A score above 8 is likely to identify hazardous and harmful drinkers. A higher total score provides increased sensitivity in identifying persons with alcohol dependence. A score above 8 should stimulate more detailed inquiry into the possibility of alcohol dependence.SCORING OF THE AUDITBased on experience gained in a study of treatment matching with persons who had a wide range of alcohol problem severity, AUDIT scores were compared with diagnostic data reflecting low, medium and high degrees of alcohol dependence. It was found that AUDIT scores in the range of 8-15 represented a medium level of alcohol problems whereas scores of 16 and above represented a high level of alcohol problems. On the basis of experience gained from the use of the AUDIT in this and other research, it is suggested that the following interpretation be given to AUDIT scores:Risk Level Intervention AUDIT score*Zone I (0-7) Alcohol Education on the dangers of excessive alcohol drinkingZone II (8-15) Simple Advice focused on the reduction of hazardous drinkingZone III (16-19) Simple Advice plus Brief Counseling and Continued MonitoringZone IV (20-40) Further diagnostic evaluation for alcohol dependence and possible referral to Specialist for Diagnostic Evaluation and TreatmentKey scoring should be subject to clinical judgment that takes into account the patient’s medical condition, family history of alcohol problems, and perceived honesty and responding to the questions. Special circumstances may require a clinical screening procedure including a physical examination and laboratory tests.*The AUDIT cut-off score may vary slightly depending on the country’s drinking patterns, the alcohol content of standard drinks, and the nature of the screening program. Clinical judgment should be exercised in cases where the patient’s score is not consistent with other evidence, or if the patient has a prior history of alcohol dependence.Other screening instruments included in the supplementary material are: the Michigan Alcohol Screening Test (MAST), the Alcohol Dependence Scale (ADS) and the Alcohol Dependence Data Questionnaire (SADD). A simple patient oriented check list can also be helpful.
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CURRENT LESSON OBJECTIVES
- List the 4 questions use in the CAGE questionnaire to screen for problem drinkers.
- Describe the use of the Alcohol Use Disorders Identification Test (AUDIT).
- Interpret the scoring of the AUDIT and other screening instruments.
- List the 7 criteria used for making a diagnosis of alcohol dependence.
- What are the 4 criteria for alcohol abuse?
- Define the terms hazardous alcohol use and harmful alcohol use.
- List physical signs and laboratory tests that assist in making a diagnosis.
- List brief interventions for alcohol use disorders and 5 behavioral therapies.
- What are the medications used to treat alcohol dependence?
- What strategies can individuals use to reduce drinking?
- List self help groups useful in the treatment of alcohol problems.
- 12. Describe the 12 steps of alcoholics anonymous (AA) and the factors involved
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