Using The AUDIT-C Tool To Screen For Unhealthy Alcohol Use From CoreIM

The following are excerpts from the show notes of 5 Pearls of Unhealthy Alcohol Use
Posted: July 11, 2018 by CoreIM. By: Dr. Katharine Lawrence, Dr. Martin Fried and Dr. Shreya P. Trivedi

Pearl 1

  • Unhealthy alcohol use is a catch-all term meant to describe a spectrum of drinking ranging from risky use all the way to alcohol use disorder.
  • The DSM-IV terms alcohol abuse and dependence have been replaced by the DSM-5 term alcohol use disorder, which is defined as a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by psychosocial, behavioral, or physiologic features
  • According to National Institute on alcohol Abuse and Alcoholism (NIAAA), risk for alcohol use disorder is thought of as daily and weekly alcohol limits:
    • For  men less than 65 years:  more than 4 drinks/day or 14 drinks/week for
    • For women and men over 65 years: more than 3 drinks/day or 7 drinks/week

Pearl 2

  • The United States Preventive Services Task Force (USPSTF) has recommended that all adults in primary care be screened for unhealthy alcohol use
  • The AUDIT-C tool is the recommended screening tool for unhealthy alcohol use, and consists of the following questions:
    • How often did you have a drink containing alcohol in the last year?
    • How many drinks containing alcohol did you have on a typical night when you were drinking?
    • How often did you have six or more drinks on one occasion in the past year?
  • single-item screening question has also been validated. It is the most sensitive question for unhealthy alcohol use.
    • For men, how many times in the last year, have you had more than four drinks in a day?
    • For women, how many times in the last year, have you had more than three drinks in a day?

Pearl 3

  • The negative health impacts of alcohol include most types of cancer with the exception of thyroid cancer.
  • Patients are often diagnosed with comorbid medical conditions that may be reversible if the underlying alcohol use disorder is diagnosed and treated appropriately
  • Labs values can be a useful tool for assessing alcohol use and educating patients on end-organ damage; however, they are not recommended for routine diagnosis of the disease
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