How to Diagnose Alcohol Use Disorder? – Screening Tests and Assessments

Alcohol use disorder (AUD) is a serious medical condition that affects nearly 20 million American citizens. It is characterized by a pattern of excessive drinking that leads to significant impairments in one’s personal, social, and professional life. The condition can range from mild to severe and, if left untreated, can lead to serious health complications and even death. Early alcoholism diagnosis is crucial in the treatment and management of the condition.1

Diagnosing alcohol use disorder can be challenging, as it requires a thorough evaluation of an individual’s drinking habits and behavior. The process typically involves a combination of self-reported information, physical examination, and laboratory tests. Medical professionals such as primary care physicians, psychiatrists, and addiction specialists can all play a role in diagnosing AUD.1

There are several tools and guidelines available to help diagnose AUD. In this article, we will explain and compare different tests for diagnosing alcohol use disorder, including screening tests, psychological and physical examinations, and laboratory assessments, and explain their strengths and weaknesses in terms of alcoholism diagnosis.

Diagnosing alcohol use disorder

Diagnosing alcohol use disorder (AUD) is the process of determining whether an individual’s drinking habits and behavior meet the criteria for an alcohol disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). This manual provides guidelines for identifying patterns of excessive drinking that lead to significant impairments in one’s personal, social, and professional life. The diagnosis is needed to understand the severity of the problem and to determine the appropriate course of treatment.2

Diagnosing alcohol use disorder can help an individual understand their drinking problem and its severity. It also helps in creating a plan for treatment, which can be crucial in managing the disorder. A proper diagnosis can also help individuals understand their triggers, possible co-occurring disorders, and the need for therapy or medication-assisted treatment.3

Alcoholism diagnosis can be categorized into several different stages and types, including:2

  • Mild AUD: An individual with mild alcohol use disorder may be able to drink without experiencing major problems as a result of their alcohol abuse.
  • Moderate AUD: An individual with a moderate alcoholism diagnosis may have difficulty maintaining employment or maintaining relationships due to more significant impairment from alcohol consumption.
  • Severe AUD: There is a severe form of AUD characterized by extreme impairment and adverse consequences. People with severe AUD are likely to suffer serious health problems, financial difficulties, and difficulty housing.

How to Diagnose Alcohol Use Disorder? 

Diagnosing alcohol use disorder is a multifaceted process that involves a combination of different physical and psychological tests and assessments. Using these methods, healthcare professionals can accurately diagnose alcohol use disorder and develop an effective treatment plan for individuals struggling with this condition.1

Some of the most common methods of diagnosing alcohol use disorder include:1

  • Screening Tests: Screening tests are a quick and easy way to determine if an individual may be struggling with alcohol use disorder. The most commonly used screening test is the alcohol use disorders Identification Test (AUDIT). This test is designed to identify individuals at risk for alcohol-related problems and ones that meet the alcoholism diagnosis criteria and is often administered by healthcare professionals or in addiction treatment centers.
  • Physical Examination: A physical examination is an important part of diagnosing alcohol use disorder. During the examination, a healthcare professional will look for signs of physical damage caused by excessive alcohol use, such as liver damage, high blood pressure, or nutritional deficiencies.
  • Psychological assessment: A psychological assessment is another important part of diagnosing alcohol use disorder. This may include a clinical interview with a mental health professional, such as a psychologist or counselor, to determine if an individual is experiencing any psychological or emotional problems related to alcohol use. They may also use questionnaires or other standardized tests to assess an individual’s emotional and psychological state.
  • Laboratory assessment: A laboratory assessment helps to confirm the alcoholism diagnosis and rule out other conditions. Blood tests, liver function tests, blood glucose tests, electrolyte tests, and complete blood counts are common laboratory tests used to diagnose alcohol use disorder.

How do Screening Tests Work? 

The purpose of an alcohol abuse screening test is to help determine whether the individual exhibits any signs of alcohol dependence or abuse. The test consists of a set of questions answered individually or in the presence of a healthcare provider.3

In most cases, you will be required to answer a series of questions regarding your drinking habits and any problems you may have experienced as a result of your drinking habits. You might be asked about how often and how much alcohol you drink and if you have experienced any negative consequences as a result.3

Alcohol abuse disorder is characterized by the fact that not all who consume alcohol meet the alcoholism diagnosis criteria. These tests are used to identify those who may be at risk so that they can receive appropriate treatment.3

Some of the most commonly used diagnostic tests include:3

  • AUD Identification Test (AUDIT): This is a multiple-choice, 10-question quiz designed to assess your drinking habits. Your drinking behavior is evaluated in terms of whether or not you have experienced negative consequences. You meet the alcoholism diagnostic criteria with a score of 8 or higher.
  • CAGE (Cut down, Annoyed, Guilty, Eye-opener): The CAGE questionnaire consists of four questions that assess your risk of developing an alcohol use disorder. A score of two or more points on the CAGE questionnaire indicates that your drinking may be problematic.
  • AUDIT-C: AUDIT-C is a shorter, three-question version of the AUDIT, commonly used in primary care for diagnosing alcohol use disorder. The higher your score, the more likely you meet the alcoholism diagnosis criteria.
  • T-ACE (Tolerance, Annoyed Cut down, Eye-opener): Specifically designed to diagnose AUD in pregnant women, the T-ACE is a 5-question test that may indicate an alcoholism diagnosis with a score of 2 or higher.
  • SBI (Screening with Brief Intervention) Tools: SBI tools help identify individuals who may have an AUD and provide them with appropriate care and treatment. The SBI tool is quick, easy, and low-cost, making it an accessible option for healthcare providers to use in identifying patients with AUD.

How is alcohol use disorder Diagnosed Through a Physical Examination?

Physical examination is an important part of the diagnostic process for alcohol use disorder (AUD). During a physical examination, a healthcare professional will typically look for signs and symptoms that may be related to excessive alcohol consumption, such as:4

  • Hypertension.
  • Jaundice.
  • Flushed face.
  • Reduced muscle tone.
  • Liver damage (enlarged or tender liver).
  • Acute respiratory distress syndrome.
  • Acute or chronic pancreatitis.
  • Alcohol-associated hepatitis.
  • Weakened immune system.
  • Malnutrition.

It is important to note that a physical examination alone may not be sufficient to diagnose alcohol use disorder, as the symptoms can be nonspecific and may be caused by other conditions. A comprehensive evaluation that includes a patient’s history, physical examination, and other diagnostic criteria may be necessary to confirm the alcoholism diagnosis.5

However, physical examination is an important part of the diagnostic process for alcohol use disorder (AUD) as it helps to eliminate other causes of symptoms associated with AUD. Additionally, a physical examination also provides a baseline for monitoring the patient’s progress in recovery, as well as identifying any potential complications of the disorder.5

How to Conduct a Psychological Assessment for Diagnosing Alcoholism?

A psychological assessment for diagnosing alcoholism typically includes several different components, such as a clinical interview, self-report questionnaires, and standardized tests for diagnosing alcohol use disorder. The assessment is usually conducted by a licensed mental health professional, such as a psychologist or a psychiatrist, in a clinical setting, such as a hospital or a private practice.6

During the clinical interview, the assessor will typically ask about the individual’s drinking history, including how much and how often they drink, as well as any problems or negative consequences that have resulted from their drinking. The self-report questionnaires may include measures of alcohol use, such as the alcohol use disorders Identification Test (AUDIT), as well as measures of related problems, such as depression or anxiety. Standardized tests may include the Michigan Alcoholism Screening Test (MAST) or the Alcohol Dependence Scale (ADS).3

The results of the psychological assessment can indicate whether an individual meets the alcoholism diagnosis criteria, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The assessment can also provide information about the severity of the individual’s alcohol use, as well as any related psychological or emotional problems. Additionally, the results can be used to develop a treatment plan and monitor progress over time.6

How is Alcoholism Diagnosed through Laboratory Assessment?

Alcoholism can be diagnosed through laboratory assessments as well, which involve the use of various tests to measure different markers of alcohol use and abuse. Some commonly used laboratory tests include:

  • Gamma-glutamyl transferase (GGT): This is an enzyme found in the liver and bile ducts. Elevated levels of GGT shown in this test for diagnosing alcohol use disorder can indicate heavy alcohol use and liver damage.7
  • Mean corpuscular volume (MCV): This test measures the average size of red blood cells. An increased MCV may indicate chronic heavy alcohol use.8
  • Carbohydrate-deficient transferrin (CDT): CDT is a protein that is found in the blood and is used to measure heavy alcohol consumption, as CDT levels are higher in those who drink.8
  • Urine tests: These tests can detect the presence of alcohol or its by-products, such as ethyl glucuronide (EtG), indicating recent alcohol consumption.8

These laboratory assessments are usually conducted in a clinical setting, such as a hospital or a medical laboratory, by trained professionals. They are usually collected through blood and urine samples. The results of these tests are usually interpreted in conjunction with other information, such as the individual’s medical history and self-reported alcohol use, to make a diagnosis of alcoholism.8

It is important to note that laboratory tests alone cannot diagnose alcohol use disorder, as other factors such as medical conditions or medications may also cause abnormal results. Therefore, laboratory tests are used as additional information to support a clinical diagnosis.8

What is the Best Method for Diagnosing Alcohol Use Disorder? 

Diagnosing alcohol use disorder (AUD) is a complex process that requires a comprehensive evaluation. It involves a combination of laboratory tests, physical examinations, psychological assessments, and self-assessment tools.9

In a clinical setting, healthcare professionals such as physicians, psychologists, or licensed clinical social workers will use a combination of these tools to assess the individual’s drinking habits, physical and mental health, and overall functioning. They will also consider any related medical conditions and the individual’s personal and family history.9

If you are worried drinking may be becoming a problem, self-assessment tools, such as the alcohol use disorders Identification Test (AUDIT) or the CAGE questionnaire, can be used to screen for AUD and provide valuable information about whether your drinking patterns qualify as alcoholism diagnosis criteria.3

It is important to note that the alcoholism diagnosis is based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and is made by a qualified healthcare professional. The use of multiple assessment tools and a thorough evaluation can help to ensure an accurate alcoholism diagnosis, which is important for developing a tailored treatment plan.2

Are you Diagnosed with Alcohol Use Disorder? Get Treatment Now in Nevada! 

Treatment options for individuals diagnosed with alcohol use disorder (AUD) include a range of interventions, including behavioral therapies, safe medical detox at a licensed facility, medication to help deal with the onset of withdrawal symptoms, and support groups. The most effective treatment plan will typically involve a combination of these approaches.10

Behavioral therapies such as cognitive-behavioral therapy (CBT) and motivational interviewing (MI) have been shown to be effective in treating AUD. These therapies help individuals to identify and change negative patterns of behavior related to alcohol use and develop coping strategies for dealing with triggers and cravings.10

Medications may also be used to treat an alcoholism diagnosis, particularly in more severe AUD cases. The most commonly used medications include naltrexone, acamprosate, and disulfiram. These medications can help to reduce cravings and prevent relapse.10

Support groups such as Alcoholics Anonymous (AA) can also be helpful in the treatment of AUD. These groups provide a supportive environment where individuals can share their experiences and receive encouragement and guidance from others who are also dealing with AUD. Most of these groups run their own hotlines, which can give patients information on treatment resources, payment options, and more.10

In addition, it is important to address any co-occurring mental health conditions and address any underlying medical issues that may be contributing to the individual’s alcoholism diagnosis. It is important to note that the treatment plan should be tailored to the individual’s needs. Close monitoring should be done throughout the process to evaluate the progress and make adjustments as needed.10

Frequently Asked Questions