Alcohol screening tests

Alcohol screening tests
 
The CAGE Test
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 T-ACE Test
The T-ACE test has four questions‚ including three from the CAGE test‚ but has proved 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.
****************
The RAPS4 Test
Buddy T
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 RAPS4 gets its name from the questions it poses to the patient which pertain to remorse (R)‚ amnesia (A)‚ performance (P)‚ and starter drinking behavior (S).
Each question pertains to the patient’s behaviors in the past year.
The RAPS4 Questions
1. Have you had a feeling of guilt or remorse after drinking?
2. Has a friend or a family member ever told you about things you said or did while you were drinking that you could not remember?
3. Have you failed to do what was normally expected of you because of drinking?
4. Do you sometimes take a drink when you first get up in the morning?
A “yes” answer to at least one of the four questions suggests that your drinking is harmful to your health and well-being and may adversely affect your work and those around you.
*************
The AUDIT Test
Alcohol Use Disorders Identification Test
World Health Organization ‚ 1982
1. How often do you have a drink containing alcohol?
(0) Never (Skip to Questions 9-10)
(1) Monthly or less
(2) 2 to 4 times a month
(3) 2 to 3 times a week
(4) 4 or more times a week
2. How many drinks containing alcohol do you have on a typical day when you are drinking?
(0) 1 or 2
(1) 3 or 4
(2) 5 or 6
(3) 7‚ 8‚ or 9
(4) 10 or more
3. How often do you have six or more drinks on one occasion?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
4. How often during the last year have you found that you were not able to stop drinking once you had started?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
5. How often during the last year have you failed to do what was normally expected from you because of drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
6. How often during the last year have you been unable to remember what happened the night before because you had been drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
7. How often during the last year have you needed an alcoholic drink first thing in the morning to get yourself going after a night of heavy drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
8. How often during the last year have you had a feeling of guilt or remorse after drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily
9. Have you or someone else been injured as a result of your drinking?
(0) No
(2) Yes‚ but not in the last year
(4) Yes‚ during the last year
10. Has a relative‚ friend‚ doctor‚ or another health professional expressed concern about your drinking or suggested you cut down?
(0) No
(2) Yes‚ but not in the last year
(4) Yes‚ during the last year
Add up the points associated with your answers above. A total score of 8 or more indicates harmful drinking behavior.
*****************
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.
*************
The TWEAK Test
The name of the test is an acronym for Tolerance‚ Worried‚ Eye-opener‚ Amnesia‚ and K/Cut down (with a poetic license use of “K” instead of “C” for cutting down on alcohol consumption).
1. How many drinks does it take to make you feel high?
2. Have close friends or relatives worried or complained about your drinking in the past year?
3. Do you sometimes take a drink in the morning when you first get up?
4. Has a friend or family member ever told you about things you said or did while you were drinking that you could not remember?
5. Do you sometimes feel the need to cut down on your drinking?
Scoring the TWEAK Test
The maximum score on the test is seven points‚ with the first two questions counting for two points each and the last three one point each. Note about question 1: If a woman responds that it takes three or more drinks to feel high‚ she scores two points.
If she responds “less than three‚” she scores zero on the question.
A total score of two or more on the test is an indication of harmful drinking and further evaluation is indicated.
Sometimes the following for question is substituted for 1: “How many drinks can you hold?” If a woman responds that she can hold more than five drinks (meaning she can drink more than five without passing out)‚ she scores two points; she scores zero if she reports less than five.
 
 

National Institute on Alcoholism and Alcohol Abuse. Assessing Alcohol Problems – A Guide for Clinicians and Researchers.(2003) Alcohol Concern.”Primary Care Alcohol Information Service.”

Russel‚ Marcia‚ et. al. (1994). Screening for Pregnancy Risk-Drinking. Alcoholism: Clinical and Experimental Research‚ 18 (5): 1156-1161.

x