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Home > Professional Reference > Alcohol Use Disorders Identification Test (AUDIT)

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Alcohol Use Disorders Identification Test (AUDIT)

This PatientPlus article is written for healthcare professionals so the language may be more technical than the condition leaflets. You may find the abbreviations list helpful.

This is a more detailed questionnaire than the CAGE Questions. It has been developed by the World Health Organisation1 as a simple screening tool to pick up the early signs of hazardous and harmful drinking and identify mild dependence.2

  • Begin the AUDIT by saying “Now I am going to ask you some questions about your use of alcoholic drinks during this past year.”
  • Read the questions as written. Record answers carefully.
  • Explain what is meant by “alcoholic drinks” by using local examples of beer, wine, vodka, etc.
  • Code answers in terms of “standard drinks”. Select the correct answer number in the box on the right.1

The Alcohol Use Disorders Identification Test: Interview Version
Read questions as written.
1. How often do you have a drink containing alcohol?
Questioner may skip to Questions 9 and 10 if reply to Question 1 is never, or if both answers to Q 2 and 3 are 0.
2. How many drinks containing alcohol do you have on a typical day when you are drinking?
3. How often do you have six or more drinks on one occasion?
AUDIT-C Score /12 (complete full questionnaire if score is 3 or more)
4. How often during the last year have you found that you were not able to stop drinking once you had started?
5. How often during the last year have you failed to do what was normally expected from you because of drinking?
6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?
7. How often during the last year have you had a feeling of guilt or remorse after drinking?
8. How often during the last year have you been unable to remember what happened the night before because you had been drinking?
9. Have you or someone else been injured as a result of your drinking?
10. Has a relative or friend or a doctor or another health worker been concerned about your drinking or suggested you cut down?
The Alcohol Use Disorders Identification Test (AUDIT) Score = /40
Scores of 8 or more are considered an indicator of hazardous and harmful alcohol use.

The calculator has been created from the questionnaire in Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG; The Alcohol Use Disorders Identification Test, Guidelines for Use in Primary Care, Second Edition, Department of Mental Health and Substance Dependence, World Health Organization, CH-1211 Geneva 27, Switzerland. ©World Health Organization 2001, reproduced here with permission.


AUDIT was tested on a sample of 913 drinking patients, and has 92% sensitivity and specificity of 94% using the ≥8/40 threshold.2

AUDIT-C (shortened form)

The AUDIT-C is a shortened version of the above using the first 3 questions only.3,4
Using a cut off ≥4 the Audit-C has a sensitivity of 86% of patients with heavy drinking and/or active alcohol abuse or dependence with a specificity of 72%. Using a cutoff of ≥3, AUDIT-C identifies 90% of patients with active alcohol abuse or dependence and 98% of patients with heavy drinking, (specificity was only 60%, false-positive rate 40%). 3

It is recommended a score of ≥3 or more points on the AUDIT-C, or a report of drinking 6 or more drinks on one occasion ever in the last year, should lead to a more detailed assessment of drinking and related problems (i.e. completion of the full questionnaire).3

Document references

  1. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG; The Alcohol Use Disorders Identification Test, Guidelines for Use in Primary Care, Second Edition, Department of Mental Health and Substance Dependence, World Health Organization.
  2. Saunders JB, Aasland OG, Babor TF, et al; Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993 Jun;88(6):791-804. [abstract]
  3. Bush K, Kivlahan DR, McDonell MB, et al; 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. [abstract]
  4. Bradley KA, DeBenedetti AF, Volk RJ, et al; AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res. 2007 Jul;31(7):1208-17. Epub 2007 Apr 19. [abstract]

Internet and further reading

Acknowledgements

EMIS is grateful to Dr Huw Thomas for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2010.
Document ID: 9152
Document Version: 12
Document Reference: bgp26159
Last Updated: 1 Jun 2009
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