Alcohol Use Disorders Identification Test - C (AUDIT-C)
A 3-item tool to screen for unhealthy alcohol use in patients who may not be alcohol-dependent.
Provided by
EVAL FoundationInstructions
- Answer up to 3 questions about your alcohol use over the past year.
- Choose the answer that is most accurate for you.
- Your total score and risk level will be calculated and displayed after you answer all questions.
- Please discuss these results with a healthcare provider. This tool is for screening, not for diagnosis.
Standard Drink Equivalents
Because alcohol can affect your health and can interfere with certain medications and treatments, it is important that we ask some questions about your use of alcohol. Your answers will remain confidential so please be honest. Make a selection that best describes your answer to each question over the past year.
Purpose and Use
The Alcohol Use Disorders Identification Test - C (AUDIT-C) is a 3-item screening tool that is a shortened version of the 10-item AUDIT tool developed by the World Health Organization (WHO) to assess alcohol consumption, drinking behaviors, and alcohol-related problems. The primary purpose of the 10-item AUDIT is to help identify individuals with hazardous or harmful patterns of alcohol consumption, as well as those with potential alcohol dependence. According to auditscreen.org, briefer versions of the AUDIT have been shown to be convenient and effective instruments for diagnosing alcohol use disorders in the a primary care setting. A 'standard drink' is defined as containing approximately 14 grams of pure alcohol (e.g., 12 oz of beer, 5 oz of wine, or 1.5 oz of spirits).
To diagnose an alcohol use disorder (AUD), further evaluation is warranted. The AUDIT-C is more effective in detecting heavy drinking and can help distinguish active and past problem drinking better than other screening questionnaires, such as the 4-item CAGE questionnaire.
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Summary
The Alcohol Use Disorder Identification Test (AUDIT) implemented in this evaluation is a modified, shortened version of the 10-question AUDIT assessment. The modified version is a 3-question alcohol screening tool (AUDIT-C) that assists in identifying persons who may have an active alcohol use disorder (AUD).
Scoring
Answers are assigned points (except for sex). The sum of these points (12 points possible) from three alcohol assessment questions determines the score and risk. If the first question about alcohol consumption is "never" then the remaining two questions will be skipped.
- Normal alcohol consumption (females <3)
- Normal alcohol consumption (males <4)
- Risk for alcohol misuse (female ≥ 3)
- Risk for alcohol misuse (male ≥ 4)
- Risk for possible liver damage (Score ≥ 5)
- Healthcare practitioner note: Confirm accuracy - Review patient's alcohol intake over the past months
- When points are only from Questions 1, they are often drinking below the AUDIT-C cutoff.
- Question 1: How often did you have a drink containing alcohol in the past year?
- Clarify with patient by reviewing alcohol intake over the past few months.
- When points are only from Questions 1, they are often drinking below the AUDIT-C cutoff.
Practitioner Next Steps
If you suspect the patient is minimizing their alcohol use, or if the patient's score is near the cutoff, consider utilizing a more comprehensive screening tool to understand the nature and extent of alcohol use.
Comprehensive validated tests for further assessment include:
- Michigan Alcoholism Screening Test (MAST)
- Alcohol Use Disorders Identification Test (AUDIT)
When screening results are positive, consider assessing the patient for alcohol withdrawal syndrome.
- In any potential setting where access to alcohol may be limited, monitor for signs or symptoms of withdrawals, even in patients who do not screen positive for alcohol misuse.
- The Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA-Ar) is a 10-item questionnaire that assess the signs, symptoms and severity of alcohol withdrawal to guide outpatient treatment.
Primary Reference: Babor, T.F., Higgins-Biddle, J.C., Saunders, J.B., & Monteiro, M.G. (2001). AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care (2nd ed.). World Health Organization.
Limitations
The AUDIT is a screening tool and not a substitute for a comprehensive diagnostic assessment by a qualified healthcare professional. Its accuracy depends on the patient's honest self-reporting, which may be influenced by recall bias or a reluctance to disclose heavy drinking. The definition of a 'standard drink' can also vary by country, which may require clarification for the user.
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All questions & possible results
Standard Drink Equivalents
Because alcohol can affect your health and can interfere with certain medications and treatments, it is important that we ask some questions about your use of alcohol. Your answers will remain confidential so please be honest. Make a selection that best describes your answer to each question over the past year.
Sex
Select one option:
- Male
- Female
1. How often did you have a drink containing alcohol in the past year?
Select one option:
- Never
- Monthly or less
- 2 to 4 times a month
- 2 to 3 times per week
- 4 or more times a week
2. How many drinks containing alcohol did you have on a typical day when you were drinking in the past year?
Select one option:
- 1 to 2 drinks
- 3 or 4
- 5 or 6
- 7 to 9
- 10 or more
3. How often did you have 6 or more drinks on one occasion in the past year?
Select one option:
- Never
- Less than monthly
- Monthly
- Weekly
- Daily or almost daily
Possible results
Normal alcohol consumption (females <3)
- Your score indicates a low level of risk for alcohol-related problems. It is recommended to continue responsible drinking habits. If you have any concerns, please discuss them with a healthcare provider.
- Your healthcare provider may provide feedback or no further action depending on your health status or medication use.
Limitations
The AUDIT is a screening tool and not a substitute for a comprehensive diagnostic assessment by a qualified healthcare professional. Its accuracy depends on the patient's honest self-reporting, which may be influenced by recall bias or a reluctance to disclose heavy drinking. The definition of a 'standard drink' can also vary by country, which may require clarification for the user.
Practitioner Next Steps
If you suspect the patient is minimizing their alcohol use, or if the patient's score is near the cutoff, consider utilizing a more comprehensive screening tool to understand the nature and extent of alcohol use.
Comprehensive validated tests for further assessment include:
- Michigan Alcoholism Screening Test (MAST)
- Alcohol Use Disorders Identification Test (AUDIT)
When screening results are positive, consider assessing the patient for alcohol withdrawal syndrome.
- In any potential setting where access to alcohol may be limited, monitor for signs or symptoms of withdrawals, even in patients who do not screen positive for alcohol misuse.
- The Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA-Ar) is a 10-item questionnaire that assess the signs, symptoms and severity of alcohol withdrawal to guide outpatient treatment.
Confirm accuracy: Review patient's alcohol intake over the past months.
When points are only from Questions 1, they are often drinking below the AUDIT-C cutoff.
- Question 1: How often did you have a drink containing alcohol in the past year?
- Clarify with patient by reviewing alcohol intake over the past few months.
Normal alcohol consumption (males <4)
- Your score indicates a low level of risk for alcohol-related problems. It is recommended to continue responsible drinking habits. If you have any concerns, please discuss them with a healthcare provider.
- Your healthcare provider may provide feedback or no further action depending on your health status or medication use.
Limitations
The AUDIT is a screening tool and not a substitute for a comprehensive diagnostic assessment by a qualified healthcare professional. Its accuracy depends on the patient's honest self-reporting, which may be influenced by recall bias or a reluctance to disclose heavy drinking. The definition of a 'standard drink' can also vary by country, which may require clarification for the user.
Practitioner Next Steps
If you suspect the patient is minimizing their alcohol use, or if the patient's score is near the cutoff, consider utilizing a more comprehensive screening tool to understand the nature and extent of alcohol use.
Comprehensive validated tests for further assessment include:
- Michigan Alcoholism Screening Test (MAST)
- Alcohol Use Disorders Identification Test (AUDIT)
When screening results are positive, consider assessing the patient for alcohol withdrawal syndrome.
- In any potential setting where access to alcohol may be limited, monitor for signs or symptoms of withdrawals, even in patients who do not screen positive for alcohol misuse.
- The Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA-Ar) is a 10-item questionnaire that assess the signs, symptoms and severity of alcohol withdrawal to guide outpatient treatment.
Risk for alcohol misuse (male ≥ 4)
- Your score suggests that your drinking is at a hazardous or harmful level.
- It would be beneficial to consider reducing your alcohol consumption.
- Please consult with a healthcare provider to discuss your drinking patterns and potential health risks.
- Your healthcare provider may provide feedback or brief intervention (Drink-Less Program) depending on your health status or medication use.
- Click Drink-Less Program for more information.
Limitations
The AUDIT is a screening tool and not a substitute for a comprehensive diagnostic assessment by a qualified healthcare professional. Its accuracy depends on the patient's honest self-reporting, which may be influenced by recall bias or a reluctance to disclose heavy drinking. The definition of a 'standard drink' can also vary by country, which may require clarification for the user.
Practitioner Next Steps
If you suspect the patient is minimizing their alcohol use, or if the patient's score is near the cutoff, consider utilizing a more comprehensive screening tool to understand the nature and extent of alcohol use.
Comprehensive validated tests for further assessment include:
- Michigan Alcoholism Screening Test (MAST)
- Alcohol Use Disorders Identification Test (AUDIT)
When screening results are positive, consider assessing the patient for alcohol withdrawal syndrome.
- In any potential setting where access to alcohol may be limited, monitor for signs or symptoms of withdrawals, even in patients who do not screen positive for alcohol misuse.
- The Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA-Ar) is a 10-item questionnaire that assess the signs, symptoms and severity of alcohol withdrawal to guide outpatient treatment.
Risk for alcohol misuse and possible liver damage (Score ≥ 5)
- Your score indicates a high likelihood of alcohol dependence.
- It is strongly recommended that you seek advice from a healthcare professional urgently. They can provide guidance and support for managing your alcohol use.
- Your healthcare provider may provide feedback, referral to a specialist, detoxification, enrollment in a therapy program, pharmacotherapy (medication) and engagement with a self-help fellowship depending on your health status or medication use.
- Click Drink-Less Program for more information on actions you can take now.
Limitations
The AUDIT is a screening tool and not a substitute for a comprehensive diagnostic assessment by a qualified healthcare professional. Its accuracy depends on the patient's honest self-reporting, which may be influenced by recall bias or a reluctance to disclose heavy drinking. The definition of a 'standard drink' can also vary by country, which may require clarification for the user.
Practitioner Next Steps
If you suspect the patient is minimizing their alcohol use, or if the patient's score is near the cutoff, consider utilizing a more comprehensive screening tool to understand the nature and extent of alcohol use.
Comprehensive validated tests for further assessment include:
- Michigan Alcoholism Screening Test (MAST)
- Alcohol Use Disorders Identification Test (AUDIT)
When screening results are positive, consider assessing the patient for alcohol withdrawal syndrome.
- In any potential setting where access to alcohol may be limited, monitor for signs or symptoms of withdrawals, even in patients who do not screen positive for alcohol misuse.
- The Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA-Ar) is a 10-item questionnaire that assess the signs, symptoms and severity of alcohol withdrawal to guide outpatient treatment.
Risk for alcohol misuse (female ≥ 3)
- Your score suggests that your drinking is at a hazardous or harmful level.
- It would be beneficial to consider reducing your alcohol consumption.
- Please consult with a healthcare provider to discuss your drinking patterns and potential health risks.
- Your healthcare provider may provide feedback or brief intervention (Drink-Less Program) depending on your health status or medication use.
- Click Drink-Less Program for more information.
Limitations
The AUDIT is a screening tool and not a substitute for a comprehensive diagnostic assessment by a qualified healthcare professional. Its accuracy depends on the patient's honest self-reporting, which may be influenced by recall bias or a reluctance to disclose heavy drinking. The definition of a 'standard drink' can also vary by country, which may require clarification for the user.
Practitioner Next Steps
If you suspect the patient is minimizing their alcohol use, or if the patient's score is near the cutoff, consider utilizing a more comprehensive screening tool to understand the nature and extent of alcohol use.
Comprehensive validated tests for further assessment include:
- Michigan Alcoholism Screening Test (MAST)
- Alcohol Use Disorders Identification Test (AUDIT)
When screening results are positive, consider assessing the patient for alcohol withdrawal syndrome.
- In any potential setting where access to alcohol may be limited, monitor for signs or symptoms of withdrawals, even in patients who do not screen positive for alcohol misuse.
- The Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised (CIWA-Ar) is a 10-item questionnaire that assess the signs, symptoms and severity of alcohol withdrawal to guide outpatient treatment.
Citation
Babor, T.F., Higgins-Biddle, J.C., Saunders, J.B., & Monteiro, M.G. (2001). AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care (2nd ed.). World Health Organization.
Literature
- The alcohol use disorders identification test: Guidelines for use in primary care. Geneva: World Health Organization, 2001 (Second Edition). — Babor TF, Higgins-Biddle JC, Saunders JB and Monteiro M. AUDIT.
- The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998 Sep 14;158(16):1789-95. — Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA.
- AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res. 2007 Jul;31(7):1208-17. — Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR.
- Effectiveness of the AUDIT-C as a screening test for alcohol misuse in three race/ethnic groups. J Gen Intern Med. 2008 Jun;23(6):781-7. — Frank D, DeBenedetti AF, Volk RJ, Williams EC, Kivlahan DR, Bradley KA.
- Alcohol use and health (2014) — Center for Disease Control and Prevention
- NIAAA has a variety of evidence-based products for health professionals and community leaders — National Institute on Alcohol Abuse and Alcoholism
