AUDIT-C is a three-question alcohol screening test drawn from the first three items of the World Health Organization's ten-question AUDIT. It asks how often you drink, how much you drink on a typical drinking day, and how often you drink heavily — and scores the answers from 0 to 12. It is a screening tool, not a diagnosis: a positive result means a conversation about drinking is worth having, not that you have an alcohol use disorder. The positive threshold differs by sex: 4 or more for men, 3 or more for women.
- What it measures
- How often and how much you drink, and heavy-drinking days
- Length
- 3 items, each scored 0–4
- Score range
- 0–12
- Positive threshold
- 4 or more for men, 3 or more for women
- Source
- Bush 1998, derived from the WHO AUDIT (public domain)
Formula
AUDIT-C (Bush 1998), the three consumption items of the WHO AUDITAUDIT-C score = q1 + q2 + q3, positive at ≥ 4 (men) or ≥ 3 (women)
- q1
- — How often you have a drink containing alcohol (0–4)
- q2
- — Standard drinks on a typical drinking day (0–4)
- q3
- — How often you have six or more drinks on one occasion (0–4)
Unlike the PHQ-9 and GAD-7, the three items do not share one answer scale — each question has its own five published labels, and the points are the position of the answer in that question's own list. The threshold is lower for women because the same intake produces a higher blood alcohol concentration on average.
AUDIT-C Alcohol Screening examples
| Input | Result | Category |
|---|---|---|
| Woman — does not drink | 0 / 12 | Negative screen |
| Man — one or two drinks a couple of times a month | 2 / 12 | Negative screen |
| Woman — a glass or two of wine most nights | 4 / 12 | Positive screen |
| Man — three or four drinks two or three times a week | 5 / 12 | Positive screen |
| Woman — monthly heavy sessions | 6 / 12 | Positive — moderate |
| Man — five or six drinks four times a week | 8 / 12 | Positive — high |
What is the AUDIT-C?
The full AUDIT is a ten-question instrument the World Health Organization developed in the 1980s to detect hazardous drinking across countries and cultures. AUDIT-C is its first three questions — the ones about consumption — validated on their own by Bush and colleagues in 1998 as a screen short enough to fit into a routine appointment.
The AUDIT is in the public domain, and AUDIT-C with it: it can be reproduced and used freely. That is why it appears on intake forms across the US Department of Veterans Affairs, Kaiser Permanente, and most primary-care systems that screen for unhealthy alcohol use.
How is the AUDIT-C scored?
Each question has five answers worth 0 to 4 points, but the answer labels are different for each one — which is why AUDIT-C is not a single Likert grid the way the PHQ-9 and GAD-7 are. Add the three answers for a total from 0 to 12.
| Points | 1. How often do you drink? | 2. Drinks on a typical day | 3. Six or more on one occasion |
|---|---|---|---|
| 0 | Never | 1 or 2 | Never |
| 1 | Monthly or less | 3 or 4 | Less than monthly |
| 2 | 2–4 times a month | 5 or 6 | Monthly |
| 3 | 2–3 times a week | 7 to 9 | Weekly |
| 4 | 4 or more times a week | 10 or more | Daily or almost daily |
One nuance is worth knowing: if all of your points come from question 1 — you drink often, but never more than a drink or two, and never six in a session — the score usually reflects drinking within recommended limits rather than a problem. The calculator flags that case for you.
What is a positive AUDIT-C score?
Four or more for men and three or more for women. The lower threshold for women is not an assumption about behaviour; it follows from body composition. Women have on average a lower proportion of body water, so the same number of drinks produces a higher blood alcohol concentration and more exposure per drink.
| Score | Men | Women | What it usually means |
|---|---|---|---|
| 0–2 | Negative | Negative | Below the screening threshold |
| 3 | Negative | Positive | At the threshold for women |
| 4–5 | Positive | Positive | Worth discussing with a clinician |
| 6–7 | Positive | Positive | A higher likelihood of alcohol use disorder |
| 8–12 | Positive | Positive | The strongest association with alcohol use disorder |
The graded rows above follow Bradley and colleagues in 2007, who showed that the likelihood of an alcohol use disorder rises steadily across scores of 4–5, 6–7 and 8–12 rather than switching on at the threshold. A 5 and an 11 are both positive screens, but they are not the same conversation.
What counts as one standard drink?
Question 2 asks about standard drinks, and almost everybody underestimates them. In the US a standard drink is any pour containing about 14 grams of pure alcohol:
| Drink | Typical strength | One standard drink |
|---|---|---|
| Regular beer | 5% ABV | 12 fl oz |
| Malt liquor | 7% ABV | 8–9 fl oz |
| Table wine | 12% ABV | 5 fl oz |
| 80-proof spirits | 40% ABV | 1.5 fl oz |
A large glass of wine poured at home is often two standard drinks, a pint of strong craft beer can be two, and a generous measure of spirits is rarely one. If your honest answer to question 2 changes once you read this table, the second answer is the one to score.
Where does AUDIT-C fall short?
- It asks only about quantity and frequency. Loss of control, cravings, failed attempts to cut down and withdrawal — the features that actually define an alcohol use disorder — are not covered.
- It relies on self-report, and under-reporting is the norm rather than the exception when the subject is drinking.
- It has no time anchor for a change: someone who quit last month may still answer as though the last year counted, or as though it did not.
- It gives no allowance for pregnancy, liver disease, certain medications, or a history of dependence — situations where any drinking carries risk regardless of score.
If you scored below the threshold but recognise any of those, the score is not the reassurance it looks like. The full ten-item AUDIT, or a conversation with a clinician, covers what these three questions cannot.
What should I do with my result?
- 1.A negative screen with no other concerns needs no action beyond staying inside recommended limits.
- 2.A positive screen is a prompt to talk to a primary-care clinician — brief counselling at this stage is one of the best-evidenced interventions in preventive medicine.
- 3.Track a fortnight of honest drinks before that appointment. A real count beats a remembered one every time.
- 4.Never stop suddenly after heavy daily drinking without medical advice — alcohol withdrawal can be dangerous and occasionally fatal.
- 5.For free, confidential help in the US at any hour, call SAMHSA's National Helpline on 1-800-662-HELP (4357).
Frequently asked questions
Does a positive AUDIT-C mean I am an alcoholic?
No. AUDIT-C screens for drinking patterns associated with risk, not for dependence. Most people who screen positive do not have an alcohol use disorder — they drink more than recommended limits. A positive result means scores in this range usually warrant a fuller conversation with a clinician.
Why is the AUDIT-C threshold lower for women?
Women have on average a lower proportion of body water than men, so the same number of drinks produces a higher blood alcohol concentration and greater exposure per drink. The validated positive cut-point is therefore 3 or more for women and 4 or more for men.
What is a good AUDIT-C score?
Zero to 2 is below the threshold for both sexes. Note the exception built into the test: if all your points come from question 1 because you drink often but never heavily, even a score at the threshold usually reflects drinking within recommended limits rather than risk.
Is the AUDIT-C the same as the AUDIT?
No. AUDIT-C is the first three questions of the World Health Organization's ten-question AUDIT — the consumption items only. The remaining seven cover dependence and alcohol-related harm. AUDIT-C is faster and screens well; the full AUDIT gives far more detail once a screen is positive.
How accurate is the AUDIT-C?
At the standard cut-points it detects most heavy drinking and active alcohol use disorder in primary-care populations, which is what a screening test is for. Its accuracy depends entirely on honest answers, and under-reporting is common — the score is only as good as the input.
Can I use AUDIT-C during pregnancy?
It can be given during pregnancy, but the thresholds do not apply in the way they do otherwise: no amount of alcohol is established as safe in pregnancy. A score of zero is the only reassuring one, and any drinking should be discussed with your obstetric clinician.
Sources
- The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking — Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA — Archives of Internal Medicine, 1998
- AUDIT-C as a brief screen for alcohol misuse in primary care — Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR — Alcoholism: Clinical and Experimental Research, 2007
- AUDIT — The Alcohol Use Disorders Identification Test: guidelines for use in primary care — World Health Organization, 2001
- Understanding Alcohol Drinking Patterns — National Institute on Alcohol Abuse and Alcoholism
- SAMHSA National Helpline — 1-800-662-HELP (4357) — Substance Abuse and Mental Health Services Administration