Which screening tool is best validated for detecting risky alcohol use in primary care and what is a common interpretive threshold?

• A. AUDIT; a threshold of 8 or more indicates hazardous or harmful drinking.
• B. CAGE; a threshold of 2 or more indicates potential problems.
• C. DAST-10; a threshold of 3 or more indicates risk.
• D. CRAFFT; a threshold of 1 indicates risk.

Answer: (A)

In primary care, you want a screening tool that can capture a broad range of risky drinking patterns, from hazardous use to possible dependence, and that’s been validated across diverse patient populations. The Alcohol Use Disorders Identification Test (AUDIT) fits this need well because it asks about frequency and quantity of drinking, plus dependence symptoms and alcohol-related problems over the past year, giving a comprehensive picture of risk rather than just whether someone already shows dependence.

A common interpretive threshold is a total score of eight or more, which indicates hazardous or harmful drinking and signals the need for brief intervention or further assessment. Higher scores reflect greater risk or possible dependence, with established categories for different levels of concern. By contrast, other tools like CAGE focus more on detecting established dependence, DAST-10 targets drug use, and CRAFFT is designed for adolescents, making them less ideal for broad primary care alcohol risk screening.