📋 AUDIT Alcohol Test

The Alcohol Use Disorders Identification Test (AUDIT) is the World Health Organization's 10-question assessment for alcohol problems, used in clinics worldwide since the 1980s. Three questions cover consumption, three cover dependence symptoms, and four cover alcohol-related harm, scored 0 to 40.

Scores fall into four zones: 0 to 7 low risk, 8 to 15 risky drinking, 16 to 19 harmful drinking, and 20-plus possible dependence. This page administers all ten questions with official scoring and zone guidance.

How to take the test

Answer for the past year, honestly. "Standard drink" means 14 grams of pure alcohol.

Scoring and the four zones

Questions 1 to 8 score 0 to 4; questions 9 and 10 score 0, 2, or 4. Maximum 40.

The zones map to WHO-recommended interventions of increasing intensity. Note that questions 4 to 6 (loss of control, morning drinking, failure to meet expectations) are the dependence cluster: points here weigh heavily toward Zone IV concern.

Worked example

Drinks 2 to 3 times weekly (3), 5 to 6 typical (2), binges monthly (2), unable to stop monthly (2), failed expectations monthly (2), no morning drinks (0), guilt monthly (2), blackouts monthly (2), no injuries (0), partner concerned this year (4). Total: 19. Zone III, harmful drinking: counseling plus monitoring, with dependence features emerging.

A lighter pattern: drinks monthly (1), 3 to 4 typical (1), binges less than monthly (1), zeros elsewhere. Total: 3. Zone I, low risk.

What each zone means

Zone I (0 to 7): low-risk pattern; education about guidelines suffices. Zone II (8 to 15): risky drinking; brief counseling, the 5-to-15-minute clinician conversation with proven trial efficacy. Zone III (16 to 19): harmful use; counseling plus active monitoring, since problems are likely already occurring.

Zone IV (20+): possible alcohol dependence; referral for full assessment and treatment planning. Important: do not stop heavy daily drinking suddenly without medical supervision, as withdrawal can be dangerous. For the shorter screen, see our AUDIT-C test, and for drink math, the alcohol units calculator.

Why clinicians trust AUDIT

AUDIT was developed across six countries and validated in dozens more, in primary care, emergency departments, and workplaces. It detects the full spectrum from risky drinking to dependence, unlike screens that only catch severe cases, and its zone system directly prescribes the response.

Its limitation is honesty: it is a self-report, and people minimize. Clinicians pair it with biomarkers (liver enzymes, CDT) when the story and the score disagree. Taken sincerely, though, it remains the best-validated alcohol assessment available.

Dependence vs harmful use: the clinical line

Questions 4 to 6 of the AUDIT are the dependence cluster: unable to stop once started, failing to do what was expected, needing a morning drink. Points here signal impaired control and withdrawal, the core of dependence, versus harmful use where the drinking causes damage but control remains.

The distinction drives treatment. Harmful use responds to counseling and monitoring; dependence usually needs structured treatment, sometimes including medication (naltrexone, acamprosate) and always including withdrawal assessment. The AUDIT's structure encodes this triage in its question order.

Why Zone IV needs medical supervision

Alcohol withdrawal can be dangerous: tremors and anxiety escalate to seizures and delirium tremens in severe dependence, typically 2 to 4 days after the last drink. That is why Zone IV guidance says do not stop abruptly without medical help.

Medically supervised withdrawal uses benzodiazepines (often via the CIWA protocol) to prevent seizures, plus thiamine to prevent Wernicke's encephalopathy. It is a short inpatient or closely monitored outpatient process, and it is the safe doorway to longer-term treatment, not the treatment itself.

AUDIT in the emergency department

Emergency departments see alcohol's sharp end: injuries, withdrawal, intoxication. The AUDIT, or often the AUDIT-C for speed, helps sort the intoxicated patient who needs observation from the dependent patient who needs a withdrawal protocol and referral. A high score changes the disposition plan.

The teachable moment matters too: an alcohol-related injury brings patients to care who never visit primary care, and brief counseling in the ED shows modest but real effects. Screening without follow-up resources is less useful, which is why the best ED programs link directly to treatment slots.

Trauma centers take this furthest: many require alcohol screening and brief intervention as a condition of verification, a policy backed by data showing reduced reinjury. The AUDIT's zone system gives that mandate a practical tool.

Screen vs diagnosis: the DSM-5 line

AUDIT zones describe risk; DSM-5 criteria diagnose alcohol use disorder (2-3 criteria mild, 4-5 moderate, 6+ severe). The screen says "look closer"; the clinical interview says "this is the diagnosis." Both have their place, and neither replaces the other.

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