Alcohol Abuse: Diagnosis
1. AUDIT (Alcohol Use Disorders Identification Test)
AUDIT is the best non-invasive method recommended by the WHO to identify the hazardous nature of alcohol consumption in patients. This method gives a simple framework to access the intervention methods to treat the compulsion. Based on CAGE’s five point trauma scale, drinking compulsion is rated for both men and women. The patient needs to answer ten questions related to his frequency and quantity of alcohol consumption, his behavior and perception of the problem that occurs due to this habit. If the person scores above ‘eight’, he/she is deemed to have been affected by alcohol abuse and necessary treatment procedures are undertaken.
2. MAST (Michigan Alcoholism Screening Test)
This is one of the oldest tests for alcohol abuse identification. The patient needs to answer 25 questions and based on the screening, scores are drawn on a point scale. However, the test is seldom used due to its long procedure. Also, the test basically tries to establish the problems that the patient has faced during his lifetime rather than focusing on his current illness and requirements. The MAST requires other firm test procedures as it is not capable of detecting the extent of the illness and the intervention steps required for the treatment.
3. PAT (Paddington Alcohol Test)
This test was designed for the patients in emergency and accident categories. This test is very short and takes one-fifth of the time of AUDIT. It helps in quick assessment but needs to be verified by the AUDIT once alcohol abuse is found to be positive in the patient.
4. Genetic predisposition test
Genes do play a role in a person resorting to alcohol abuse. The interaction of the body and mind to the situations and experience may lead to dependency to provide protection or susceptibility. Many abuse resultant genes have been identified and many more are on the verge of identification. Allele or genetic locus result in significant phenotypic traits. The dopamine receptor genes in humans have detectable variations for polymorphism, also referred to as DRD2 Taql. An A1 allele patient suffers from mild abuse.
5. DSM diagnosis
This is a categorical system of classification. Patients are labelled to have been affected in mild, moderate and severe levels. The five axes or dimensions of diagnosis include clinical disorders, personality and intellectual disorders, acute medical and physical disorders, psychosocial factors and the last one is meant for children by the name of Children’s Global Assessment Scale. Medical and rehabilitation treatment is suggested after DSM diagnosis.
6. Urine and Blood tests
The Blood Alcohol Content (BAC) is a reliable test for determining alcohol abuse. Although this test is unable to differentiate between compulsive drinkers and normal drinkers, long term drinking does show some significant effects on the body and this is helpful in determining the level of abuse. The indications are enlarged MCV (Macrocystosis), elevation of ALT and AST, elevated GGT and high CDT (Carbohydrate deficient transferrin). However, the blood tests need to be accompanied by screening methods like the AUDIT.
7. The FAST test
The FAST test is again a type of screening test designed for quicker identification and lessen the process time required by AUDIT test. However, this test has proved to work well with the general population. The FAST test consists of four screening questions which are again taken from the AUDIT methodology. This shortened version of the AUDIT test is popular as it has a 93% detectability.
8. RAPS4 (Rapid Alcohol Problems Screen) test
The RASP4 test screens alcohol abuse level in the last 12 months based on four question quiz. The RASP4 quiz has been found to be highly effective among all ethnic groups and gender. The RASP is named according to its remorse (R), amnesia (A), performance (P), and starter drinking behavior categorization.
9. Biochemical markers
This is a laboratory test which is not based upon the performance in the screening tests. More research is underway to develop highly reliable markers. Diagnosis through biochemical markers gives accurate results like level of abuse and the exact amount and procedures for detoxification.