Alcohol Use Disorder Identification Test (AUDIT)

The AUDIT is a screening instrument to detect excessive and harmful patterns of alcohol use. It was developed by the World Health Organization (WHO) in an initiative to develop a reliable and valid measure in identifying alcohol abuse. The AUDIT was developed to be used by General Practitioners and other professionals in the primary health care industry and is easy to use and interpret. It comprises of a 10-item questionnaire appropriate for adolescents and adults of all ages. It can be completed by clients as a self-report, or used in an interview by the practitioner. It takes approximately 2 to 3 minutes to be completed and clients are invited to ask for clarification on any items. The 10 items address three areas of drinking behaviour; Hazardous Alcohol use (items 1,2,3), Dependence symptoms (items 4,5,6) and harmful alcohol use (7,8,9,10).

Two examples of items on the AUDIT questionnaire are;

  1. How often do you have a drink containing alcohol?

(0) Never [Skip to Qs 9-10] (1) Monthly or less (2) 2 to 4 times a month (3) 2 to 3 times a week (4) 4 or more times a week

  1. Have you or someone else been injured as a result of your drinking?

(0) No (2) Yes, but not in the last year (4) Yes, during the last year

To interpret the AUDIT sum each item score to get an overall score which can be interpreted as per the guideline cut off points; 8-15 hazardous, 16-19 harmful and >20 is dependent. The guidelines should be considered tentative and subject to clinical judgement. Important information can be obtained by interpreting which items received the high scores (harmful, hazardous or dependence items).

The AUDIT has been found to have good reliability and consistency with ICD-10 definitions of alcohol dependence and harmful alcohol use (Babor, Higgins-Biddle, Saunders &  Monterio, 2001). Meneses-Gaya et al (2009) systematic review of psychometric properties found a mean Cronbach’s alpha of .80 across 10 studies investigating internal consistency. The AUDIT presented excellent sensitivity and specificity values (Menese-Gaya et al 2009). In the initial comparative study across 6 countries a cut off point of 8 yielded sensitivities in mid .90’s and specificities averaged in the .80’s.

The AUDIT is free to use and does not require specific training to administer, the manual is available on Turning point website http://www.turningpoint.org.au/Treatment/Online-Self-Assessment.aspx. Turning point have developed ‘The Adult AOD Screening and Assessment Instrument” Clinical Guide that list instructions and advice for the AUDIT along with other AOD screening tools. The AUDIT is a screening tool to assist to interpret levels of hazards drinking. A clinical interview and other assessments are required for a formal diagnosis.

 

References

Menese- Gaya, C., Zuardi, A., Loureiro, S., & Crippa, J. (2009). Alcohol use disorders identification test (AUDIT): An updated systematic review of psychometric properties. Psychology & Neuroscience, 2(2), 83-97 DOI: 10.3922/j.psns.2009.1.12

Heather, N. (2006). WHO collaborative project on identification and management of Alcohol-related problems in primary health care. Retrieved from http://www.who.int/substance_abuse/publications/identification_management_alcoholproblems_phaseiv.pdf?ua=1

Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., Monterio, M. G. (2001). AUDIT: The Alcohol Use Disorders Identification Test Guidelines for Use in Primary Care (second edition) Retrieved from http://www.who.int/substance_abuse/publications/audit/en/