Berkeley Alcohol Awareness Month 2006
Adult Alcohol Screening Tool for Self-Assessment
The following may assist you to look at your use of alcohol. This is a composite of two highly respected alcohol screening tools: the
Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization, and the CAGE questionnaire
developed by the University of North Carolina. Read each question and choose the response that fits you best. There are resources for
more assistance in the Berkeley and campus areas.
1. How often do you have a drink containing alcohol?
( ) never (0)
( ) monthly or less (1)
( ) two to four times/month (2)
( ) two or three times/week (3)
( ) four or more times/week (4)
2. How many drinks containing alcohol do you have on a typical
day when you are drinking?
( ) 1 or 2 (0)
( ) 3 or 4 (1)
( ) 5 or 6 (2)
( ) 7-9 (3)
( ) 10 or more (4)
3. How often do you have 6 or more drinks on one occasion?
( ) never (0)
( ) less than monthly (1)
( ) monthly (2)
( ) weekly (3)
( ) daily or almost daily (4)
4. How often in the last year have you been unable to remember what
happened the night before because of drinking?
( ) never (0)
( ) less than monthly (1)
( ) monthly (2)
( ) weekly (3)
( ) daily or almost daily (4)
5. How often in the last year have you found that you were not
able to stop drinking once you started?
( ) never (0)
( ) less than monthly (1)
( ) monthly (2)
( ) weekly (3)
( ) daily or almost daily (4)
6. Have you or another been injured as a result of your drinking?
( ) no (0)
( ) yes, but not in the last year (2)
( ) yes, during last year (4)
7. How often in the last year have you failed to do what is expected
from you because of drinking (missed deadlines, poor class or
work attendance, missed family activities)?
( ) never (0)
( ) less than monthly (1)
( ) monthly (2)
( ) weekly (3)
( ) daily or almost daily (4)
8. Has a relative, friend, doctor or other person expressed concern
about your drinking or suggested you cut down?
( ) no (0)
( ) yes, but not in the last year (2)
( ) yes, during last year (4)
9. How often in the last year have you needed a drink in the
morning to get going after a heavy drinking session?
( ) never (0)
( ) less than monthly (1)
( ) monthly (2)
( ) weekly (3)
( ) daily or almost daily (4)
10. How often in the past year have you had feelings of guilt or
remorse after drinking?
( ) never (0)
( ) less than monthly (1)
( ) monthly (2)
( ) weekly (3)
( ) daily or almost daily (4)
11. Have people annoyed you by criticizing your drinking?
( ) no (0)
( ) yes, but not in the last year (2)
( ) yes, during last year (4)
12. Have you ever felt you should cut down on your drinking?
( ) no (0)
( ) yes, but not in the last year (2)
( ) yes, during last year (4)
Scoring
Total your score for all 12 questions. Next, total your score for the last four questions only (9-12). You should now have two
scores, one for the whole sheet, and one for the last 4 questions only.
For the Whole Sheet: Your score__________. A score of 8 or more for all 12 questions indicates that a risky level of alcohol
consumption is likely. See the resources below to talk with someone.
For the last 4 questions only: Your score__________. A score of 1-2 indicates that you may have a drinking problem. A score
of 3 or more indicates there is a significant possibility that you have a problem with alcohol. See the resources handouts to talk
with someone.
WEB Screening for adults.doc 2006
Be honest!
Ever rode in a CAR driven by someone (or
yourself) who was high, been drinking or using
drugs?
Ever use alcohol/drugs to RELAX, feel better about
yourself, or fit in?
Ever use alcohol/drugs while you are
ALONE?
Ever FORGET things you did while using alcohol/drugs?
Do your family or friends say you should cut down on
your drinking /drug use?
Ever get in TROUBLE while using
alcohol/drugs?
Answering "yes" to two or more may mean that drinking is
getting in the way of other things you want to do. Talk to
someone about this: parent, teacher, counselor, minister,
friend.
WEB Screening for youth.doc
Worried about a friend or family member’s drinking?
Answer the following questions.
The questions refer to alcohol, but may also apply to other substance
use.
Section 1:
Does my friend/family member:
□ Drink when feeling stressed, to forget worries, or to
relax
□ Feel embarrassed or ashamed about what happens while under
the influence
□ Make unsuccessful attempts to cut down or stop drinking
□ Cause harm to self or others as a result of drinking
□ Need to drink more and more in order to achieve the
desired effect
□ Drink alone regularly
□ Need to pre-party or be drunk in social settings
□ Forget periods of time when drinking
□ Lose cell phones, wallets, or other items when drunk
□ Have school, health, social, family, or money problems
caused by drinking
Section 2: My experiences of my friend or family member’s drinking:
□ I’ve been hurt or embarrassed by this person’s drinking.
□ I’m afraid to say something to him/her about the drinking.
□ I’ve told lies to cover up this person’s drinking
consequences.
□ I’ve blamed this person’s drinking on his/her other
friends.
□ I’ve made threats such as, “If you don’t stop drinking,
I’ll leave you.”
□ Our plans frequently get upset or cancelled, because of
his/her drinking.
□ Our gatherings and holidays have been spoiled because of
drinking.
□ I’ve often ridden in a car with a driver who has been
drinking.
If you relate to any of these, consider talking with someone today.
Confidential and non-judgmental consultation is available for you and
the person you’re concerned about.
WEB Screening for family or friend.doc 2006