Utility of the AUDIT for screening adolescents for problematic alcohol use in the emergency department

The emergency department is a setting conducive to screening adolescents for problematic alcohol use, who can then be targeted for further evaluation and intervention. This study examined the utility of the Alcohol Use Disorders Identification Test (AUDIT) as a screening measure for identifying young adolescents in an urban emergency department (ED). Adolescents (13-17 years old) who presented to the ED were screened as part of a larger study. A total of 859 adolescents, who denied alcohol use prior to their ED visit were administered the AUDIT. Of the 500 younger adolescents (13-15 years old), approximately 4% (n=22) were classified as AUDIT-positive using a cut-score of four or greater. Of the 359 older adolescents (16-17 years old), almost 19% (n=67) were classified as AUDIT-positive. The ability of shorter versions of the AUDIT to identify AUDIT-positive adolescents (as classified by the 10-item AUDIT using a cut-score of four or greater) was also explored. Since the adolescents in the current study were not alcohol-positive at the time of the ED visit, they would likely have been missed by biochemical alcohol screening alone. Screening procedures that employ the AUDIT may be most efficient when adapted for the specific adolescent age group (younger versus older), thus identifying the highest number of adolescents who should be targeted for intervention. Lowering the recommended adult cut-scores on the shorter versions of the AUDIT appears necessary to identify adolescents who may benefit from intervention or referral.