AUDIT-C for Alcohol Use
Identifies at-risk drinkers (i.e., binge drinking) who may not be alcohol-dependent.
When to 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)