AUDIT (Alcohol Use Disorders Identification Test): Take It, Score It, Understand Your Results
The AUDIT (Alcohol Use Disorders Identification Test) is a 10-item self-report screening questionnaire developed by the World Health Organization to identify drinking patterns that may put your health at risk. It covers three areas — how much and how often you drink, signs of alcohol dependence, and alcohol-related harms — and takes about 2 to 4 minutes to complete. The AUDIT produces a 0-40 score that helps a clinician decide whether brief counseling, further assessment, or specialist referral is warranted. The AUDIT is a screening tool, not a diagnosis of alcohol use disorder: results should be reviewed with a healthcare professional.
What is the AUDIT?
The AUDIT (Alcohol Use Disorders Identification Test) is a 10-item alcohol screening questionnaire developed by the World Health Organization (WHO) and first published in 1989. It was specifically designed for use in primary care settings and is one of the most widely used and rigorously validated alcohol screening instruments in the world. The AUDIT has been translated into more than 30 languages and is freely available for clinical use. A shorter version called the AUDIT-C uses only the first 3 consumption items and is sometimes used when time is very limited; this page covers the full 10-item AUDIT.
What the AUDIT measures
The AUDIT is organized into three conceptual areas. Items 1 to 3 measure alcohol consumption — how often you drink, how many standard drinks you typically have, and how often you have six or more drinks on one occasion. Items 4 to 6 measure signs of alcohol dependence — loss of control, drinking earlier in the day, and morning drinking. Items 7 to 10 measure alcohol-related problems — feeling guilty, blackouts, injuries, and concern from others. By covering all three areas, the AUDIT can distinguish between low-risk drinking, hazardous or harmful drinking patterns, and patterns suggestive of alcohol dependence — which lab-based markers of liver function or blood alcohol alone cannot do.
How the AUDIT is administered
The AUDIT is a self-report questionnaire that takes about 2 to 4 minutes to complete. Each item offers a fixed set of multiple-choice responses scored from 0 to 4, except items 9 and 10 which use a 0 / 2 / 4 scale. You can complete the AUDIT on paper, on a screen, or have a clinician ask the questions in an interview format — the validation work supports both modes. A standard drink is defined as the amount of any alcoholic beverage containing about 10 grams of pure alcohol (slightly under one U.S. standard drink of 14 grams), so honest reporting depends on understanding the standard-drink concept and applying it to whatever you drink.
Who uses the AUDIT
The AUDIT is used routinely in primary care, emergency departments, hospital pre-admission assessments, and behavioral health screening programs. The U.S. Preventive Services Task Force recommends that primary care clinicians screen all adults for unhealthy alcohol use and provide brief behavioral counseling when appropriate, and the AUDIT and AUDIT-C are the two screening instruments the USPSTF specifically lists as suitable for this purpose. The AUDIT is also used in public health surveys, occupational health programs, and research on alcohol-related disease. Outside clinical settings, individuals sometimes use it as a private self-assessment to reflect on their own drinking.
AUDIT is a screening tool, not a diagnosis
The AUDIT identifies drinking patterns that may carry health risk, but it does not by itself diagnose alcohol use disorder (AUD) — a clinical diagnosis based on DSM criteria that requires a clinician's evaluation. A high AUDIT score is a signal that further conversation with a clinician is warranted, not a verdict. A low score does not guarantee that alcohol is not affecting your health, particularly if you have other risk factors or symptoms. If you are concerned about your drinking or someone else's drinking, talk to a clinician — effective treatments exist and early intervention has better outcomes than waiting. SAMHSA's National Helpline (1-800-662-HELP) offers free, confidential 24/7 support in the United States.
How to score and interpret your results
Scoring the AUDIT is straightforward: add the numbers from all 10 items. Items 1 through 8 each score 0 to 4. Items 9 and 10 use a 0, 2, or 4 scale, giving a total range of 0 to 40. Higher totals indicate a greater likelihood that drinking is causing harm or that alcohol dependence is present. The AUDIT is a screening tool, not a diagnosis of alcohol use disorder. Your total places drinking on a risk continuum that a clinician reads alongside your medical history.
The WHO cutoff bands divide the 0-40 range into four interpretive zones. The 8-point threshold is the original Saunders 1993 cutoff for hazardous or harmful drinking, with splits at 15 and 20 to separate likely moderate from likely severe dependence.
Cutoff bands and what they suggest
| AUDIT total | Risk zone | What it suggests |
|---|---|---|
| 0 | Abstainer | No alcohol-related problems in the past year |
| 1-7 | Low risk | Drinking within WHO low-risk guidelines |
| 8-14 | Hazardous or harmful | Drinking pattern is likely causing health or social harm |
| 15-19 | Likely moderate dependence | Pattern consistent with moderate alcohol use disorder |
| 20-40 | Likely severe dependence | Pattern consistent with severe alcohol use disorder and significant harm |
A score of 8 or higher was chosen as the principal cutoff for a clear reason. In the original 6-country WHO validation study, 92% of people with hazardous or harmful drinking scored 8 or more, while 94% of non-hazardous drinkers scored below 8. That sensitivity-specificity balance is why the 8-point threshold has remained the global standard.
How to read a borderline result
A score near a cutoff is not a hard verdict. A 7 in someone who drinks heavily on weekends still warrants a conversation. A 9 in someone who under-reported portions may underestimate true risk. The 15+ and 20+ thresholds in particular are flags for a full clinical assessment, not stand-alone labels.
AUDIT vs AUDIT-C: when is the short form used?
The AUDIT-C is a 3-item subset using only the consumption questions from the full AUDIT. It asks how often you drink, how many standard drinks you typically have, and how often you have six or more drinks on one occasion. It takes about 1 to 2 minutes. It is designed for fast routine screening when a clinician needs a quick signal rather than a full risk profile.
The U.S. Preventive Services Task Force lists both AUDIT and AUDIT-C as suitable adult primary-care screeners, with a Grade B recommendation supporting routine use. The AUDIT-C trades depth for speed. It captures consumption well but does not directly ask about dependence symptoms or alcohol-related problems, which are covered by items 4 through 10 of the full AUDIT.
Side-by-side comparison
| Feature | AUDIT (full) | AUDIT-C |
|---|---|---|
| Items | 10 | 3 (consumption only) |
| Time | 2-5 minutes | 1-2 minutes |
| Domains covered | Consumption, dependence, alcohol-related problems | Consumption only |
| Score range | 0-40 | 0-12 |
| Typical positive cutoff | 8 or higher (single threshold) | Sex-specific thresholds used in primary care |
| Sensitivity (best evidence) | 92% at cutoff 8 | 0.73-0.97 (women), 0.82-1.00 (men) |
The AUDIT-C is often the screen of choice in busy primary care. The full AUDIT is preferred when a clinician wants a richer picture of dependence and harm, or when an AUDIT-C result is positive and a closer look is needed.
What a positive screen means — and what it doesn’t
A positive AUDIT — typically a score of 8 or higher — means your drinking pattern is statistically linked with hazardous or harmful use. It does not mean you have alcohol use disorder. The AUDIT is a screening tool, not a diagnosis. A diagnosis of AUD is made by a clinician using DSM criteria that look at a year-long pattern of behavior, not at a single questionnaire result.
According to MedlinePlus, AUD may be present when two or more of 11 specific behaviors have occurred in the past year. These behaviors include drinking longer or more than intended, unsuccessful attempts to cut down, persistent cravings, drinking that interferes with work or family, needing more to get the same effect, or withdrawal symptoms when stopping. The AUDIT touches several of these areas but does not substitute for a clinician working through the criteria with you.
What typically happens after a positive screen
In primary care, a positive AUDIT usually leads to a short conversation rather than an immediate diagnosis. USPSTF data show that brief behavioral counseling — a median of 1 session lasting about 30 minutes — is linked with a reduction of about 1.59 drinks per week and lower odds of exceeding recommended limits. The number needed to treat is roughly 7. That means for every seven people who receive brief counseling after a positive screen, one extra person ends up drinking within recommended limits. Scores in the 15+ or 20+ bands may lead to specialist referral.
A positive screen does not mean you must stop drinking permanently, it does not commit you to a specific treatment, and it does not put a label on your record without your involvement. The AUDIT surfaces information for a conversation. What happens next is shaped by that conversation, not by the number alone.
How accurate is the AUDIT?
The AUDIT is one of the most rigorously validated alcohol screening tools in the world. The original 6-country WHO study gave a 150-item assessment to 1,888 primary care attendees and selected the final 10 items by their ability to identify hazardous and harmful drinking. At the recommended cutoff of 8, the validation reported 92% sensitivity and 94% specificity. In plain terms, the AUDIT correctly identified 92 of every 100 hazardous or harmful drinkers and correctly cleared 94 of every 100 non-hazardous drinkers.
Since 1993, more than 300 studies have examined the AUDIT’s validity across different populations and settings. The instrument performs well in women, minority group members, and college students. It has shown particular strength in trauma patient populations, where it has outperformed both physician judgment and blood alcohol content testing for identifying possible alcohol use disorders.
Where accuracy is reduced
No screening instrument performs equally well in every group. The AUDIT’s accuracy is reduced in older adults. Age-related changes in alcohol metabolism, body water content, and medication use mean the same self-reported intake can carry different risks than in younger adults. Clinicians may use age-adjusted instruments such as the CARET for older patients instead.
AUDIT-C performance
The AUDIT-C, the 3-item consumption-only version, has its own validation profile. Across primary care studies, sensitivity ranges from 0.73 to 0.97 in women and 0.82 to 1.00 in men. Sex-specific cutoffs apply because women generally reach equivalent risk at lower consumption than men. Accuracy depends heavily on the chosen cutoff and the screened population. Some clinicians pair questionnaire screening with a biomarker check such as the GGT liver enzyme test, though questionnaires generally detect risky drinking earlier than liver tests.
Limitations and considerations
Self-report and honesty
The AUDIT relies entirely on what you tell it. Under-reporting is common, especially for items about quantity, heavy-drinking frequency, and alcohol-related problems. A clinician who suspects under-reporting may follow up with extra questions or liver biomarker tests such as AST or ALT. These markers are less sensitive to early hazardous use than the AUDIT itself, and a normal liver panel does not rule out risky drinking.
Standard-drink confusion
The AUDIT’s quantity questions assume you know what a standard drink is, and definitions vary by country. The original WHO research defined a drink as 8 to 13 grams of pure alcohol, while some countries use 20 grams. In the United States, a standard drink is 12 ounces of 5% beer, 5 ounces of 12% wine, or 1.5 ounces of 40% liquor. Restaurant pours, cocktails, and craft beers can easily contain more than one standard drink, and miscounting can shift your score by several points.
Not a comprehensive assessment
A brief screen is not the same as a full diagnostic interview. The AUDIT covers a year-long window and asks about typical patterns. It may miss episodic heavy drinking, recent changes, or co-occurring problems such as drug use, mental health conditions, or sleep disturbance. Multi-substance screening tools such as ASSIST — or single-substance tools like the DAST-10 — are listed by the USPSTF for broader substance coverage.
Populations where AUDIT is not the first choice
The USPSTF recommends specific instruments for groups where the standard AUDIT is not the best-validated option. For pregnant women, instruments such as TWEAK, T-ACE, 4P’s Plus, and NET are typically preferred. For adolescents (12-17 years), the CRAFFT is more commonly recommended, and the USPSTF rates evidence for screening adolescents as Grade I — insufficient to weigh benefits and harms. For older adults, the CARET addresses age-related risks more directly. The full AUDIT uses a single cutoff of 8 without sex stratification. Sex-specific thresholds apply to the AUDIT-C and to NIAAA risky-use definitions.
Harms of screening itself
The USPSTF identified potential stigma, labeling, anxiety, and privacy concerns as harms of alcohol screening, though it concluded that direct harms from the screening process itself are minimal. How a result is communicated, and the trust between you and your clinician, matter as much as the score.
Frequently asked questions
What is the AUDIT alcohol test?
The AUDIT (Alcohol Use Disorders Identification Test) is a 10-item questionnaire developed by the World Health Organization and first published in 1989. It screens for hazardous drinking, harmful drinking, and likely alcohol dependence, and is among the most widely validated alcohol screening tools worldwide.
What is a good AUDIT score?
A score of 0 to 7 indicates low-risk drinking by WHO guidelines. 8 to 14 suggests hazardous or harmful drinking that warrants a conversation with a clinician. 15 to 19 suggests likely moderate dependence, and 20 or higher suggests likely severe dependence — both bands point toward a full clinical assessment.
What does an AUDIT score of 8, 15, or 20 mean?
These are the three WHO threshold points. 8 or higher identifies hazardous or harmful drinking with 92% sensitivity. 15 or higher indicates likely alcohol dependence. 20 or higher suggests likely severe dependence — typically a trigger for specialist referral.
What is a good AUDIT-C score?
The AUDIT-C uses sex-specific cutoffs because women generally reach equivalent alcohol-related risk at lower consumption than men. Across primary care studies, sensitivity ranges from 0.73 to 0.97 in women and 0.82 to 1.00 in men. A higher AUDIT-C score warrants either follow-up with the full AUDIT or a clinical conversation.
Is the AUDIT the same as an “am I an alcoholic” quiz?
No. The AUDIT screens for risky drinking patterns; it does not diagnose alcohol use disorder. A clinical AUD diagnosis requires a clinician to apply DSM criteria — a year-long pattern of 11 specific behaviors, of which two or more must be present. The AUDIT touches some of these areas but is a signal, not a verdict.
How long does the AUDIT take?
The full AUDIT takes about 2 to 5 minutes to complete. The shorter AUDIT-C takes 1 to 2 minutes. Both can be done on paper, on a screen, or as a brief interview with a clinician.
Is the AUDIT free to use?
Yes. The AUDIT was developed and published by the World Health Organization and is freely available for clinical, educational, and research use.
Can I take the AUDIT online by myself?
Yes — the AUDIT was designed for healthcare practitioners but is adaptable for self-administration, and validation work supports both modes. A self-administered score is most useful as a starting point for a conversation with a clinician, especially at 8 or higher.
What to do with your results and when to seek help
What you do with an AUDIT result depends on your score band and overall health. The AUDIT is a screening tool, not a diagnosis of alcohol use disorder. Its job is to surface a signal for a conversation, not to prescribe action on its own. The ladder below is a general guide; your clinician will personalize it.
Action ladder by score band
- Score 0-7 (low risk): Maintain low-risk drinking. NIAAA defines risky use as more than 4 drinks per day or 14 per week for men 21-64, and more than 3 per day or 7 per week for women and adults 65+. No alcohol is recommended in pregnancy, before driving, or with certain medications or conditions.
- Score 8-14 (hazardous or harmful): Talk with your primary care clinician. Brief behavioral counseling — typically about 1 session of 30 minutes — is linked with a reduction of around 1.59 drinks per week. This is the most common range where brief intervention helps.
- Score 15-19 (likely moderate dependence): A full clinical assessment is recommended. Your clinician may apply DSM criteria to evaluate whether AUD is present and discuss next steps.
- Score 20-40 (likely severe dependence): Seek prompt specialist evaluation. MedlinePlus notes that alcohol withdrawal symptoms can include tremors, anxiety, nausea, sweating, and in severe cases fever, seizures, and hallucinations. Any plan to reduce or stop heavy long-term drinking should be made with a clinician, not attempted alone.
Treatment options exist
MedlinePlus advises anyone concerned about possible AUD to consult a healthcare provider for evaluation and personalized treatment planning. For more severe patterns, options can include longer behavioral programs, mutual-help groups, and structured outpatient or inpatient care. A person with alcohol use disorder generally has better outcomes with earlier intervention.
Free and confidential help
In the United States, the SAMHSA National Helpline is a free, confidential, 24/7 service:
- 1-800-662-HELP (4357) — free, confidential, English and Spanish, 24/7, 365 days a year
- Treatment referral and information for individuals and family members
- No personal information required
If you are in crisis or thinking about harming yourself, call or text 988 for the Suicide and Crisis Lifeline. Heavy alcohol use is linked with increased risk of accidents, suicide, and other emergencies. Related screening tools include the DAST-10 for drug use and the PHQ-9 for co-occurring depression, which often accompanies heavy alcohol use.