AUDIT (Alcohol Use Disorders Identification Test)
Hazardous drinking, harmful use and possible dependence (past year)
- WHO
- AWMF S3 Alkohol (076-001)
Sources last checked: 2026-10-13
AUDIT (Alcohol Use Disorders Identification Test)
Hazardous drinking, harmful use and possible dependence (past year)
Items are paraphrased; the official WHO or national version is the one for formal administration. One “drink” is a standard drink (WHO ≈ 10 g alcohol; national definitions differ). Two or more points on items 4–6 or on items 9–10 are significant even when the total is low.
Interpretation
| 0–7 — zone I (lower risk) | The WHO manual assigns alcohol education to zone I. Women and people > 65 years: a cut-off of 7 increases sensitivity. |
|---|---|
| 8–15 — zone II (hazardous) | The WHO manual assigns simple advice focused on reducing hazardous drinking to zone II. |
| 16–19 — zone III (harmful) | The WHO manual assigns simple advice plus brief counselling and continued monitoring to zone III. |
| 20–40 — zone IV (possible dependence) | The WHO manual assigns referral to a specialist for diagnostic evaluation and treatment of alcohol dependence to zone IV. |
What is the AUDIT (Alcohol Use Disorders Identification Test)?
The AUDIT is a ten-item screening test developed by the World Health Organization in a six-country study (Saunders 1993). It covers alcohol consumption (items 1–3), dependence symptoms (4–6) and alcohol-related harm (7–10), each scored 0–4, for a total of 0–40. The WHO manual groups scores into four risk zones that guide brief advice, counselling or referral.
When to use it
- Screening adults for hazardous or harmful drinking and possible dependence
- Choosing the intensity of a brief intervention
- Case-finding in primary care, emergency departments and hospital wards
When not to use it
- To diagnose alcohol dependence — the WHO manual links zone IV to a diagnostic evaluation
- In patients who are intoxicated or in withdrawal at the time of questioning
How it is calculated
| Criterion | Points |
|---|---|
| 1. How often do you drink alcohol? | |
| Never | 0 |
| Monthly or less | 1 |
| 2–4 times a month | 2 |
| 2–3 times a week | 3 |
| 4 or more times a week | 4 |
| 2. Standard drinks on a typical drinking day | |
| 1–2 | 0 |
| 3–4 | 1 |
| 5–6 | 2 |
| 7–9 | 3 |
| 10 or more | 4 |
| 3. How often six or more drinks on one occasion? | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 4. Past year: unable to stop drinking once started | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 5. Past year: failed to do what was normally expected because of drinking | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 6. Past year: needed a first drink in the morning after heavy drinking | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 7. Past year: guilt or remorse after drinking | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 8. Past year: unable to remember the night before because of drinking | |
| Never | 0 |
| Less than monthly | 1 |
| Monthly | 2 |
| Weekly | 3 |
| Daily or almost daily | 4 |
| 9. You or someone else injured as a result of your drinking | |
| No | 0 |
| Yes, but not in the past year | 2 |
| Yes, during the past year | 4 |
| 10. Relative, friend or health worker concerned about your drinking or suggested cutting down | |
| No | 0 |
| Yes, but not in the past year | 2 |
| Yes, during the past year | 4 |
Clinical pearls and limitations
- Items are paraphrased; the official WHO or national version is the one for formal administration. One “drink” is a standard drink (WHO ≈ 10 g alcohol; national definitions differ). Two or more points on items 4–6 or on items 9–10 are significant even when the total is low.
- A cut-off of 8 is standard; the WHO manual suggests 7 for women and people over 65.
- Points on items 4–6 suggest dependence and points on items 9–10 indicate harm, even when the total is low.
- Drink sizes differ between countries — define a standard drink before asking items 2 and 3.
- The German S3 guideline (AWMF 076-001) recommends the AUDIT for screening with grade A.
Frequently asked questions
What AUDIT score is a problem?
8 or more indicates hazardous or harmful drinking; 16–19 suggests harmful use, for which the WHO manual describes brief counselling; for 20 or more the WHO manual describes evaluation for dependence.
AUDIT or AUDIT-C?
AUDIT-C (the first three items) is quicker and good for consumption screening; the full AUDIT also captures dependence and harm and is used to choose the intervention.
What is a standard drink?
The WHO manual uses about 10 g of pure alcohol. National definitions vary (e.g. 8 g UK unit, 14 g US drink).
Evidence and guidelines
- Primary source: Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT: The Alcohol Use Disorders Identification Test. Guidelines for use in primary care, 2nd ed. WHO/MSD/MSB/01.6a. World Health Organization, 2001.
- S3-Leitlinie „Screening, Diagnose und Behandlung alkoholbezogener Störungen“ (AWMF 076-001), Kurzfassung 2020: AUDIT soll zum Screening eingesetzt werden (Empfehlungsgrad A).
- Saunders JB et al. Development of the AUDIT: WHO collaborative project on early detection of persons with harmful alcohol consumption — II. Addiction 1993;88(6):791-804.
Have a follow-up question?
Medelix answers clinical questions from current guidelines and studies — every statement with its source.
Ask Medelix about the AUDIT (Alcohol Use Disorders Identification Test)Related calculators
Embed this calculatorFree to use on your website, intranet or teaching page. Copy the code below.
<iframe src="https://medelix.ai/en/embed/audit" title="AUDIT (Alcohol Use Disorders Identification Test) – Medelix" width="100%" height="620" style="border:0;max-width:720px" loading="lazy"></iframe>
<p><a href="https://medelix.ai/en/calculators/audit-alcohol-test">AUDIT (Alcohol Use Disorders Identification Test) calculator by Medelix</a></p>For healthcare professionals and medical students. These tools support, and do not replace, clinical judgement. Always check results against the original source and your local protocols.