AUDIT-C: Alcohol Use Screen

What is the AUDIT-C?

The AUDIT-C is a brief, three-item screening questionnaire for hazardous drinking and possible alcohol use disorder. It is made up of the three alcohol-consumption questions from the World Health Organization's 10-item Alcohol Use Disorders Identification Test (AUDIT), and was validated as a standalone screen by Bush and colleagues in 1998 within the U.S. Department of Veterans Affairs.

The AUDIT-C asks only about consumption — how often a person drinks, how much they typically drink, and how often they drink heavily — which makes it fast enough to use routinely while still detecting the drinking patterns most associated with harm. It takes under a minute to complete and is widely used in primary care, behavioral health intake, and outcome monitoring.

As one of the consumption-only items derived from the AUDIT, the AUDIT-C is freely available in the public domain for clinical and research use.

The Three Questions

1. How often do you have a drink containing alcohol?
2. How many standard drinks containing alcohol do you have on a typical day when you are drinking?
3. How often do you have six or more drinks on one occasion?

AUDIT-C Scoring

Each of the three items is scored from 0 to 4, so the total ranges from 0 to 12. Higher scores reflect heavier and more frequent drinking. A respondent who reports no alcohol use scores 0.

The AUDIT-C is a screen, not a diagnosis: it identifies who warrants a fuller conversation or assessment, not who has a disorder. The validated positive-screen cut-points are sex-specific — a score of 4 or more for men and 3 or more for women indicates that drinking is in the hazardous range and a more detailed assessment is warranted.

Interpreting the Total Score

Beyond the positive/negative cut, the total score reflects a graded risk: the higher the AUDIT-C score, the stronger the likelihood of an alcohol use disorder. The bands below are a common interpretive guide.

The positive-screen threshold is sex-specific: men screen positive at 4+, women at 3+. A woman scoring 3 is a positive screen even though it falls in the lower band above — always apply the sex-specific cut-point alongside the total-score bands.

Clinical Applications

Because it is so short, the AUDIT-C is well suited to routine intake and to periodic re-screening across a caseload — the kind of measurement that catches a shift in drinking before it becomes the presenting problem. Hazardous drinking frequently co-occurs with depression, anxiety, trauma, and sleep difficulty, and a one-minute screen makes it visible without a dedicated substance-use intake.

Administered repeatedly, the AUDIT-C also works as an outcome measure. Tracking the score across a course of treatment shows whether interventions aimed at drinking are moving consumption in the right direction, and gives both clinician and client a concrete, non-judgmental number to anchor the conversation.

A positive AUDIT-C is a prompt for a conversation, not a label. The score opens the door to a brief intervention, a fuller assessment with the complete 10-item AUDIT, or a referral — depending on the score, the client, and the clinical context.

Reliability & Validity

The AUDIT-C has been validated across primary care, behavioral health, and diverse demographic groups, and shows good test–retest reliability for a self-report consumption measure. At the standard cut-points it performs comparably to the full 10-item AUDIT for detecting hazardous drinking and active alcohol use disorders, while taking a fraction of the time.

Screening performance varies by population and by where the cut-point is set, which is why sex-specific thresholds are used. As with any screen, the AUDIT-C is most accurate when its result is interpreted in the context of the clinical interview rather than read in isolation.