Simplifying alcohol assessment: two questions to identify alcohol use disorders

Area of Science:

• Addiction Medicine
• Psychiatry
• Primary Care

Background:

• A single question effectively screens for hazardous drinking.
• Identifying alcohol use disorder (AUD) among positive screens is time-consuming.
• A brief assessment tool for AUD is needed in primary care.

Purpose of the Study:

• Develop and validate a brief assessment instrument for AUD using DSM-IV criteria.
• Create a tool for use in primary care settings.

Main Methods:

• Four cross-sectional surveys of past-year drinkers were analyzed.
• Samples included emergency department patients, general population, family medicine practices, and a national survey (NESARC).
• Diagnostic interviews were conducted using standardized instruments.

Main Results:

• Two key constructs identified: recurrent drinking in hazardous situations and drinking more than intended.
• Among those screening positive, the two items showed high sensitivity (77-95%) and specificity (62-86%) for AUD across samples.
• The NESARC sample demonstrated 77% sensitivity and 86% specificity.

Conclusions:

• Two questions derived from these constructs can efficiently assess AUD.
• This brief instrument offers a reasonably accurate method for primary care clinicians.
• It aids in identifying AUD among patients who screen positive on initial questions.