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Screening for alcohol problems

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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:

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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