Does everyone who screens positive on the AUDIT-C need a full assessment or referral?
Not everyone needs a full diagnostic assessment or referral. Since the AUDIT-C score reflects severity, the raw score can be used to assess the likelihood that the patient has alcohol dependence. For patients with AUDIT-C scores 4-7 (3-7 for women) and no prior alcohol treatment, the provider can offer a brief alcohol intervention, and follow-up to evaluate how the patient responds (as the first step). If patients do not respond, further assessment may be helpful to identify alcohol abuse and dependence, other substance use disorders, and unrecognized psychiatric comorbidity. Patients with a history of alcohol treatment and higher AUDIT-C scores will often have alcohol dependence. Patients with AUDIT-C scores of 8 or more have been shown to be at increased risk for many complications of drinking and should be more fully assessed if possible and offered referral as appropriate. If providers want to assess patients for specific symptoms due to drinking, questions #4-10 of the full AUDIT
