Association between alcohol screening scores and alcohol-related risks among female veterans affairs patients

Evidence-based brief interventions for primary care patients with at-risk drinking include personalized feedback on alcohol-related risks, yet little is known about associations between alcohol screening scores and outcomes among women. This study evaluated associations between scores on the three-item Alcohol Use Disorders Identification Test-consumption (AUDIT-C) questionnaire and self-reported alcohol-related risks and consequences among veteran women.

Female outpatients from an urban Veterans Affairs facility were mailed annual surveys (1998-2000) (response rates: 65% Years 1 and 2, 55% Year 3). Measures were obtained from each respondent's first completed survey and included a gender-specific AUDIT-C (0-12 points), self-reported alcohol-related consequences, problem drinking or other drug use, and health risks. The prevalence of each outcome across AUDIT-C score groups (0, 1-2, 3, 4, 5-7, 8-12) was estimated using logistic regression, adjusting for age, race, and marital status.

Among 2,670 respondents, 23.7% screened positive for alcohol misuse (AUDIT-C ≥3). For three out of the five alcohol-related consequences (tolerance, blackouts, felt needed to cut down), adjusted prevalence increased at AUDIT-C scores of 3 or more. The remaining alcohol-related consequences (morning eye openers, family/friends worried) increased at scores of 4 or more, as did self-reported problem drinking or other drug use. Associations between health risks (two or more sexual partners, sexually transmitted diseases, injuries, domestic violence, hepatitis/cirrhosis) and AUDIT-C scores were less consistent, but prevalence generally increased at scores of 5 or more.

Increasing scores on the AUDIT-C reflect increasing prevalence of self-reported alcohol-related risks and consequences among women. These results provide clinicians with gender-specific information on alcohol-related risks that could be incorporated into brief interventions.