AUDIT C Score Calculator

The AUDIT-C measures alcohol consumption itself rather than its consequences, which is why all three of its items ask about drinking behaviour over the past year and none ask about guilt, criticism, or withdrawal. Question 1 scores how often the person drinks, from never at 0 points to four or more times a week at 4 points. Question 2 scores the typical number of standard drinks on a drinking day, from 1 to 2 drinks at 0 points to 10 or more at 4 points. Question 3 scores how often six or more drinks are consumed on one occasion, capturing heavy episodic drinking that the first two questions can miss in someone who drinks rarely but drinks a great deal when they do. The three items are summed for a total of 0 to 12. A standard drink in the United States contains about 14 grams of ethanol, roughly 12 ounces of 5 percent beer, 5 ounces of 12 percent wine, or 1.5 ounces of 40 percent spirits, whereas the World Health Organization definition uses 10 grams. The usual positive thresholds are 4 or more for men and 3 or more for women, the lower female cutoff reflecting higher blood alcohol concentrations per unit consumed because of smaller body water volume. Scores of 8 or above are strongly associated with alcohol dependence. The instrument screens rather than diagnoses: a score of 0 is also returned by people in long-term recovery, self-reported intake is systematically underestimated, and patients frequently misjudge what counts as one standard drink, particularly with high-gravity craft beers and home-poured spirits.

The parent instrument, the full 10-item Alcohol Use Disorders Identification Test, came out of a World Health Organization collaborative project that screened patients across six countries to build a tool that would work outside the specialist alcohol clinic. John Saunders, Olaf Aasland, Thomas Babor, Juan Ramon de la Fuente, and Marcus Grant described the finished AUDIT in the journal Addiction in 1993. Its first three questions covered consumption, the remaining seven covered dependence symptoms and alcohol-related harm. The abbreviated version was created because ten questions were too many for routine primary care contact. Kristen Bush and colleagues at the Veterans Affairs health system published the AUDIT-C in Archives of Internal Medicine in 1998, showing that the three consumption items alone performed about as well as the full questionnaire for detecting heavy drinking, while taking well under a minute to administer. Katharine Bradley and colleagues extended the validation in 2007, establishing the sex-specific cutoffs now in common use. The Veterans Affairs system adopted it as a mandatory annual screen, which produced one of the largest bodies of real-world screening data anywhere and helped drive its spread into general primary care, emergency departments, and prenatal clinics. The US Preventive Services Task Force recommendation that all adults 18 and older be screened for unhealthy alcohol use in primary care settings cemented brief instruments of this kind as standard practice.