Screening for Unhealthy Alcohol Use

  • Katharine Bradley
  • Douglas Berger


Primary medical care should include routine alcohol screening to identify patients with unhealthy alcohol use, whether an alcohol use disorder or risky drinking. Screening should include all adult primary care patients as well as adolescents. Although it is important that screening be done with a validated instrument, there are a number of similarly accurate alcohol screening questionnaires for identifying the entire spectrum of unhealthy drinking, and some of them are very brief. We believe that primary care clinicians should commit two validated questions to memory: one to assess any alcohol use and one single-item alcohol screening question (SASQ). However, in settings with EMRs and systems for universal screening, we favor use of the AUDIT-C because of the information it provides on reported typical drinking and on the severity of unhealthy drinking, as well as the utility of a scaled marker for measuring the severity of unhealthy alcohol use and changes over time. Finally, primary care clinicians and others conducting screening must all be carefully trained about recommended drinking limits and risks associated with drinking above them, the purpose of alcohol screening and the efficacy of brief alcohol interventions, including practicing asking validated screening questions in a comfortable manner.


Brief Intervention Episodic Heavy Drinking Risky Drinking Alcohol Screening Unhealthy Alcohol 
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Authors and Affiliations

  1. 1.Group Health Research Institute, Group Health Cooperative; Northwest Center of Excellence in Substance Abuse Treatment and Education and Health Services Research & Development, VA Puget Sound Health Care System, Department of Veterans Affairs; Departments of Medicine and Health ServicesUniversity of WashingtonSeattleUSA
  2. 2.General Medicine Service, VA Puget Sound Health Care System, Department of Veterans Affairs; Department of MedicineUniversity of WashingtonSeattleUSA

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