The AUDIT-10 is an alcohol screening tool developed by the World Health Organization. It is considered the “gold standard” alcohol screening tool for SBIRT. The AUDIT 10 is most commonly used with adults over the age 18, though it can be used with adolescents as young as 12 years of age. This screening is comprised of 10 screening questions. Completing the AUDIT-10 can take between 3-5 minutes depending upon the responses a patient provides. This screening can be given on paper and completed by the patient, but is often given verbally. Listen to the screening as it is administered.

The first three questions relate to the frequency and levels of alcohol use. These questions determine hazardous alcohol use. Questions 4-6 focus on alcohol abuse that may indicate symptoms of dependence. This includes reduced control when drinking and drinking first thing in the morning or throughout the day. Questions 7-10 collect information about harmful alcohol use and problems that occur as a result of drinking. As you can see, some of the questions may generate conversation. This is one reason that when possible, it is recommended that the same health professional that verbally completes the AUDIT-10 also provides the follow-up conversation. Doing so allows for a smoother transition from giving the screening to completing the follow-up actions.

Once the screening questions have been asked, the score can be calculated. Each question has several responses that are assigned values between zero and four. The value of each question is added together to determine the final score.

The AUDIT-10 scores are categorized into levels of risk: Zone I-IV. Zone I is the lowest level of risk and Zone IV is the highest. Scoring thresholds are based on the age of the patient completing the assessment. The scores below are based on adult scoring for individuals 18 years of age and older. Proper scoring is imperative in determining the appropriate intervention for the patient. Here are the guidelines for using the score to determine the next steps.

The DAST-10 is a 10 question screening tool used to measure a patient’s drug use patterns. The DAST-10 is a condensed version of the 28-item DAST designed by Dr. Harvey Skinner out of the Centre for Addiction and Mental Health in Toronto Canada. This questionnaire aims to measure the consequences experienced due to drug use. This includes the use and abuse of all drugs (cocaine, heroin, marijuana etc.), illegal use of prescription medications, and over-the-counter medications. Alcohol and tobacco use are not included in this screening. This screening can be staff administered or patient administered. Listen to the screening as it is administered.

This screening will likely evoke additional conversation between the interviewer and the patient. It is highly recommended that the same health professional that verbally completes the DAST-10 also provides the follow-up conversation. In fact, it is most likely that the screening and follow-up conversation are integrated throughout the screening process. Doing so decreases patient discomfort and increases continuity of care. When administering the DAST-10 it is important to know the questions and ask them word for word. Though some questions may feel uncomfortable or awkward, changing the question may influence the results. Health professionals that administer the DAST or any other screening should review each tool thoroughly and practice asking the questions.
Once the screening has been completed, the score can be calculated. Each “Yes” is given one point. “No” responses are given a zero.

Because the DAST-10 is publicly available and found on multiple websites, there are a few variations in the questions and scoring procedures. Some versions have question # 3 as a reverse scored question where the No response is given a point and the yes response is the zero value. Be sure to read all questions on the version of the tool you use to confirm the scoring. The final score is the sum of all of the responses. The DAST-10 scores are categorized into levels of risk based on problems reported in the screening.

Any score above zero is considered a positive screening and will result in some form of follow-up conversation. If a pre-screening process was completed before providing the full screening, it is highly unlikely that any patients would score a zero and have a negative result. Positive scores can indicate three levels of risk: Low, moderate and Substantial/Severe.
(Read scores allowed using format: A score of 1-2 is a low level of risk or is considered “risky behavior or use”; a brief intervention is the recommended next step. A score of 3-5 is a moderate level of risk or considered “harmful behavior or use”;  brief treatment is the recommended next step. A score of 6-10 is a substantial or severe level of risk and referral to treatment is the recommended next step.”

The CRAFFT is a six question screening tool used to identify substance use and associated behaviors in youth and adolescents between the ages of 12 to 21. It is recommended that youth and young adults under the age of 21 are screened annually using the CRAFFT. This screening is reliable and valid, and is recommended by the American Academy of Pediatrics’ Committee on Substance Abuse.  The CRAFFT and the AUDIT-10 are highly correlated for understanding risks associated with alcohol use. The CRAFFT however offers an advantage over the AUDIT-10 because it also assesses for substance use risks. The CRAFFT is often administered verbally by a health care professional, but it may also be self-administered.  Listen to the screening as it is administered with the prescreening questions.

The top three questions are the pre-screening questions. These three tools are not considered part of the CRAFFT and have not been researched and normed as part of the CRAFFT, though these questions have been readily accepted for use leading up to the CRAFFT. As noted in the pre-screening section, the CRAFFT is uniquely administered because all patients complete the pre-screening questions AND the first question of the CRAFFT. However, only a positive pre-screening results in the full CRAFFT.  If the patient answers “no” to all 3 opening questions, he or she only needs to answer the first question in the next section. If a patient answers “yes” to any of the opening questions, the entire CRAFFT screening should be completed.

“CRAFFT” is an acronym of one key word from each of the 6 questions. Scoring the CRAFFT is quick and simple. Each question is either a zero (no) or one (yes). Scores range from 0 to 6. Scores over 2 are considered “positive” screen and will indicate the need for additional assessment and specialized services.