What is an effective tool for screening alcohol use disorder (AUD)?

From the Guidelines

The AUDIT (Alcohol Use Disorders Identification Test) is the most recommended screening tool for detecting alcohol-related problems in primary care settings, due to its sensitivity in detecting alcohol misuse and abuse or dependence. Several studies have evaluated the effectiveness of different screening tools, including the AUDIT, CAGE, TWEAK, and T-ACE, with the AUDIT being the most studied and widely recommended 1. The AUDIT consists of 10 questions that assess consumption patterns, dependence symptoms, and alcohol-related problems, making it a comprehensive tool for identifying potential alcohol use disorders.

Some of the key features of the AUDIT include:

• Sensitivity in detecting alcohol misuse and abuse or dependence
• Can be used alone or embedded in broader health risk or lifestyle assessments
• Available at the National Institute on Alcohol Abuse and Alcoholism Web site: www.niaaa.nih.gov/publications/instable.htm Other screening tools, such as the CAGE questionnaire, are also effective, but the AUDIT is generally considered the most reliable and widely applicable 1. The TWEAK and T-ACE tools are specifically designed for pregnant women and can detect lower levels of alcohol consumption that may pose risks during pregnancy.

In terms of implementation, healthcare providers should choose screening strategies that are appropriate for their clinical population and setting, and conduct screenings in a private setting with a non-judgmental approach 1. Positive screens should prompt further evaluation and appropriate referrals to treatment resources. Effective interventions to reduce alcohol misuse include an initial counseling session of about 15 minutes, feedback, advice, and goal-setting, with further assistance and follow-up as needed 1.

From the Research

Alcoholic Screening Tools

There are several screening tools available to identify individuals with alcohol use disorders. Some of the most commonly used tools include:

• The Alcohol Use Disorders Identification Test (AUDIT) 2, 3, 4
• The CAGE questionnaire 5
• The Michigan Alcoholism Screening Test (MAST) 2, 6

Characteristics of Alcoholic Screening Tools

The characteristics of these screening tools are as follows:

• The AUDIT is a 10-item Core questionnaire that is useful for early detection of hazardous or harmful drinking, while the AUDIT Clinical Instrument is better applied to identification and/or confirmation of cases of alcohol dependence 2
• The AUDIT-C, a shortened version of the AUDIT, appears approximately equal in validity to the full scale for males 3
• The CAGE questionnaire is a simple, sensitive, and specific screening test for alcohol abusers, with a sensitivity of 85 percent and a specificity of 89 percent 5
• The USAUDIT is an adapted version of the AUDIT, compatible with US guidelines and standard drink size, providing greater accuracy in measuring alcohol consumption than the AUDIT-C 4

Effectiveness of Alcoholic Screening Tools

The effectiveness of these screening tools has been evaluated in various studies:

• The AUDIT has been shown to be sensitive and specific in discriminating alcoholics from medical patients, and is useful for early detection of hazardous or harmful drinking 2
• The CAGE questionnaire has been shown to be a simple and effective screening tool for alcohol abusers, with a high sensitivity and specificity 5
• The AUDIT-C has been shown to be approximately equal in validity to the full AUDIT scale for males, and is a useful screening tool for alcohol use disorders 3