20th February 2024

Diagnosis of alcohol dependence

Recognition of alcohol dependence is crucial as it is associated with increased morbidities and mortality from direct alcohol use and the co-morbidities it causes. 

NICE recommends using the AUDIT score to screen and identify patients with alcohol issues. Screening should be performed routinely at any opportunity, including patients with physical or mental co-morbidities and those who display stigmata of alcohol misuse (abnormal GGT/MCV; signs of frequent alcohol use including dilated facial capillaries, tremors; high-risk associations including substance misuse). The AUDIT score can help identify hazardous drinking, harmful drinking, and alcohol dependence. 

When alcohol dependence is picked up on the screening tool, clinicians can use the Severity of Alcohol Dependence Questionnaire (SADQ) score to quantify this. Patients should also be assessed for signs and symptoms of alcohol withdrawal with prompt treatment if identified.