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    Alcohol & drugs · 10 items · 0–40

    Alcohol Use Disorders Identification Test: Scoring, Cutoffs & Interpretation

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

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    AUDIT0 / 10

    Over the last year, how often have you been bothered by…

    01

    How often do you have a drink containing alcohol?

    Item score-
    02

    How many drinks containing alcohol do you have on a typical day when you are drinking?

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    03

    How often do you have six or more drinks on one occasion?

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    04

    How often during the last year have you found that you were not able to stop drinking once you had started?

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    05

    How often during the last year have you failed to do what was normally expected of you because of drinking?

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    06

    How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?

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    07

    How often during the last year have you had a feeling of guilt or remorse after drinking?

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    08

    How often during the last year have you been unable to remember what happened the night before because of your drinking?

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    09

    Have you or someone else been injured because of your drinking?

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    10

    Has a relative, friend, doctor, or other health worker been concerned about your drinking or suggested you cut down?

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    0 of 10 answered0 / 40

    The clinician's brief

    Last reviewed: · Reviewed by Lotte Kjær Svalberg

    What this scale measures.

    The AUDIT measures hazardous and harmful alcohol use over the past year across three domains: consumption (items 1-3), dependence symptoms (items 4-6), and alcohol-related harm (items 7-10). Each of the first eight items is scored 0-4 and the last two 0/2/4, giving a total of 0-40.

    It is designed to detect problem drinking along the full spectrum - from hazardous consumption well before dependence, through harmful use, to probable dependence - which distinguishes it from lifetime screens like the CAGE that mainly detect established dependence.

    Where it comes from.

    The AUDIT was developed by the World Health Organization through a six-country collaborative study and published by Saunders and colleagues in 1993 - the first screening instrument designed cross-nationally and validated across primary care populations. In the original study the >=8 cutoff identified 92% of hazardous or harmful drinkers while excluding 94% of non-cases.

    Babor and colleagues' 2001 WHO manual defined the four risk zones used today and standardised administration. It is a WHO instrument, free to reproduce and use for clinical purposes.

    How scoring works.

    Sum all ten items for a total of 0-40. The WHO manual defines four zones: 0-7 low risk (alcohol education), 8-15 hazardous drinking (brief advice), 16-19 harmful drinking (brief counselling and continued monitoring), 20-40 possible dependence (referral for diagnostic assessment).

    A lower cutoff of 7 is often recommended for women, adolescents and adults over 65, whose risk rises at lower consumption.

    Score
    Severity
    Interpretation
    0–7
    Low risk
    Low-risk drinking.
    8–15
    Increasing risk
    Hazardous drinking. Offer brief advice.
    16–19
    Higher risk
    Harmful drinking. Brief counselling and continued monitoring.
    20–40
    Possible dependence
    Possible alcohol dependence. Refer for diagnostic assessment.

    How well it performs.

    In the original WHO multi-country validation, a cutoff of >=8 showed sensitivity around 0.92 and specificity around 0.94 for hazardous or harmful drinking. A 2002 review across dozens of studies (Reinert & Allen) found sensitivities typically in the 0.80s-0.90s across primary care, emergency and psychiatric settings, with internal consistency around alpha 0.80. The three-item AUDIT-C consumption subset preserves most of the screening accuracy at a fraction of the length.

    alpha ~ 0.80
    Internal consistency
    92%
    Sensitivity (>=8)
    94%
    Specificity (>=8)
    4
    Risk zones (WHO)

    How it compares to the alternatives.

    Instrument
    Items
    Time
    When to reach for it
    AUDIT
    10
    ~2-3 min
    The default full-spectrum alcohol screen; detects hazardous use before dependence. Free (WHO).
    AUDIT-C
    3
    ~30 s
    Consumption-only triage; step up to the full AUDIT if positive (>=4 men / >=3 women).
    CAGE
    4
    ~30 s
    Lifetime dependence screen; quick but misses hazardous drinking and recent-onset problems.
    CAGE-AID
    4
    ~30 s
    CAGE adapted to include drugs - use when screening alcohol and drugs together briefly.
    DAST-10
    10
    ~2 min
    Drug-use counterpart to the AUDIT; use alongside it for full substance screening.
    SADQ
    20
    ~5 min
    Severity of established dependence - for treatment planning (e.g. withdrawal management), not screening.

    Right tool, wrong tool.

    Reach for it when

    • -Routine intake screening in psychiatry and primary care
    • -Annual re-screening
    • -Establishing a baseline before brief intervention
    • -Monitoring change after brief advice

    Reach for something else when

    • -Time allows only seconds (AUDIT-C)
    • -You need to grade established dependence severity for withdrawal planning (SADQ)
    • -Screening for drug use (DAST-10)
    • -The patient may under-report - collateral history and biomarkers (GGT, CDT, PEth) complement any self-report screen

    Reading the score with care.

    The AUDIT is a self-report of a stigmatised behaviour, so its precision depends on candour and context: scores obtained in routine, non-judgmental screening are more reliable than those taken during acute presentations or where disclosure has consequences. Zone boundaries are guidance, not diagnosis - a 16 in a young binge-drinking patient and a 16 in an older daily drinker call for different conversations. Re-screen after brief intervention to measure change.

    What it cannot tell you.

    The AUDIT screens for risk; it does not diagnose alcohol use disorder - DSM-5/ICD-11 criteria require a clinical interview. Self-report under-estimates consumption in dependent drinkers. The 12-month window misses recent escalation in the last weeks. Standard cutoffs were derived largely from adult male primary-care samples; use adjusted cutoffs for women, adolescents and older adults, and interpret with cultural drinking norms in mind.

    Common questions from clinicians

    FAQ

    References

    Source literature.

    1. [1]Saunders JB, Aasland OG, Babor TF, et al. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project. (1993) ↩
    2. [2]Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT: The Alcohol Use Disorders Identification Test - Guidelines for Use in Primary Care, 2nd ed. WHO/MSD/MSB/01.6a. (2001) ↩
    3. [3]Bush K, Kivlahan DR, McDonell MB, et al. The AUDIT alcohol consumption questions (AUDIT-C). (1998) ↩
    4. [4]Reinert DF, Allen JP. The Alcohol Use Disorders Identification Test: an update of research findings. (2007) ↩

    Related scales

    Instruments clinicians often use alongside this one

    substance-use

    AUDIT-C

    Alcohol Use Disorders Identification Test - Consumption

    Three-item alcohol consumption screen; the consumption subset of the WHO AUDIT.

    Open scale

    substance-use

    CAGE

    CAGE Questionnaire

    Four-item lifetime screen for problem drinking.

    Open scale

    substance-use

    DAST-10

    Drug Abuse Screening Test-10

    Ten-item yes/no screen for drug use problems (excluding alcohol and tobacco).

    Open scale

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