Text adapted in 2022 from The Primary Care Addiction Toolkit (online only). A complete list of Toolkit authors, editors and contributors is available here.
The Alcohol Use Disorders Identification Test (AUDIT)
The Alcohol Use Disorders Identification Test (manual and questionnaire) is a useful 10-item survey that patients can fill out in the waiting room or during a face-to-face interview. It was developed initially as a screening test, but can be used to gather more information about alcohol use.
The AUDIT asks how much the person drinks and whether they have experienced negative consequences of drinking. When scored, the AUDIT helps to differentiate at-risk drinking from alcohol use disorder.
A cut-off score of 8 or more indicates hazardous or harmful drinking, as well as a possible alcohol use disorder. Newer research suggests that the cut-off score be lower for women (Johnson et al., 2013; Levola & Aalto, 2015; Neuman et al., 2004). A score higher than 15 indicates a more severe alcohol use disorder.
Level-appropriate interventions for alcohol use
Most people who use alcohol do so at a low-risk or at-risk level. However, 21 percent of people who drink exceed the guidelines for chronic harm and 15 percent exceed the guidelines for acute harm (Statistics Canada, 2013). About 2.5 percent have a moderate or severe alcohol use disorder.
Interventions should match the category of drinking
Patients with more severe alcohol use disorder need more intensive interventions. These include ongoing counselling, medications (naltrexone and acamprosate) and connections to other treatment programs. Screening and brief interventions delivered by primary care providers are very effective at reducing drinking in patients with at-risk drinking and mild alcohol use disorder (Bertholet et al., 2005).
In Alcohol Use: