected by many factors.
  • Calibration and maintenance are essential for accuracy.
  • Your own records can protect you if there’s a problem.
  • Education helps you avoid and respond to false positives.

Practice Tip

If you get a positive result and haven’t been drinking, ask for a retest right away. Write down everything you did, ate, drank, or used in the past 24 hours.

Final Reminder

​CAM programs can help courts monitor alcohol use — but they are not perfect. False positives, data interpretation problems, and equipment issues can happen. Knowing these risks and keeping your own records will help protect you and give you the best chance of completing your program successfully.

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For further study:

  1. Karns‐Wright et al. "The correspondence between transdermal alcohol monitoring and daily self-reported alcohol consumption" Addictive behaviors (2018) doi:10.1016/j.addbeh.2018.06.006.
    https://www.sciencedirect.com/science/article/abs/pii/S030646031830618X?via%3Dihub
  2. Barnett et al. "Predictors of detection of alcohol use episodes using a transdermal alcohol sensor." Experimental and clinical psychopharmacology (2014) doi:10.1037/a0034821. https://psycnet.apa.org/doiLanding?doi=10.1037%2Fa0034821
  3. Dougherty 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) doi:10.1037/a0029021. https://psycnet.apa.org/doiLanding?doi=10.1037%2Fa0029021
  4. Voas "Monitoring Drinking" Transportation research record journal of the transportation research board (2010) doi:10.3141/2182-01. https://journals.sagepub.com/doi/10.3141/2182-01
  5. Dougherty et al. "The Potential Clinical Utility of Transdermal Alcohol Monitoring Data to Estimate the Number of Alcoholic Drinks Consumed" Addictive disorders & their treatment (2015) doi:10.1097/adt.0000000000000060. https://journals.lww.com/addictiondisorders/abstract/2015/09000/the_potential_clinical_utility_of_transdermal.2.aspx
  6. Simons et al. "Quantifying alcohol consumption: Self-report, transdermal assessment, and prediction of dependence symptoms" Addictive behaviors (2015) doi:10.1016/j.addbeh.2015.06.042. https://www.sciencedirect.com/science/article/abs/pii/S0306460315002403?via%3Dihub
  7. Hill‐Kapturczak et al. "Accounting for sex-related differences in the estimation of breath alcohol concentrations using transdermal alcohol monitoring" Psychopharmacology (2014) doi:10.1007/s00213-014-3644-9. 8. https://link.springer.com/article/10.1007/s00213-014-3644-9
  8. Barnett et al. "Contingency management for alcohol use reduction: A pilot study using a transdermal alcohol sensor" Drug and alcohol dependence (2011) doi:10.1016/j.drugalcdep.2011.04.023. https://www.sciencedirect.com/science/article/abs/pii/S0376871611002080?via%3Dihub
  9. Hill‐Kapturczak et al. "Do Variable Rates of Alcohol Drinking Alter the Ability to Use Transdermal Alcohol Monitors to Estimate Peak Breath Alcohol and Total Number of Drinks?" Alcoholism clinical and experimental research (2014) doi:10.1111/acer.12528. https://onlinelibrary.wiley.com/doi/10.1111/acer.12528
  10. Nishank "Peri-Operative Management of Patients with Continuous Alcohol Monitoring Devices: A Case Report and Review of Literature." Journal of anesthesia and anesthetic drugs (2022) doi:10.54289/jaad2200104. https://www.acquirepublications.org/Journal/Anesthesia/Articles/JAAD2200104
  11. Jalal et al. "Development and Characterization of Fuel Cell Sensor for Potential Transdermal Ethanol Sensing" Ecs transactions (2016) doi:10.1149/07231.0025ecst. https://iopscience.iop.org/article/10.1149/07231.0025ecst
  12. Mathias et al. "Estimating resource utilization demands in implementing statewide screening, brief intervention, and referral to treatment for alcohol-impaired drivers" Traffic injury prevention (2019) doi:10.1080/15389588.2018.1528500. https://www.tandfonline.com/doi/full/10.1080/15389588.2018.1528500
  13. Calverley et al. "A systematic review of alcohol education programs for young people: do these programs change behavior?" Health education research (2020) doi:10.1093/her/cyaa049. https://academic.oup.com/her/article-abstract/36/1/87/6031209?redirectedFrom=fulltext
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