Alcohol Use Screening Tests

Why this test may be ordered

• Your provider may do a screening test as part of a routine health care visit.
• You may also have a screening test if a provider thinks that you could have a problem with alcohol.
• If your family, friends, or co-workers express concerns about your drinking, talk to your provider about getting a screening.
• Your provider may also recommend a screening if they notice signs and symptoms of an AUD.

Preparation and collection

You don't need any special preparations for an alcohol use screening test.

Mental Health and Behavior

Taking a questionnaire may involve emotional discomfort when answering personal questions about alcohol use. Privacy of responses should be ensured. False-positive and false-negative results are possible; results are not diagnostic by themselves.

Understanding results

Screening results are typically reported as screen-positive or screen-negative. Depending on the questionnaire used, a higher score indicates a higher likelihood of unhealthy alcohol use or alcohol use disorder (AUD). Your healthcare provider will interpret the result in the context of your symptoms and history.

• screen-positive: Your score indicates a higher-likelihood of unhealthy alcohol use or AUD. For example, a score of 8 or more on the AUDIT test, or two or more 'yes' answers on the CAGE test, may suggest this. The number of symptoms you report can also indicate how severe the disorder might be, but further evaluation by a healthcare provider is needed to confirm. Limitation: Screening test results are not diagnostic by themselves. A positive result does not confirm alcohol use disorder; further assessment by a healthcare professional is required. Next step: Discuss with your healthcare provider for further evaluation and possible treatment plan. This may include brief intervention, counseling, medication, or support groups.
• screen-negative: Your score indicates a lower-likelihood of unhealthy alcohol use or AUD at this time. For example, a score below 8 on the AUDIT test, or fewer than two 'yes' answers on the CAGE test, may suggest this. However, this does not rule out future risk. Limitation: Screening test results are not diagnostic by themselves. A negative result does not guarantee no future risk or unhealthy alcohol use. Your provider may still advise monitoring your drinking habits. Next step: Continue routine monitoring; discuss any concerns with your healthcare provider. If your drinking changes or you develop symptoms, consider re-screening.

• Screening tests are not diagnostic by themselves; they only indicate a higher or lower likelihood of unhealthy alcohol use or alcohol use disorder (AUD).
• A screen-positive result does not confirm AUD; further evaluation by a healthcare professional is required.
• A screen-negative result does not guarantee no future risk or unhealthy alcohol use.
• Some questionnaires (e.g., CAGE) are no longer recommended due to lower accuracy.
• Results may be affected by reluctance to report alcohol use honestly.

What to do next

If your screening result is screen-positive, discuss with your healthcare provider for further evaluation and possible treatment plan. This may include brief intervention, counseling, medication, or support groups. If screen-negative, continue routine monitoring and discuss any concerns with your provider.

• How often do you have a drink containing alcohol?
• How many drinks containing alcohol do you have on a typical day when you are drinking?
• How often do you have six or more drinks on one occasion?
• Have you ever felt you should cut down on your drinking?
• Have people annoyed you by criticizing your drinking?

Evidence source

U.S. National Library of Medicine: Alcohol Use Screening Tests