AUDIT-C alcohol use screening test

What AUDIT-C measures

AUDIT-C is a 3-item screen for hazardous drinking and possible alcohol use disorder. It does not measure dependence directly — it measures consumption pattern, which is the strongest single predictor of alcohol-related harm.

The three items capture:

1. Frequency — how often you drink
2. Quantity — how much on a typical drinking day
3. Heavy episodic use — how often you have ≥6 drinks at one occasion

Each item scores 0–4. Total range: 0–12.

Interpretation table (Bush 1998)

A positive screen does not mean dependence — it means consumption is high enough that brief intervention is justified.

Why screening is endorsed

The USPSTF 2018 statement (Grade B) recommends screening every adult in primary care, including pregnant women. The evidence base:

• Brief intervention after positive screen reduces consumption by ~3 drinks/week on average and reduces heavy drinking days.
• Effect sizes are larger in those with hazardous use (positive screen) than in dependent drinkers.
• AUDIT-C takes <1 minute and has sensitivity 0.74–0.95, specificity 0.65–0.92 for hazardous use depending on cut-off.

What “brief intervention” actually means

A positive AUDIT-C does not automatically mean rehab. The standard pathway is:

1. Feedback — your provider shares the score and what it suggests.
2. Personalised advice — what level would be lower-risk for you given age, comorbidities, medications, pregnancy.
3. Goal-setting — agreed reduction target, often “below 14 units/week” (UK CMO) or “no more than 1 drink/day women, 2 drinks/day men” (US).
4. Follow-up — re-screen in 3–6 months.

Most people benefit. A small subset will need referral to specialist services — typically those scoring ≥8 or with established dependence symptoms.

Lower-risk drinking — international guidelines

Different countries have different “low-risk” thresholds. They have all been moving downward as evidence accumulates:

• UK (CMO 2016): ≤14 units/week, spread across ≥3 days, with several alcohol-free days
• Canada (CCSA 2023): ≤2 drinks/week to minimize risk; 3–6 drinks/week increases risk; ≥7 drinks/week clearly elevates cancer and cardiovascular risk
• USA (DGA 2020): ≤1 drink/day for women, ≤2 for men if you choose to drink
• Australia (NHMRC 2020): ≤10 standard drinks/week, ≤4 on any day

The 2018 Lancet Global Burden of Disease analysis concluded that the level of alcohol consumption that minimizes health loss is zero — though the harm gradient is gentle below ~1 drink/day.

Related calculators

• PHQ-9 depression screen — alcohol misuse and depression frequently co-occur.
• GAD-7 anxiety screen — many drink to manage anxiety; treating anxiety often reduces use.
• BMI calculator — alcohol contributes substantial empty calories.

Limitations

• Self-report under-counts. Even with anonymous screens, people typically under-report. Assume the true level is somewhat higher than reported.
• Recent change in pattern. AUDIT-C asks about a typical recent month. If you’ve been “dry January” or had a hard week, score the typical pattern, not these atypical weeks.
• Pregnancy. Any alcohol in pregnancy carries risk. Score 0 for any drink is the recommended target.
• Adolescents and older adults have somewhat different validated cut-offs in the literature; the standard 4/3 thresholds are reasonable defaults but discuss with a provider.

Privacy

All calculations run in your browser. We never see, log, or store your individual answers. Only an anonymous event (locale, severity band, sex selection) is sent to a privacy-respecting analytics service.