What is the appropriate intervention for a patient scoring a level 2 on the Alcohol Use Disorders Identification Test (AUDIT) screen?

Appropriate Intervention for a Patient with AUDIT Score of 2

For a patient scoring a level 2 on the AUDIT screen, brief advice and education about alcohol use is the most appropriate intervention, as this score indicates low-risk drinking that does not require intensive intervention. 1

Understanding AUDIT Scores and Risk Levels

• An AUDIT score of 2 falls well below the threshold for hazardous or harmful drinking, which is generally considered to be a score of 8 or higher 1
• This score indicates the patient is likely engaging in low-risk drinking patterns that do not currently pose significant health concerns 1
• For context, the AUDIT consists of 10 questions with scores ranging from 0-40, with higher scores indicating greater likelihood of hazardous or harmful drinking 1

Recommended Intervention Approach

Brief Advice and Education

• Provide positive reinforcement for maintaining low-risk drinking patterns 1
• Educate the patient about standard drink sizes and recommended drinking limits:
  • For men under 65: no more than 14 standard drinks per week and no more than 4 drinks on any single day 1
  • For women and men over 65: no more than 7 standard drinks per week and no more than 3 drinks on any single day 1
• Briefly discuss the health benefits of maintaining low-risk drinking patterns or abstinence 1

Prevention-Focused Counseling

• Provide information about situations that could lead to increased drinking (stress, social pressure) 1, 2
• Discuss strategies to avoid risky drinking situations and maintain current low-risk patterns 1
• Emphasize the importance of not driving after drinking any amount of alcohol 1

Implementation in Clinical Practice

• This brief intervention can be delivered in approximately 5 minutes during a routine office visit 1
• Use a non-judgmental, supportive approach that acknowledges the patient's current low-risk drinking status 1, 2
• Document the screening result and brief intervention in the medical record 1

Follow-up Recommendations

• Routine rescreening at annual visits is sufficient for patients with AUDIT scores in this range 1
• No specialized referral is needed at this time given the low-risk score 1
• Encourage the patient to maintain current low-risk drinking patterns or consider abstinence if appropriate 1

Common Pitfalls to Avoid

• Overreacting to a low AUDIT score by recommending unnecessary intensive interventions 2
• Failing to provide any feedback or education, missing an opportunity for prevention 1
• Not distinguishing between low-risk drinking (AUDIT score of 2) and higher-risk patterns that would require more intensive intervention 1
• Assuming that a low score means the patient will always maintain low-risk drinking patterns in the future 1