Screening

Early diagnosis of unhealthy alcohol use or alcohol-use disorder can allow clinicians to initiate treatment promptly, in order to lessen the impact from emotional, medical, occupational, financial, and social complications. Screening for unhealthy alcohol use and assessment and diagnosis of alcohol-use disorder can be performed by clinicians at various points in the process of providing healthcare services:

  • As part of a routine examination

  • Prior to prescribing a medication that interacts with alcohol

  • In the accident and emergency department or trauma centre (especially with presentations secondary to trauma/injuries, violence)[56]​ 

  • During pregnancy

  • When there are health problems that might be alcohol-related (e.g., cardiac arrhythmia, dyspepsia, liver disease, hypertension, depression, anxiety, insomnia, trauma).

The United States Preventive Services Task Force recommends screening all adults in primary care settings over the age of 18, and to provide brief interventions for all patients who report at-risk drinking and offer treatment to those with alcohol-use disorder.[57]​ Nonetheless, only 23% of physicians used a validated instrument to screen for alcohol use, in one multi-site study.[58]

A specific questionnaire that may be used to screen people for unhealthy alcohol use is the 10-question Alcohol Use Disorders Identification Test (AUDIT).[35] The AUDIT is sensitive in identifying less severe drinking problems.[36] A modified three-question version, the AUDIT-C, has been validated against the full AUDIT and has a similar sensitivity.[59]

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