Alcohol Screening Tests Ideal for Healthcare Settings

An alcohol screening test helps determine if you abuse alcohol or have alcohol use disorder. An emergency room might use a short test that makes a determination based on the first question, while a mental health professional has time to administer a longer test with more questions.

The reliability of shorter tests may not be as high as the longer ones. After the initial diagnosis, a longer test helps determine if your case of alcohol use disorder is mild, moderate, or severe.

One of the oldest and most popular screening tools for alcohol abuse is the CAGE test, which is a short, four-question test that diagnoses alcohol problems over a lifetime.

• C - Have you ever felt you should cut down on your drinking?
• A- Have people annoyed you by criticizing your drinking?
• G - Have you ever felt bad or guilty about your drinking?
• E - Eye-opener: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

Two "yes" answers indicate problems with alcohol.

The disadvantage of the CAGE test is it's not very accurate for older people, white women, and African- and Mexican-Americans.

The T-ACE test has four questions, including three from the CAGE test, but has proven more accurate in diagnosing alcohol problems in both men and women.

• T - Does it take more than three drinks to make you feel high?
• A - Have you ever been annoyed by people's criticism of your drinking?
• C - Are you trying to cut down on drinking?
• E - Have you ever used alcohol as an eye opener in the morning?

Two "yes" answers indicate possible alcohol abuse or dependence.

One of the most accurate tests is the Alcohol Use Disorders Identification Test (AUDIT). It's accurate up to 94 percent of the time and across ethnic and gender groups.

It has 10 multiple choice questions scored on a point system, and a score over eight indicates an alcohol problem.

The disadvantage is that it takes longer to administer and is more difficult to score than the shorter tests.

The Rapid Alcohol Problems Screen (RAPS) asks questions similar to the CAGE test, but from a different perspective. One "yes" answer indicates a possible alcohol abuse problem and the results are accurate across gender and ethnic groups.

The Michigan Alcohol Screening Test effectively diagnoses adults and adolescents. It has 22 yes or no questions, with six positive responses indicating a drinking problem.

The disadvantage is the length and time required to score it. 

The FAST test is a four-question quiz designed specifically for patients in urgent care or emergency room situations. The test is easy to score, but only detects 90 percent of alcohol problems detected by the AUDIT test.

The Paddington Alcohol Test (PAT) is for patients getting treatment for falls and accidents in the emergency room. This three-questions test is easy to score.

The disadvantage is that it asks direct questions about how much alcohol the patient consumes, which patients tend to minimize or deny.

The Self-Administered Alcoholism Screening Test (SAAST) is a 35-question test that asks questions about the patient's loss of control, job performance, drinking consequences, and family history of alcoholism.

One major advantage is that there is a version of the test a loved one can fill out.