How to Take and Score the FAST Alcohol Screening Test

The FAST Alcohol Screening Test is Effective

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The FAST alcohol screening test screens patients for hazardous drinking in busy medical offices and emergency rooms. It's specially designed to make a fast assessment.

The First Question is the Most Important

The majority of patients who take the FAST test only have to answer the first question. So, depending on your response to the first question of the test, you might not need to answer the other questions at all. This is what makes the FAST test potentially the shortest hazardous drinking screening tool available today.

The 4 Questions on the FAST Test

Here are the four questions on the FAST test:

1. How often do you have eight or more drinks on one occasion?

__ Never    __ Less Than Monthly    __ Monthly    __ Weekly    __ Daily or Almost Daily

2. How often during the last year have you been unable to remember what happened the night before because you had been drinking?

__ Never    __ Less Than Monthly    __ Monthly    __ Weekly    __ Daily or Almost Daily

3. How often during the last year have you failed to do what was normally expected of you because of your drinking?

__ Never    __ Less Than Monthly    __ Monthly    __ Weekly    __ Daily or Almost Daily

4. Has a relative or friend, a doctor or other health worker been concerned about your drinking or suggested you cut down?

__ No    __ Yes, but not in the last year.    __ Yes in the last year.

How to Score the FAST Test

To score the FAST test, use the following guide to scoring questions 1, 2 and 3:

  • Never: 0 points
  • Less than monthly:1 point
  • Monthly: 2 points
  • Weekly: 3 points
  • Daily or almost daily: 4 points

To score question 4 use the guide below: 

  • No: 0 points
  • Yes, but not in the last year: 2 points
  • Yes, in the last year: 4 points

Analyzing the Results of the FAST Test

Now that you have the score, it's time to analyze the results. As a general rule, higher scores are better than lower scores. 

  • The maximum score you can get on the FAST test is 16.
  • A total score of 3 indicates hazardous drinking.
  • If a person answers "never" on the first question, he or she is not a hazardous drinker and the remaining questions are not necessary.
  • If a person answers "weekly" or "daily or almost daily" on the first question, he or she is considered a hazardous drinker and you can skip the rest of the questions.
  • If a person answers "monthly" or "less than monthly" to the first question, you need the other three questions to complete the screening for hazardous drinking.

The FAST Test Compare With the AUDIT Test and Cage Test

The AUDIT test, a longer screening test, is also an effective screening tool. However, it takes too long to administer and score in most busy physician offices and emergency rooms.  

The FAST test is a short, two-phase test that has four key questions from the AUDIT test. When compared to the full AUDIT test, the FAST test detects 93 percent of hazardous drinkers detected by the longer version.

The CAGE test measures alcohol dependency over a lifetime and, like the FAST test, has four questions. The FAST test, in contrast, measures hazardous drinking in the past 12 months. 

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