AUDIT (Alcohol Use Disorders Identification Test)
Hazardous drinking, harmful use and possible dependence (past year)
- WHO
- AWMF S3 Alkohol (076-001)
Sources last checked: 2026-10-13
AUDIT (Alcohol Use Disorders Identification Test)
Hazardous drinking, harmful use and possible dependence (past year)
Items are paraphrased; the official WHO or national version is the one for formal administration. One “drink” is a standard drink (WHO ≈ 10 g alcohol; national definitions differ). Two or more points on items 4–6 or on items 9–10 are significant even when the total is low.
Interpretation
| 0–7 — zone I (lower risk) | The WHO manual assigns alcohol education to zone I. Women and people > 65 years: a cut-off of 7 increases sensitivity. |
|---|---|
| 8–15 — zone II (hazardous) | The WHO manual assigns simple advice focused on reducing hazardous drinking to zone II. |
| 16–19 — zone III (harmful) | The WHO manual assigns simple advice plus brief counselling and continued monitoring to zone III. |
| 20–40 — zone IV (possible dependence) | The WHO manual assigns referral to a specialist for diagnostic evaluation and treatment of alcohol dependence to zone IV. |
What is the AUDIT (Alcohol Use Disorders Identification Test)?
The AUDIT is a ten-item screening test developed by the World Health Organization in a six-country study (Saunders 1993). It covers alcohol consumption (items 1–3), dependence symptoms (4–6) and alcohol-related harm (7–10), each scored 0–4, for a total of 0–40. The WHO manual groups scores into four risk zones that guide brief advice, counselling or referral.
When to use it
- Screening adults for hazardous or harmful drinking and possible dependence
- Choosing the intensity of a brief intervention
- Case-finding in primary care, emergency departments and hospital wards
When not to use it
- To diagnose alcohol dependence — the WHO manual links zone IV to a diagnostic evaluation
- In patients who are intoxicated or in withdrawal at the time of questioning
How it is calculated
| Criterion | Points |
|---|---|
| 1. How often do you drink alcohol? | |
| Never | 0 |
| Monthly or less | 1 |
| 2–4 times a month | 2 |
| 2–3 times a week | 3 |
| 4 or more times a week | 4 |
| 2. Standard drinks on a typical drinking day | |
| 1–2 | 0 |
| 3–4 | 1 |
| 5–6 | 2 |
| 7–9 | 3 |
| 10 or more | 4 |
| 3. How often six or more drinks on one occasion? | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 4. Past year: unable to stop drinking once started | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 5. Past year: failed to do what was normally expected because of drinking | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 6. Past year: needed a first drink in the morning after heavy drinking | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 7. Past year: guilt or remorse after drinking | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 8. Past year: unable to remember the night before because of drinking | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 9. You or someone else injured as a result of your drinking | |
| No | 0 |
| Yes, but not in the past year | 2 |
| Yes, during the past year | 4 |
| 10. Relative, friend or health worker concerned about your drinking or suggested cutting down | |
| No | 0 |
| Yes, but not in the past year | 2 |
| Yes, during the past year | 4 |
Clinical pearls and limitations
- Items are paraphrased; the official WHO or national version is the one for formal administration. One “drink” is a standard drink (WHO ≈ 10 g alcohol; national definitions differ). Two or more points on items 4–6 or on items 9–10 are significant even when the total is low.
- A cut-off of 8 is standard; the WHO manual suggests 7 for women and people over 65.
- Points on items 4–6 suggest dependence and points on items 9–10 indicate harm, even when the total is low.
- Drink sizes differ between countries — define a standard drink before asking items 2 and 3.
- The German S3 guideline (AWMF 076-001) recommends the AUDIT for screening with grade A.
Frequently asked questions
What AUDIT score is a problem?
8 or more indicates hazardous or harmful drinking; 16–19 suggests harmful use, for which the WHO manual describes brief counselling; for 20 or more the WHO manual describes evaluation for dependence.
AUDIT or AUDIT-C?
AUDIT-C (the first three items) is quicker and good for consumption screening; the full AUDIT also captures dependence and harm and is used to choose the intervention.
What is a standard drink?
The WHO manual uses about 10 g of pure alcohol. National definitions vary (e.g. 8 g UK unit, 14 g US drink).
Evidence and guidelines
- Primary source: Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT: The Alcohol Use Disorders Identification Test. Guidelines for use in primary care, 2nd ed. WHO/MSD/MSB/01.6a. World Health Organization, 2001.
- S3-Leitlinie „Screening, Diagnose und Behandlung alkoholbezogener Störungen“ (AWMF 076-001), Kurzfassung 2020: AUDIT soll zum Screening eingesetzt werden (Empfehlungsgrad A).
- Saunders JB et al. Development of the AUDIT: WHO collaborative project on early detection of persons with harmful alcohol consumption — II. Addiction 1993;88(6):791-804.
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<p><a href="https://medelix.ai/en/calculators/audit-alcohol-test">AUDIT (Alcohol Use Disorders Identification Test) calculator by Medelix</a></p>For healthcare professionals and medical students. These tools support, and do not replace, clinical judgement. Always check results against the original source and your local protocols.