Tests
1st tests to order
diagnostic interview
Test
A diagnostic interview uses the DSM-5-TR (or ICD-11) criteria to make a diagnosis of alcohol use disorder.[3][4]
A validated questionnaire (e.g., Alcohol Use Disorders Identification Test [AUDIT]) can assist in screening or be used as a proxy for the DSM-5-TR criteria.[35][36] [ Alcohol Consumption Screening AUDIT Questionnaire Opens in new window ]
Result
presence of at least 2 of the 11 DSM-5-TR criteria over a 12-month period indicates AUD: mild AUD is presence of 2-3 criteria; moderate is presence of 4-5 criteria; severe is presence of 6 or more criteria
alcohol level (breath and blood)
Test
Breath analyzers do not directly measure blood alcohol content (BAC), but instead provide an estimate of the BAC.
BACs >200 mg/dL with limited impairment can indicate tolerance to the effects of alcohol but do not diagnose alcohol use disorder. A BAC of 400 mg/dL is lethal for 50% of adults.
Result
values in the range of 50-100 mg/dL are typically associated with some impairments in memory, coordination, and judgment in nondependent users
Clinical Institute Withdrawal Assessment for Alcohol, revised (CIWA-Ar)
Test
The revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) is the standard assessment instrument used to quantify the severity of alcohol withdrawal symptoms.[38] Clinical Institute Withdrawal Assessment of Alcohol Scale, revised (CIWA- Ar) Opens in new window
See Alcohol withdrawal.
Result
≥8 to 10 indicates presence of significant alcohol withdrawal symptoms
Tests to consider
carbohydrate-deficient transferrin (CDT)
Test
A highly sensitive test for heavy drinking, CDT utilizes alcohol inhibition of the transfer of sugars to glycoproteins.[41] False positives can be found in patients with liver cirrhosis. CDT is less sensitive in women.
Result
increased concentrations found in serum after regular, heavy alcohol intake
gamma glutamyl transpeptidase (gamma-GT), alanine aminotransferase (ALT), aspartate aminotransferase (AST)
Test
Gamma-GT, in particular, correlates with alcohol consumption and is sometimes used to monitor drinking behavior.
These tests are not sensitive enough to diagnose alcohol use disorder.[41]
Result
increased values of gamma-GT, AST, ALT
CBC
Test
Alcohol suppresses the bone marrow.
Result
normal to low Hb, Hct; low platelets (<100,000 mm³)
urinary ethyl glucuronide
Test
Testing by liquid chromatography-mass spectrometry can detect very small levels of alcohol in the urine within several days of consumption. However, incidental use of alcohol-containing products (e.g., medications, hand sanitizers, cosmetics, etc.) can lead to false positive results.[40]
Result
elevated
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