How to Identify Alcohol Problems in the Family

How to Identify Alcohol Problems in the FamilyYou might think you know how much alcohol someone in the family is using. But it’s all too easy for loved ones to become adept in the art of concealment.

They might tell half-truths, even outright lie — anything to prevent a parent or concerned family member from discovering what’s going on. When this happens, what can you do? Eliminate much of the guesswork by learning how to identify alcohol problems in the family.

Simple Assessment Survey

 It sounds too easy to be true, and in fact it’s only a preliminary assessment, but a simple survey called the Alcohol Use Disorders Identification Test (AUDIT) can help parents and family members screen for and tentatively assess the presence of alcohol problems in a loved one. The survey, developed by the World Health Organization (WHO), takes about five minutes to complete and has been tested internationally in primary care settings with a high degree of reliability and validity.

The survey was designed for physicians and health care practitioners to screen for excessive drinking and assist in a brief assessment before referring patients to a clinician for specific treatment, but it can also be useful for parents or family members, as well as individuals worried about their own alcohol use. It contains 10 questions with multiple choice answers and is scored based on numerical value — the higher the number, the more likely certain interventions and counseling or treatment might be necessary.

Completion of the survey alone doesn’t necessarily indicate a problem with alcohol or the severity of the problem if there is one. It does, however, serve as an early and important warning of problems associated with alcoholic consumption — a warning you can act on.

The 10 Questions

 The National Institutes of Health reprinted the following 10 AUDIT questions and answers for scoring with permission from WHO, changing the wording question #3 about number of drinks on one occasion to reflect standard drink sizes in the U.S.:

  1. How often do you have a drink containing alcohol? (0 – never; 1 – monthly or less; 2 – two to four times a month; 3 – two to three times a week; 4 – four or more times a week)
  2. How many drinks containing alcohol do you have on a typical day when you are drinking? (0 – one or two; 1 – three or four; 2 – five or six; 3 – seven to nine; 4 – ten or more)
  3. How often do you have five or more drinks on one occasion? (0 – never; 1 – less than monthly; 2 – monthly; 3 – weekly; 4 – daily or almost daily)
  4. How often during the last year have you found that you were not able to stop drinking once you had started (0 – never; 1 – less than monthly; 2 – monthly; 3 – weekly; 4 – daily or almost daily)
  5. How often during the last year have you failed to do what was normally expected of you because of drinking? (0 – never; 1 – less than monthly; 2 – monthly; 3 – weekly; 4 – daily or almost daily)
  6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? (0 – never; 1 – less than monthly; 2 – monthly; 3 – weekly; 4 – daily or almost daily)
  7. How often during the last year have you had a feeling of guilt or remorse after drinking? (0 – never; 1 – less than monthly; 2 – monthly; 3 – weekly; 4 – daily or almost daily)
  8. How often during the last year have you been unable to remember what happened the night before because of your drinking? (0 – never; 1 – less than monthly; 2 – monthly; 3 – weekly; 4 – daily or almost daily)
  9. Have you or someone else been injured because of your drinking? (0 – no; 2 – yes, but not in the last year; 4 – yes, during the last year)
  10. Has a relative, friend, doctor or other health care worker been concerned about your drinking or suggested you cut down? (0 – no; 2 – yes, but not in the last year; 4 – yes, during the last year)

The Scoring

A score of eight or more might indicate hazardous or harmful alcohol use. A score in the range of eight to 15 represents a medium level of risk for alcohol problems, which could be addressed with simple advice focused on reducing hazardous drinking. Scoring between 16 and 19 suggests a need for brief counseling and continued monitoring by a medical professional. An AUDIT score of 20 or higher clearly calls for further diagnostic evaluation for alcohol dependence.

What to Do With the Results

Again, this 10-question survey might help identify problems with alcohol in the family or with one family member. After administering the test or conducting a self-test, use the scoring to determine whether further counseling, intervention or treatment might be appropriate.

Consult with your loved one’s doctor — or your own doctor, if you’re completing the test for yourself — and find out what counseling or treatment avenues are available. There’s professional help available to overcome alcohol dependence and addiction, and to get you or your love one on the road to recovery.

By Suzanne Kane

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