India B. Carson, RN, MSN
Clinical Product Specialist

Primary care providers often screen their patients for a variety of conditions, including alcohol use.  Screening is not the same as diagnostic testing, which can establish a definite diagnosis.  Instead, screening is used to identify people who are likely to have a disorder, as determined by their answers to certain questions.  Evidence suggests that even if patients are not meeting the requirements for alcohol dependence or abuse, they may be consuming alcohol at levels which place them at risk for increased problems.[1]  A variety of screening tools are available to identify these at-risk patients to ensure that they can be helped through the necessary interventions.

The Alcohol Use Disorders Identification Test (AUDIT) is a screening tool that was developed in 1982 by the World Health Organization.  This screening tool accurately classifies 95% of people as either alcoholic or non-alcoholics by asking ten questions related to alcohol use.  A resulting score of eight or more indicates harmful drinking behavior[2].  This tool offers a simple way to screen and identify patients who may be at risk for developing problems related to their alcohol consumption and can be found here:  https://www.integration.samhsa.gov/AUDIT_screener_for_alcohol.pdf[3].

The Alcohol Use Disorders Identification Test-Concise (AUDIT-C) is a very simple three-question screening tool for harmful drinking which can be administered alone or as part of a lengthier survey or assessment.  At TCS, this tool is utilized as part of our Health Risk Assessment (HRA), as it is only three questions in length and can be easily incorporated into a longer assessment.  A copy of the AUDIT-C can be found here:  https://cde.drugabuse.gov/sites/nida_cde/files/Audit-C_2014Mar24.pdf[4].

The CAGE AID is a commonly used screening tool for both drug and alcohol use.  However, it can be used to determine whether a more comprehensive alcohol assessment is needed.  A copy of this tool can be found at:  https://www.integration.samhsa.gov/images/res/CAGEAID.pdf[5].  These questions can also be adapted to include drug use.

As previously mentioned, there are quite a variety of screening tools available.  If you are searching for one, please consider reviewing the Substance Abuse and Mental Health Service Administration (SAMHSA) website and look for specific recommendations.  Lastly, you can find additional reference material at the National Institutes of Health section on National Institute on Alcohol Abuse and Alcoholism.

[1] National Institute on Alcohol Abuse and Alcoholism, Alcohol Alert. Retrieved from: https://www.niaaa.nih.gov/alcohols-effects-health  Retrieved on March 4, 2020.

2 SAMHSA-HRA Center for Integrated Health Solutions.  Screening Tools.  Retried from: https://www.integration.samhsa.gov/AUDIT_screener_for_alcohol.pdf on March 4, 2020.

3 SAMHSA-HRA Center for Integrated Health Solutions.  Screening Tools.  Retrieved from: https://cde.drugabuse.gov/sites/nida_cde/files/Audit-C_2014Mar24.pdf on March 4, 2020.

4 SAMHSA-HRA Center for Integrated Health Solutions.  Screening Tools.  Retrieved from: https://www.integration.samhsa.gov/images/res/CAGEAID.pdf on March 4, 2020.