Clinical practice · August 3, 2026 · 5 min read
AUDIT Scoring: Hazardous, Harmful, and Dependent Drinking Thresholds
How to score the WHO AUDIT, what 8/16/20 mean, sex-adjusted cut-offs, and when to use AUDIT-C or CAGE instead.
The WHO's AUDIT remains the best-validated alcohol screen for clinical practice: 10 items over the past year, items 1-8 scored 0-4 and items 9-10 scored 0/2/4, total 0-40.
The bands
- 0-7 Low risk
- 8-15 Hazardous use — brief advice and monitoring
- 16-19 Harmful use — brief counselling and continued monitoring
- 20-40 Possible dependence — full assessment, consider referral for specialized treatment
Some guidelines lower the initial threshold to 7 for women and adults over 65, worth applying in practice.
AUDIT vs its shorter cousins
- AUDIT-C (first 3 items, consumption only) suits high-volume screening; 4+ for men and 3+ for women flag for the full AUDIT.
- CAGE (4 yes/no lifetime items, cut-off 2) detects dependence-pattern drinking but misses current hazardous use — pair it with consumption questions rather than using it alone.
Delivering the result
Scores in the hazardous band respond meaningfully to simple structured feedback: the score, the band, what the band means against population norms, and an open question. The FRAMES brief-intervention structure fits inside ten minutes of a regular session.
Documentation
Record the score, band, the conversation, and the plan, and re-administer at intervals during treatment. Trend matters: a 19 falling to 11 across three months is a treatment outcome worth seeing.
The AUDIT and CAGE are both in PsychApp's library with automatic scoring, band summaries, and trends. Browse all 24 instruments.
Frequently asked questions
What AUDIT score indicates alcohol dependence?
Scores of 20+ suggest possible dependence and warrant comprehensive assessment. Remember AUDIT screens for risk patterns; dependence is a clinical diagnosis.