From the Research
The AUDIT-C is considered positive when a patient scores 4 or more points for men, or 3 or more points for women, as supported by the most recent study 1. This brief 3-question alcohol screening tool assesses frequency of drinking, typical quantity consumed, and frequency of heavy drinking (6 or more drinks on one occasion). Each question is scored from 0-4 points, with a maximum possible score of 12. A positive score indicates hazardous drinking or an active alcohol use disorder, warranting further assessment. The gender-specific thresholds reflect physiological differences in alcohol metabolism between men and women, as women generally develop alcohol-related problems at lower consumption levels than men due to differences in body water content and alcohol dehydrogenase activity. Some key points to consider when interpreting AUDIT-C scores include:
- The AUDIT-C cut-offs ≥4 and ≥5 exhibited low positive predictive values in detecting hazardous use and dependence, but demonstrated a specificity ranging from 68.5 to 82.1% with negative predictive values from 98.2 to 100% 1.
- The AUDIT-C has been validated as a screening tool for problem drinking in various populations, including those with psychiatric disorders 2 and in primary care settings 3. Healthcare providers should follow up a positive screen with a more comprehensive assessment to determine the appropriate level of intervention, which may range from brief counseling to referral for specialized treatment depending on the severity of the alcohol use. It is essential to prioritize the most recent and highest quality study, which in this case is 1, to ensure that the recommended cut-off scores are based on the latest evidence. Other studies, such as 2 and 3, provide additional support for the use of AUDIT-C as a screening tool, but may not reflect the most current recommendations. Studies unrelated to the AUDIT-C, such as 4 and 5, do not provide relevant information for determining when the AUDIT-C is positive and should not be considered in this context.