📋 AUDIT-C Alcohol Screener

The AUDIT-C is the three-question short form of the World Health Organization's alcohol screening test, and it is the most validated brief alcohol screener in medicine. It asks about drinking frequency, typical quantity, and binge frequency, scoring each 0 to 4 for a maximum of 12.

A score of 4 or more in men, or 3 or more in women, screens positive for unhealthy alcohol use. This page administers the three questions with the official scoring and explains what a positive or negative screen means.

How to take the screener

Answer for the past year. A "standard drink" is 14 grams of pure alcohol: 12 oz of regular beer, 5 oz of wine, or 1.5 oz of spirits.

Scoring and cutoffs

Each answer scores 0 to 4 points. The cutoffs differ by sex because alcohol affects women more at the same intake.

The test is a screen, not a diagnosis: a positive result means "worth a fuller assessment," not "you have alcohol use disorder." Sensitivity and specificity at these cutoffs both run around 80 to 90 percent in primary care.

Worked example

Drinks 2 to 3 times a week (3 points), typically 5 to 6 drinks (2 points), binges monthly (2 points). Total: 7. For a man (cutoff 4) or a woman (cutoff 3), this screens positive, and the pattern, regular heavy sessions, is exactly what the questions are designed to catch.

Contrast: drinks monthly or less (1), 1 to 2 drinks typically (0), never binges (0). Total: 1. Negative screen for both sexes.

After a positive screen

A positive AUDIT-C usually leads to the full 10-question AUDIT, which grades severity and guides the response: brief counseling for risky drinking, closer follow-up for harmful use, referral for likely dependence. Brief counseling in primary care genuinely reduces drinking in trials, which is why screening exists.

If you want the fuller picture now, take our full AUDIT test. To check what your drinks actually contain, use our alcohol units calculator. And if drinking feels hard to control, the SAMHSA National Helpline (1-800-662-4357) is free, confidential, and open 24/7.

Why three questions work

The AUDIT-C keeps the three consumption questions from the full AUDIT and drops the seven about consequences and dependence. Consumption turns out to predict problems well enough for screening: frequency finds the daily drinkers, quantity finds the heavy-session drinkers, and binge frequency finds the risky-pattern drinkers.

Its brevity is the point. Clinicians actually use it because it takes 30 seconds, which is why it appears in VA clinics, primary care, and emergency departments worldwide. The best screening test is the one that gets done.

Brief counseling: what actually happens

A positive AUDIT-C in primary care typically triggers a 5 to 15 minute conversation, not a lecture. The clinician shares the score, asks what the patient makes of it, offers clear advice to cut back, and gauges readiness to change. Motivational interviewing techniques, open questions and reflective listening, outperform warnings.

Trials show this brief intervention reduces drinking by a meaningful margin, which is remarkable for a quarter-hour chat. The mechanism is partly the screening itself: many people have never totaled their weekly intake, and the number does the persuading.

AUDIT-C in special populations

The standard cutoffs were validated in general adult primary care, and adjustments apply elsewhere. In pregnancy, any drinking is the concern, so the screen functions as a conversation starter rather than a scored test. In adolescents, lower thresholds apply since any regular drinking is risky.

In older adults, the same score can mean more harm: slower metabolism, more medications interacting with alcohol, and higher fall risk. Some geriatric guidelines suggest the female cutoff (3+) for older men too. Context adjusts interpretation even when the questions stay the same.

The one-question screens

Can a single question screen for unhealthy drinking? The SASQ (Single Alcohol Screening Question), "How many times in the past year have you had 5 or more drinks (men) or 4 or more (women) in a day?", performs surprisingly well, with sensitivity rivaling longer instruments for detecting unhealthy use.

Emergency departments and busy clinics use it because one question fits where three do not. A positive answer triggers the fuller assessment; a negative one usually ends the inquiry. It trades nuance for completion, and in screening, completion is most of the battle.

The AUDIT-C remains the better tool when 30 seconds are available: it adds frequency and typical quantity, catching the steady daily drinker the binge question misses. Think of SASQ as the smoke alarm and AUDIT-C as the inspection.

For informational purposes only, not medical advice. Consult a healthcare professional.