Alcohol Screen (AUDIT) - PDF Document

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  1. Alcohol Screen (AUDIT) Low Strength Beer 425ml 2.7% Alcohol Wine 100ml 12% Alcohol This guide contains examples of one standard drink. A full strength can or stubbie contains one and a half standard drinks. Introduction Because alcohol use can affect health and interfere with certain medications and treatments, it is important that we ask you some questions about your use of alcohol. Your answers will remain confidential, so please be as accurate as possible. Try to answer the questions in terms of ‘standard drinks’. Please ask for clarification if required. Please tick the response that best fits your drinking. Monthly or less AUDIT Questions 2 - 4 times a month 2 - 3 times a week 4 or more times a week Never Score Sub totals 1. How often do you have a drink containing alcohol? Go to Qs 9 & 10 1 or 2 3 or 4 5 or 6 7 to 9 10 or more 2. How many standard drinks do you have on a typical day when you are drinking? Less than monthly Daily or almost daily Never Monthly Weekly 3. How often do you have six or more standard drinks on one occasion ? 4. How often during the last year have you found that you were not able to stop drinking once you had started? 5. How often during the last year have you failed to do what was normally expected of you because of drinking? How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? How often during the last year have you had a feeling of guilt or remorse after drinking? 6. 7. 8. How often during the last year have you been unable to remember what happened the night before because you had been drinking? Yes, but not in the last year Yes, during the last year No 9. Have you or someone else been injured because of your drinking? 10. Has a relative, friend, doctor, or other health care worker been concerned about your drinking or suggested you cut down? TOTAL Probably Not Supplementary Questions No Unsure Possibly Definitely Do you think you presently have a problem with drinking? Neither difficult nor easy Very easy Fairly easy Fairly difficult Very difficult In the next 3 months, how difficult would you find it to cut down or stop drinking? D0718 - 8/09 - P1 of 2

  2. How to score and interpret the AUDIT The World Health Organization’s Alcohol Use Disorders Identification Test (AUDIT) is a very reliable and simple screening tool which is sensitive to early detection of risky and high risk (or hazardous and harmful) drinking. It has three questions on alcohol consumption (1to3), three questions on drinking behaviour and dependence (4 to 6) and four questions on the consequences or problems related to drinking (7 to 10). The Supplementary Questions do not belong to the AUDIT and are not scored. They provide useful clinical information associated with the client’s perception of whether they have an alcohol problem and their confidence that change is possible in the short-term. They act as an indication of the degree of intervention required and provide a link to counselling or brief intervention following feedback of the AUDIT score to the client. Scoring the AUDIT • The columns in the AUDIT are scored from left to right. • Questions1to8 are scored on a five-point scale from 0, 1, 2, 3, and 4. • Questions9&10 are scored on a three -point scale from 0, 2 and 4. • Record the score for each question in the “score” column on the right, including a zero for questions 2 to8 if ‘skipped’. • Record a total score in the “TOTAL” box at the bottom of the column. The maximum score is 40. Consumption score Add up questions 1 to 3 and place this sub-score in the adjacent single box in the far right column (maximum score possible = 12). A score of 6 or 7 may indicate a risk of alcohol-related harm, even if this is also the total score for the AUDIT (e.g. consumption could be over the recommended weekly intake of 28 for men and 14 for females in the absence of scoring on any other questions). Drinking may also take place in dangerous situations (e.g. driving, fishing/boating). Scores of 6 to 7 may also indicate potential harm for those groups more susceptible to the effects of alcohol, such as young people, women, the elderly, people with mental health problems and people on medication. Further inquiry may reveal the necessity for harm reduction advice. Dependence score Add up questions 4 to 6 and place this sub-score in the adjacent single box in the far right column (maximum score possible = 12). In addition to the total AUDIT score, a secondary ‘dependence’ score of 4 or more as a subtotal of questions 4 to 6, suggests the possibility of alcohol dependence (and therefore the need for more intensive intervention if further assessment confirms dependence). Alcohol-related problems score Any scoring on questions 7 to 10 warrants further investigation to determine whether the problem is of current concern and requires intervention. AUDIT Total score Dependence score Risk level Possible Interventions • Use ‘Right Mix’ materials to reinforce low-risk drinking, particularly for those who previously had alcohol problems or whose circumstances may change. Harm reduction advice may be appropriate for those in susceptible groups (see ‘Consumption Score’ above). Low-risk 0 - 7 below 4 • • Brief Intervention - feedback of AUDIT and harm reduction advice may be sufficient Ideally also: - setting goals and limits - a motivational interview - self-monitoring of drinking - use of “The Right Mix” self-help guide Counselling may be required. Risky or hazardous level. Moderate risk of harm. May include some clients currently experiencing harm (especially those who have minimised their reported intake and problems). 8 - 15 below 4 • Assess for dependency 4 or more • • • Brief Intervention (all components) is a minimum requirement. Assessment for more intensive intervention. Counselling using CBT principles and motivational interviewing in individual sessions and/or in groups. Follow-up and referral where necessary. High-risk or harmful level. Drinking that will eventually result in harm, if not already doing so. May be dependent. 16 - 19 below 4 • Assess for dependence 4 or more • Further assessement preferably including family and significant others. More intensive counselling and/or group program. Consider referral to medical or specialist services for withdrawal management. Pharmacotherapy to manage cravings. Relapse prevention, longer-term follow-up and support. High-risk Definite harm, also likely to be alcohol dependent. Assess for dependence. 20 or more below 4 • • Almost certainly dependent. Assess for dependency. 4 or more • • D0718 - 8/09 - P2 of 2