Alcohol Use Screening Tests

What are alcohol use screening tests?

Alcohol use screening tests are questionnaires you answer about your alcohol use. Your responses are used to check for unhealthy alcohol use. Unhealthy alcohol use, also called alcohol misuse, use can cause health problems and may lead to alcohol use disorder (AUD). AUD is a brain disorder in which you can't stop or control your drinking, even though it causes distress and harm. It can cause problems in your work, relationships, and health. AUD can be mild, moderate, or severe, depending on your symptoms.  Severe AUD used to be called alcohol dependence and alcoholism.

Unhealthy alcohol use can also include binge drinking, which is drinking so much at once that your blood alcohol concentration (BAC) level is 0.08% or more. For a man, this usually happens after having five or more drinks within a few hours. For a woman, it is after about four or more drinks within a few hours. Not everyone who binge drinks has an AUD, but they are at higher risk of getting one.

Besides checking for unhealthy alcohol use, alcohol screening tests can let you know if you are at risk for AUD. This risk may depend on how much, how often, and how quickly you drink alcohol. Knowing that you are at risk may help you to cut back on your drinking.

If the alcohol screening test finds that you do have AUD, you and your health care provider can make an effective treatment plan for you.

Other names: Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, Cut down Annoyed, Guilty, Eye-opener (CAGE) tool, Tolerance, Annoyed Cut down, Eye-opener (T-ACE) tool, Screening with Brief Intervention (SBI) Tool

What are they used for?

Alcohol use screening tests are questionnaires used to check for unhealthy alcohol use and your risk for AUD. Some tests can also help show if your disorder is mild, moderate, or severe.

Why do I need an alcohol use screening test?

Your provider may do a screening test as part of a routine health care visit. You may also have a screening test if a provider thinks that you could have a problem with alcohol. The screening may include questions to help identify if you have symptoms of alcohol use disorder (AUD). These can include:

• Drinking more or longer than you planned.
• Trying to cut down or quit but being unable to do it.
• Hiding liquor bottles and glasses so others don't see evidence of drinking.
• Having strong cravings for alcohol.
• Continuing to drink even if it causes problems in your personal relationships, work, school, and/or health.
• Building up a tolerance to alcohol. That means you need more and more alcohol to feel its effects.
• Using alcohol when it's not safe, such as driving.
• Having symptoms of withdrawal such as tremors, headache, weakness, sweating, or nausea when you try to stop drinking.

Some people with AUD don't know or want to admit they have a problem. If your family, friends, or co-workers express concerns about your drinking, talk to your provider about getting a screening. Your provider may also recommend a screening if they notice signs and symptoms of an AUD.

What happens during an alcohol use screening test?

Your primary care provider or a mental health provider may do an alcohol use screening. A mental health provider is a health care professional who specializes in diagnosing and treating mental health problems. Some mental health providers specialize in treating AUD and other substance use disorders.

There are different types of alcohol use screening tests. But they each include questions about your drinking habits and how they may affect your life. The most commonly used alcohol screening tests are:

• Alcohol Use Disorders Identification Test (AUDIT). This test contains 10 multiple-choice questions about how much and how often you drink alcohol and if you have any alcohol-related problems or reactions. The answers are scored on a point system. A score of 8 or more may indicate AUD.
• AUDIT-C is a shortened version of the Alcohol Use Disorders Identification Test (AUDIT). It contains three multiple-choice questions. Each answer is valued from 0 to 4 points. The higher the score, the more likely it is you have AUD.
• Cut down Annoyed, Guilty, Eye-opener (CAGE). This test is still often used, but it's no longer recommended because there are better tests available. It contains the following yes or no questions:
  • Have you ever felt you should cut down on your drinking?
  • Have people annoyed you by criticizing your drinking?
  • Have you ever felt bad or guilty about your drinking?
  • Eye-opener: have you ever had a drink first thing in the morning to steady your nerves?
  Two or more "yes" answers may be a sign of AUD.
• The NIAAA Single Alcohol Screening Question (SASQ). This test isn't scored and may be part of a routine health care visit. Your provider may first ask how often you have had an alcoholic drink in the past year, but the SASQ test only contains one question.
  • How many times in the past year have you had (4 for women, or 5 for men) or more drinks in a day?
  If your answer is one or more, then your provider may want to ask additional questions to help determine if you have, or are at risk, for AUD. Two or more "yes" answers to those questions may be a sign of AUD.
• Screening with Brief Intervention (SBI) Tools. These tests contain a series of yes or no questions to help identify, reduce, and prevent alcohol misuse. They can help identify brief interventions and the best treatment for you. Brief interventions are short-term counseling sessions and treatment strategies. These are meant to help you change your drinking behaviors and habits. If your test shows you have or are at risk for AUD, a long-term treatment plan may be recommended.

Some questionnaires, including the Alcohol Use Disorders Identification Test (AUDIT), are available online for self-testing. You can ask your provider how to access these tests.

Will I need to do anything to prepare for the test?

You don't need any special preparations for an alcohol use screening test.

Are there any risks to the test?

There is no risk in taking a questionnaire.

What do the results mean?

Some results may show whether you have AUD. Others may show you how severe your AUD may be. For those tests, your results may be in one of the following or similarly named categories:

• Mild. You have two to three symptoms of AUD. This pattern of drinking puts your health at risk and/or has harmful social effects on you or others. If you have symptoms now, you may be at risk for more serious problems in the future. Your provider may recommend steps to help you change your drinking habits.
• Moderate. You have four or five symptoms of AUD. Your provider may recommend a brief intervention or other treatments.
• Severe. You have six or more symptoms of AUD. You may need more intensive treatment. This can include seeing a specialist, medicines, support groups, and/or addiction recovery programs.

Is there anything else I need to know about an alcohol use screening test?

Some people with AUD can change their behaviors to cut back on drinking. Other people will need to stop completely. This is known as abstinence. Depending on the severity of your disorder, your provider may recommend one or more of the following treatments:

• Brief or long-term counseling from a mental health provider who specializes in treating AUD. This may help you learn ways to change your drinking behavior and not start drinking again.
• Support groups. There are many different approaches and formats to alcohol use disorder support groups. Groups may help provide peer support to stop or cut back on your drinking. Talk with your provider to find a group and approach that's right for you.
• Medicines. Certain medicines may reduce your cravings for alcohol. These medicines are to help you stop, cut back, quit, or not start drinking again.