AUDIT-C Alcohol Use Calculator

How does this AUDIT-C alcohol use calculator work?

The AUDIT-C questionnaire provides alcohol screening aimed at identifying cases with alcohol misuse, abuse and dependence. AUDIT-C is the acronym of the Alcohol Use Disorders Identification Test Consumption, the publication of WHO based on a study from 1990.

This is a very popular alcohol screening model and helps specialists, health care practitioners or researchers decide on and initiate intervention. One of the main advantages is that it is a very straight forward and easy to administer questionnaire. Should not be confounded with blood alcohol tests that evaluate the amount of alcohol in the system after a certain amount of drinks per unit of time.

■ Q1 – Q3 focus on alcohol consumption and the score range is between 0 and 12. Each of the questions has different answer choices that are awarded a specific number of points. Scores of 5 in men and 4 in women or more make the AUDIT-C test positive and indicate a higher drinking risk and likelihood that the patient’s alcohol consumption has or may have an impact on his or her health.

■ Q4 – Q6 concentrate on alcohol dependence while Q7 – Q10 refer to alcohol related problems. For the last 7 questions, score equal to or higher than 8 in men and 7 in women are strongly suggestive. Some clinicians consider that scores above 20 are consistent with alcohol dependence but the AUDIT-C model is not specifically designed to assess dependence so can offer just a simple guideline on the situation.

Alcoholism symptoms

Alcohol misuse defines the spectrum from risky drinking to severe alcohol dependence. It includes cases with heavy drinking, associated mortality and morbidity.

Screening for alcohol misuse allows the identification of cases that need various degrees of counselling, intervention or even referral to other specialists.

Some of the most common alcohol dependence symptoms include:

■ Inability to control drinking.

■ Increase in drank quantity in time.

■ Experiencing withdrawal symptoms when not consuming alcohol.

■ Giving up activities to drink.

■ Drinking despite this causing family and health problems.

Some of the conditions developed by patients with hazardous drinking patterns include:

■ Hypertension;

■ Congestive heart failure (CHF);

■ Liver disease;

■ Increased stroke risk;

■ Breast cancer;

■ Pancreas cancer;

■ Reflux (GERD) Upper gastrointestinal (GI) bleed;

■ Different types of injuries;

■ Post traumatic stress disorder (PTSD);

■ Depression;

■ Insomnia.

The symptoms accompanying withdrawal from alcohol range in severity depending on the case and include:

■ Headaches;

■ Shaking;

■ Sweating;

■ Fever;

■ Nausea;

■ Stomach pain;

■ Anxiety;

■ Restlessness;

■ Trouble concentrating;

■ Hypertension.

Alcohol addiction treatment

Based on the scores in the AUDIT-C model, there have been set some guidelines for medical professional to know how to refer their patients:

Scores below 7 are deemed to just require alcohol education and advice, scores between 8 and 19 should receive advice and counselling while score above 20 should be referred to specialists for a diagnosis and treatment.

First resort treatment methods after counselling are based on the patient’s ability to refrain from drinking, set boundaries, avoid drinking triggers, monitor alcoholic concentration in beverages and manage alcohol cravings.

Second resort treatment includes evaluation and diagnosis for health problems and psychological symptoms.

Recommended drinking limits

The National Institutes for Health (NIH) has established consumption limits above which people are considered to have alcohol related problems. Of course these are general guidelines and the limit also depends on personal factors such as general health, lifestyle or gender.

The recommendations state no more than 14 drinks a week and no more than 4 drinks at once for men while for women the limit is 7 drinks per week and no more than 3 at once.

A drink is considered:

■ 12 ounces of beer;

■ 5 ounces of wine;

■ 1.5 ounces of hard liquor.

A unit of alcohol, a reference often used when discussing about alcohol consumption, is equivalent to:

■ Half pint of beer;

■ Small glass of wine (regular glass is 2 units);

■ Small glass of cherry;

■ 1 measure of spirits;

■ 1 measure of aperitifs.

References

1) Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. (1998) The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med; 158(16):1789-95.

2) Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR. (2007) AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res; 31(7):1208-17.

3) Frank D, DeBenedetti AF, Volk RJ, Williams EC, Kivlahan DR, Bradley KA. (2008) Effectiveness of the AUDIT-C as a screening test for alcohol misuse in three race/ethnic groups. J Gen Intern Med; 23(6):781-7.

4) Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. (1993) Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction; 88(6):791-804.