Table 1.

Alcohol Screening Instruments

Instrument	No. of Items in Instrument	Approx. Time to Administer (min)	Applicable Population	Scoring That Indicates Risk and Statistical Performance (Sensitivity; Specificity)	Copyright, Source(s), and Cost‡‡	Link(s)
NIAAA Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide29	2 to 3 depending on severity	~2	Adolescents ages 9 to 18	Elementary or middle school adolescents (≤ 15 years old) reporting any alcohol use (0.89; 0.91)33 High school adolescents (≥ 16 years old) reporting ≥ 6 days of past-year alcohol use (0.88; 0.81)33	Copyright: N/A Source: N/A Cost: Free online	Publicly available NIAAA guide containing screening questions (page 8): https://www.niaaa.nih.gov/sites/default/files/publications/YouthGuide.pdf
Screening to Brief Intervention (S2BI)34*	3 (additional 4 if past-year use indicated)	~2	Adolescents ages 12 to 17	Adolescents reporting alcohol use once or twice in the past year (0.96; 0.92) Adolescents reporting alcohol use monthly in the past year (0.79; 0.96) Adolescents reporting alcohol use weekly or more in the past year (1.00; 0.88)	Copyright: N/A Source: N/A Cost: Free online	Publicly available NIDA link to online version with options for patient or clinician administration: https://www.drugabuse.gov/ast/s2bi/#/
Brief Screener for Tobacco, Alcohol, and Other Drugs (BSTAD)38*	6 (additional 3 to 11 if past-year use indicated)	~2	Adolescents ages 12 to 17	≥ 2 days of past-year alcohol use (0.96; 0.85)	Copyright: N/A Source: N/A Cost: Free online	Publicly available NIDA link to web-based instrument with options for patient or clinician administration: https://www.drugabuse.gov/ast/bstad/#/
Alcohol Use Disorders Identification Test (AUDIT)	10	~2 to 3	Adolescent girls ages 12 to 19, adults,§ pregnant women, older adults	Positive score indicating risk: Adolescent girls: ≥ 5 (0.95; 0.77)32 Adults: ≥ 8 (0.38–0.73; 0.89–0.97)18** Pregnant women: > 018 Older adults: ≥ 5 (0.86; 0.87)54	Copyright: 1989, Thomas Babor and the World Health Organization Sources: World Health Organization, Division of Mental Health & Prevention of Substance Abuse, 1211 Geneva 27, Switzerland Email: Publications@who.int Thomas F. Babor, Alcohol Research Center, University of Connecticut, Farmington, CT Cost: Core questionnaire can be reproduced without permission; test and manual are free; training module costs $75	Publicly available link to self-report instrument: https://cde.drugabuse.gov/sites/nida_cde/files/AUDIT-SelfReport_v1.0_2014May20.pdf
Alcohol Use Disorders Identification Test-Concise (AUDIT-C)	3	~1	Adolescent girls ages 12 to 19, adult women,† pregnant women, older adults	Adolescent girls: ≥ 3 (0.96; 0.65)32 Adult women: ≥ 3 (0.73–0.97; 0.34–0.89)18 Pregnant women: > 0 (NR‡)18 Older adults: ≥ 4 (0.94; 0.80)54	Copyright: N/A Source: N/A Cost: Free online	Publicly available SAMHSA link: https://www.integration.samhsa.gov/images/res/tool_auditc.pdf
Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT)37*	4 (additional 5 if past-year use indicated)	~2 to 3	Adolescents ages 12 to 21	≥ 1 (0.94; 0.74)30,39 Optimal cutoff score indicating heightened risk for SUD: ≥ 2 (0.79; 0.97)39	Copyright: 2001, Boston Children’s Hospital Source: The Center for Adolescent Substance Abuse Research, Children’s Hospital, 300 Longwood Ave., Boston, MA 02115 Phone: 617-355-5433 Email: crafft@childrens.harvard.edu Cost: N/A	Publicly available SAMHSA link which states that the CRAFFT may be reproduced in [this] exact form for use in clinical settings courtesy of the Center for Adolescent Substance Abuse Research at the Boston Children’s Hospital: https://www.integration.samhsa.gov/clinical-practice/sbirt/CRAFFT_Screening_interview.pdf Link from Boston Children’s Hospital with additional information: http://crafft.org/
NIAAA Single Item Alcohol Screening Questionnaire (SASQ)52	1	~1	Adults	≥ 1 (0.82; 0.79)18	Copyright: N/A Source: N/A Cost: N/A	Publicly available SAMHSA link to NIAAA’s Helping Patients Who Drink Too Much: A Clinician’s Guide, which includes NIAAA SASQ (page 4): https://www.integration.samhsa.gov/clinical-practice/Helping_Patients_Who_Drink_Too_Much.pdf Publicly available USPSTF Final Recommendation Statement: Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions, includes NIAAA SASQ question: https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions
Quick Drinking Screen (QDS)44,109	3	~1	Adults	Scoring based on presence of NIAAA defined at-risk drinking (i.e., more than 3 drinks on any day or 7 drinks per week for adult women) in past 90 days43††	Copyright: 2003, Sobell & Sobell Source: Linda C. Sobell, PhD, ABPP, Center for Psychological Studies, Nova Southeastern University, 3301 College Ave., Fort Lauderdale, FL 33314 Email: sobelll@nova.edu Cost: Free	Publicly available link that states that this screener can be freely used as it is in the public domain: https://www.nova.edu/gsc/forms/quick_drinking_screen.pdf
Tolerance, Annoyed, Cut Down, Eye Opener (T-ACE)31	4	~1	Women of childbearing age	≥ 2 (0.69–0.88; 0.71–0.89)25	Copyright: 1989, Harcourt Health Sciences; permission needed to publish Sources: S. Martier, Ob/Gyn, 4707 Saint Antoine, Detroit, MI 48201 Permissions Department, Mosby, Inc. (a division of Elsevier), 6277 Sea Harbor Dr., Orlando, FL Phone: 407-345-3994 http://www.us.elsevierhealth.com/ Cost: N/A	Publicly available NIAAA link containing copyright information: https://pubs.niaaa.nih.gov/publications/t_ace.htm Publicly available NIAAA link containing T-ACE questions: https://pubs.niaaa.nih.gov/publications/arh28-2/78-79.htm
Tolerance, Worried, Eye Opener, Amnesia, K-Cut Down (TWEAK)31	5	~2	Pregnant women	≥ 2 (0.71–0.91; 0.73–0.83)25	Copyright: None Source: Marcia Russell Prevention Research Center, 1995 University Avenue, Suite 450, Berkeley, CA 94704 Phone: 510-883-5703 Email: russell@prev.org Cost: Free	Publicly available NIAAA link with more information: https://pubs.niaaa.nih.gov/publications/assessingalcohol/instrumentpdfs/74_tweak.pdf
Normal Drinker, Eye-Opener, Tolerance (NET)47	3	~1	Pregnant women	≥ 2 (0.61; 0.87)47	Copyright: 1989, Lippincott Williams & Wilkins Source: Lippincott Williams & Wilkins Permissions Department, 351 West Camden St., Baltimore, MD 21201 Phone: 410-528-4050 Email: permissions@lww.com http://www.lww.com/permissions/index.htm Cost: N/A	Not publicly available
Parents, Partner, Past, Present Pregnancy (4P’s Plus)48*	5	~1	Pregnant women	≥ 1 (0.87; 0.76)48	Copyright: The National Training Institute/NTI Upstream Source: NTI Upstream, 180 N. Michigan Ave., Suite 700, Chicago, IL 60601 Cost: Licensing fees may apply	Publicly available link with more information: https://www.ntiupstream.com/4psabout
Substance Use Brief Screen (SUBS)53*	4	~1	Adults	Any response other than “never” on alcohol binge question: (0.85; 0.77)	Copyright: N/A Source: N/A Cost: N/A	Publicly available NIH publication with more information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4475501/
Cut Down, Annoyed, Guilty, Eye-Opener (CAGE)57	4	~1	Adults	≥ 2 (0.14–0.39; 0.97)	Copyright: None Source: N/A Cost: Freely available as it is in the public domain and no permission is necessary unless used in a profit-making endeavor	Publicly available SAMHSA link: https://www.integration.samhsa.gov/clinical-practice/sbirt/CAGE_questionaire.pdf
Michigan Alcohol Screening Test–Geriatric Version (MAST-G)57	24	~5 to 10	Older adults	≥ 5 (0.70–0.91; 0.81–0.85)	Copyright: 1991, The Regents of the University of Michigan Source: Frederick C. Blow, PhD, University of Michigan Alcohol Research Center, 400 E. Eisenhower Parkway, Suite A, Ann Arbor, MI 48104 Phone: 313-998-7952 Cost: Free online	Publicly available NIH link to SAMHSA’s Substance Abuse Among Older Adults: Treatment Improvement Protocol No. 26 (page 55): https://www.ncbi.nlm.nih.gov/books/NBK64419/pdf/Bookshelf_NBK64419.pdf
Short Michigan Alcohol Screening Test–Geriatric Version (SMAST-G)57	10	Not reported	Older adults	≥ 2 (0.52; 0.96)	Copyright: 1991, The Regents of the University of Michigan Source: N/A Cost: N/A	Publicly available link provided by The Hartford Institute for Geriatric Nursing, New York University, Rory Meyers College of Nursing: https://consultgeri.org/try-this/general-assessment/issue-17.pdf
Comorbidity Alcohol Risk Evaluation Tool (CARET)	10	~2 to 5	Older adults	A positive response in any of the seven risk categories (0.92; 0.51)54	Copyright: N/A Source: N/A Cost: N/A	Not publicly available

NIAAA = National Institute on Alcohol Abuse and Alcoholism; NIDA = National Institute on Drug Abuse; NIH = National Institutes of Health; SAMHSA = Substance Abuse and Mental Health Services Administration.

^*Instrument screens for alcohol and other substances.

^†Recommended AUDIT-C cutoff score is different for adult women (≥ 3) and men (≥ 4).18

^‡Not reported.

^§Recommended AUDIT cutoff score is the same for adult women and men (≥ 8).18

^**Several U.S.-based studies show more optimal balances of sensitivity and specificity at lower AUDIT cutoffs (e.g., 3, 4, 5); preliminary findings from the USPSTF 2018 updated evidence report and systematic review indicates that lower cutoffs may be preferred.18

^††Sensitivity and specificity are not reported for this instrument.

^‡‡N/A, information was not available or retrievable. None, the instrument explicitly states that no copyright is held. Cost: N/A, no information was found regarding cost. Free/free online, the information pertaining to the instrument explicitly states that it is available to the public.