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    Patent Pending

    AUDIT-C for Alcohol Use

    Identifies at-risk drinkers (i.e., binge drinking) who may not be alcohol-dependent.
    When to Use
    Pearls/Pitfalls
    Why Use
    • The 4-item CAGE questionnaire is the briefest effective screening test for lifetime alcohol abuse/dependence, but it is not sensitive for detecting heavy drinking and does not distinguish between active and past problem drinking. The AUDIT-C is more effective in identifying this population.
    • AUDIT-C can be included among standard history questions or general health intake questionnaires in primary care, emergency department, psychiatric and inpatient hospital settings.
    • Other at-risk populations where AUDIT-C or another alcohol screening assessment is indicated include:
      • Pregnant women
      • College students
      • Arrested and incarcerated persons, especially DWI and domestic violence offenders
    • AUDIT-C is a 3-item alcohol screen that can help identify persons who are hazardous drinkers or have active alcohol use disorders.
    • The AUDIT-C is a modified, shortened version of the 10-question AUDIT instrument. Its briefer design makes it more practical for incorporation into routine patient interviews or health history questionnaires in a primary care setting.
    • AUDIT-C is a screening tool. An abnormal or positive screening result may thus “raise suspicion” about the presence of an alcohol use problem, while a normal or negative result should suggest a low probability of an alcohol use problem. Assessment for purposes of diagnosis occurs in subsequent stages of evaluation.
    • Physicians often overlook alcohol problems in patients. (Kitchens JM 1994)
    • Simply asking patients how much they drink often leads to an estimate lower than the actual number of alcoholic drinks per day.
    • Alcohol disorders are treatable despite physician bias otherwise. (Kitchens JM 1994)
    • Without identification and treatment alcohol problems lead to significant morbidity and mortality:
      • Alcohol is a major factor in suicides, homicides, violent crimes, and fatal motor vehicle accidents. Nearly 88,000 people die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. (Centers for Disease Control and Prevention 2014)
      • Alcohol is primarily or secondarily implicated in a large number of medical problems.
      • The mortality rate in those who drink six or more drinks per day is 50% higher than the rate in matched controls. (Klatsky AL 1992)
    Never
    0
    Monthly or less
    +1
    Two to four times a month
    +2
    Two to three times per week
    +3
    Four or more times a week
    +4
    1 or 2 drinks
    0
    3 or 4
    +1
    5 or 6
    +2
    7 to 9
    +3
    10 or more
    +4
    Never
    0
    Less than monthly
    +1
    Monthly
    +2
    Weekly
    +3
    Daily or almost daily
    +4

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    Next Steps
    Evidence
    Creator Insights
    Dr. Katharine Bradley

    About the Creator

    Katharine Bradley, MD, MPH, is a senior Investigator at the Group Health Research Institute and concentrates on identifying and addressing unhealthy alcohol use in primary care. She is currently leading the NIH's Alcohol Abuse and Alcoholism Study. Formerly, Dr. Bradley worked at the Veterans Affairs (VA) Puget Sound Health Care System, where she practiced primary care for over 15 years.

    To view Dr. Katharine Bradley's publications, visit PubMed

    Are you Dr. Katharine Bradley? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. Katharine Bradley
    Are you Dr. Katharine Bradley?