AUDIT-C scoring
Use the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) to support your clinical assessment. Enter the client’s responses below to calculate a total and compare it with the common cut-offs for men and women. This tool is for clinicians and supports, rather than replaces, a clinical interview.
Because alcohol use can affect your health and can interfere with certain medications and treatments, it is important that we ask some questions about your use of alcohol. Your answers will remain confidential so please be honest. Place an X in one box that best describes your answer to each question.
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Running total: 0 / 12
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How to score the AUDIT-C
- Ask about the client’s drinking and choose one answer for each of the three consumption questions.
- Each question scores 0 to 4 points, from the first answer to the last. The points are shown next to each answer.
- Add the three answers for a total from 0 to 12.
- Compare the total with the common cut-offs: 4 or more for men and 3 or more for women.
AUDIT-C cut-offs
| Total score | Result |
|---|---|
| 0 to 2 | below the cut-offs for women and men |
| 3 | at the cut-off for women, below the cut-off for men |
| 4 to 12 | at or above the cut-offs for women and men |
What the score means and what it does not
In a primary care validation study, the AUDIT-C thresholds that best balanced sensitivity and specificity for alcohol misuse were 4 or more in men and 3 or more in women, the same as in earlier Veterans Affairs studies. The WHO guide notes that any points on question 2 or 3 indicate consumption at a hazardous level. The AUDIT-C asks only about consumption; the full AUDIT adds questions on dependence and alcohol-related harm. A total at or above the cut-off is a positive screen, not a diagnosis, so follow up with a clinical interview.
Using the AUDIT-C over time
The WHO interview version asks about drinking during the past year. When you repeat the AUDIT-C to review change, use the same time frame each time and discuss the answers with the client. A change in total alone does not establish a treatment effect.
Frequently asked questions
What is a positive AUDIT-C score?
Common cut-offs are 4 or more for men and 3 or more for women. A total at or above the cut-off is a positive screen for alcohol misuse that needs follow-up in a clinical interview.
Why are the cut-offs different for men and women?
Validation studies found that the thresholds that best balanced sensitivity and specificity differed: 4 or more in men and 3 or more in women. This tool shows both cut-offs rather than asking for the client’s sex.
What are the AUDIT-C questions?
They are the first three AUDIT questions: how often the client has a drink containing alcohol, how many drinks on a typical drinking day, and how often six or more drinks on one occasion.
What counts as a drink?
The AUDIT assumes a standard drink of 10 grams of alcohol. A US standard drink is 14 grams, so the WHO guide suggests adapting drink sizes, and possibly question 3, to local standards.
What is the difference between the AUDIT-C and the AUDIT?
The AUDIT-C uses only the three consumption questions, scored 0 to 12. The full AUDIT adds seven questions about dependence and alcohol-related harm, scored 0 to 40 with four WHO risk zones.
Sources
The AUDIT-C uses the first three questions of the AUDIT, developed by the World Health Organization. As a WHO-approved instrument, the AUDIT is in the public domain. Questions are from the self-report version in the WHO guide (Box 10).