How to Take and Score the FAST Alcohol Screening Test

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.

Many 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.

Questions on the FAST Alcohol Screening 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

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

• The maximum score you can get on the FAST test is 16.
• If a person answers "never" on the first question, they are 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, they are considered a hazardous drinker and they can also skip the rest of the questions.
• If a person answers "monthly" or "less than monthly" to the first question, they need to answer the other three questions to complete their full screening for hazardous drinking.
• A minimum score of 3 (question 1) or a combined total score (questions 1, 2, 3, and 4) of 8 or more indicates hazardous drinking.

The FAST Test Compared With the AUDIT Test and Cage Test

The AUDIT test, a longer screening test, is also an effective screening tool. However, it's often too time consuming to administer and score in many 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 93–94% 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 over the past 12 months.