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Substance use

AUDIT

Alcohol Use Disorders Identification Test

Ten-item WHO screen for hazardous, harmful, and dependent alcohol use.

Items
10
Time
~5 min
Cost
free
Ages
18+

When to use the AUDIT

Use the AUDIT at intake with every adult client to quantify alcohol risk, and again whenever drinking is implicated in a setback. Scores sort clients into brief-intervention, monitoring, or full-assessment pathways.

What the AUDIT measures

Items 1–3 cover consumption (frequency, typical quantity, heavy episodes). Items 4–6 cover dependence symptoms (impaired control, increased salience, morning drinking). Items 7–10 cover alcohol-related harms (guilt, blackouts, injuries, others' concern).

Use the AUDIT when

  • Universal intake screening — most hazardous drinking is invisible without a measure
  • Drinking is named as a coping strategy for anxiety, trauma, or insomnia
  • Before starting a medication that interacts with alcohol
  • Monitoring during recovery or a moderation plan

Why use the AUDIT instead of another measure

The AUDIT covers consumption, dependence symptoms, and consequences in ten items, so a single score maps to a defined WHO intervention tier. The AUDIT-C (first three items) works when time is short and still detects hazardous use well.

When not to use the AUDIT

  • The concern is a non-alcohol substance — use the DUDIT or DAST
  • You need a diagnosis of alcohol use disorder — this is a risk screen, not a diagnostic interview
  • Withdrawal is suspected; that requires immediate medical assessment, not a questionnaire

Scoring and bands

0–7
Low risk
8–15
Increasing/hazardous risk — brief intervention recommended
16–19
Higher-risk drinking — brief intervention + monitoring
20+
Possible alcohol dependence — full assessment indicated

Cutoffs
≥8 is the standard cutoff for hazardous drinking (≥7 for women in some guidelines). The AUDIT-C (items 1–3) can be used for quicker screening — ≥4 for men, ≥3 for women.

What AUDIT results mean — and what to do next

0–7

Low-risk drinking.

Next stepBrief education on limits; no intervention indicated.

8–15

Hazardous or increasing-risk drinking.

Next stepDeliver a brief motivational intervention and set a concrete reduction plan.

16–19

Higher-risk drinking with likely harm.

Next stepBrief intervention plus structured monitoring and a return visit; consider specialist referral.

20+

Possible alcohol dependence.

Next stepRefer for full diagnostic assessment and medical review; discuss withdrawal risk before any abrupt cessation.

How often to re-administer

Annually as routine screening, or monthly when drinking is an active treatment target.

What to pair it with

PHQ-9 and GAD-7 (self-medication patterns) and PCL-5 (trauma-driven use).

How to talk about the score

AUDIT scores invite an MI conversation. Avoid framing the score as a label. 'This score puts you in a range where most people see meaningful benefit from changes — what does that bring up for you?'

Limitations

  • 12-month recall window — may miss recent escalation
  • Self-report — under-reporting is common, especially when consequences are present
  • Doesn't capture other substances
  • Cultural drinking norms vary

Best used for

  • Primary care screening
  • Intake screening for any clinical population
  • Annual re-screening in continuing care

Frequently asked questions about the AUDIT

Should I score lower for women?

Most guidelines lower the AUDIT-C cutoff for women (3 vs. 4) given physiological differences. The full AUDIT cutoff of 8 is generally retained.

Is AUDIT-C enough on its own?

AUDIT-C is a faster screen; positive AUDIT-C should be followed by the full AUDIT to characterize severity and consequences.

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