Screening for alcohol problems

screening for alcohol problems

Screening is a systematic process of identifying people whose alcohol consumption places them at increased risk of physical, psychological or social problems and who would benefit from a preventive intervention (1)

Screening can be done in three ways:

• screening questionnaires
  • Alcohol Use Disorders Identification Test (AUDIT)
  • AUDIT-C and AUDIT-PC - these are shortened forms of the AUDIT and are used when there is insufficient time to administer the full AUDIT.
  • the CAGE
  • the 5-Shot Questionnaire
  • Fast Alcohol Screening Test (FAST)
  • Michigan Alcoholism Screening Test (MAST)
    
    
• biological markers of recent alcohol consumption
  • completely objective and cannot be distorted in the same way as questionnaires
  • mainly used in assessing the severity and progress of an established alcohol related problem, or as part of a secondary care assessment
  • the following are currently used to detect levels of alcohol consumption
    • blood or breath alcohol concentration
    • mean corpuscular volume (MCV)
    • serum gamma-glutamyltransferase (GGT)
    • aspartate aminotransferase
    • alanine aminotransferase
    • carbohydrate deficient transferrin (CDT)
    • HDL-cholesterol
    • Uric acid
      
      
• clinical indicators by clinicians using clinical history or signs at physical examination
  • the following physical disorders and signs are suggestive of harmful drinking
    • hypertension
    • frequent accidents
    • dilated facial capillaries
    • bloodshot eyes
    • hand or tongue tremor
    • gastrointestinal disorders
    • duodenal ulcers
    • cognitive impairment

NICE recommends that professionals in the National Health Service should carry out alcohol screening as part of routine practice

Reference:

• (1) National Institute for Health and Clinical Excellence (NICE) 2010. Alcohol-use disorders: preventing harmful drinking
• (2) The National Treatment Agency for Substance Misuse (NTA) 2006. Review of the Effectiveness of Treatment for Alcohol Problems
• (3) Day E, Copello A, Hull M. Assessment and management of alcohol use disorders. BMJ. 2015;350:h715