Hazardous and Harmful Alcohol Use
Also known as: Hazardous drinking · Harmful drinking · AUDIT framework
Framework that separates drinking into a graded risk continuum rather than a yes-or-no diagnosis. It comes from the World Health Organization's ICD-10 vocabulary, where hazardous use is a pattern that raises the risk of harm before any harm has happened, and harmful use is a pattern that has already damaged physical or mental health. Dependence sits beyond both and is a separate category. The point of the distinction is timing: it was built to find people early, in general health care, while the pattern is still cheap to change, which is why the measurement asks about ordinary drinking behaviour instead of about symptoms of illness. Three things get read together and none of them alone: how much and how often a person drinks, whether the drinking has started to run itself, and whether it has begun to cost anything. A reading on this continuum is a screening signal about a pattern of behaviour over a period, not a statement about a person and not a diagnosis.
- Source:
- Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption II. Addiction, 88(6), 791-804. Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). AUDIT: Guidelines for Use in Primary Care (2nd ed.). Geneva: World Health Organization. WHO/MSD/MSB/01.6a.
Constructs
Alcohol Use Risk
The risk carried by a person's current pattern of drinking, read across three things at once: how much and how often they drink, whether the drinking has begun to run itself (not stopping once started, needing a morning drink, blackouts), and whether it has already cost something (guilt, failed obligations, injury, other people saying so). It is graded rather than binary, and it is deliberately about a pattern over a period rather than about a person: the same reading can describe a stretch of months that ends. Because the questions are transparent, the measurement is easy to understate on purpose, which limits what a low reading can prove and leaves a high one hard to explain away.
Instruments
- The Alcohol Use Disorders Identification Test(AUDIT)Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (development, 1993); Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (manual, 2001); World Health Organization2001