Investigations
Your Organisational Guidance
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Alcoholmisbruik bij jongerenPublished by: Federaal Wetenschapsbeleid (Belspo)Last published: 2015Alcoholmisbruik bij jongerenPublished by: Federaal Wetenschapsbeleid (Belspo)Last published: 20151st investigations to order
diagnostic interview
Test
A diagnostic interview uses the DSM-5-TR (or ICD-11) criteria to make a diagnosis of alcohol use disorder.[4][5]
The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) or Single Item Alcohol Screening Questionnaire (SASQ) are validated screening tools that may be used initially to identify people with unhealthy alcohol use or possible alcohol use disorder. A screen positive result may be followed by a more in-depth secondary screen using the full AUDIT tool, preliminary to DSM-5-TR assessment.[41][46][47] [ Alcohol Consumption Screening AUDIT Questionnaire Opens in new window ]
Result
presence of at least 2 of the 11 DSM-5-TR criteria over a 12-month period indicates alcohol use disorder (AUD): mild AUD is presence of 2-3 criteria; moderate is presence of 4-5 criteria; severe is presence of 6 or more criteria
alcohol level (breath and blood)
Test
Breath analysers do not directly measure blood alcohol content (BAC), but instead provide an estimate of the BAC.
BACs >200 mg/dL with limited impairment can indicate tolerance to the effects of alcohol but do not diagnose alcohol use disorder. A BAC of 400 mg/dL is lethal for 50% of adults.
Result
values in the range of 50-100 mg/dL are typically associated with some impairments in memory, co-ordination, and judgement in non-dependent users
Clinical Institute Withdrawal Assessment for Alcohol, revised (CIWA-Ar)
Test
The revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) is the standard assessment instrument used to quantify the severity of alcohol withdrawal symptoms.[49] Clinical Institute Withdrawal Assessment of Alcohol Scale, revised (CIWA- Ar) Opens in new window
See Alcohol withdrawal.
Result
≥8 to 10 indicates presence of significant alcohol withdrawal symptoms
Investigations to consider
carbohydrate-deficient transferrin (CDT)
Test
CDT reflects alcohol inhibition of the transfer of sugars to glycoproteins.[54] CDT has fairly good specificity but low sensitivity, and needs to be interpreted in the context of other biomarkers and clinical history.[43][51][52]
Result
increased concentrations found in serum after regular, heavy alcohol intake
gamma glutamyl transpeptidase (gamma-GT), alanine aminotransferase (ALT), aspartate aminotransferase (AST)
Test
Gamma-GT, in particular, correlates with alcohol consumption and is sometimes used to monitor drinking behaviour.
These tests are not sensitive enough to diagnose alcohol use disorder.[54]
Result
increased values of gamma-GT, AST, ALT
FBC
Test
Heavy alcohol use suppresses the bone marrow, usually manifesting as macrocytosis. Sensitivity is low, so MCV needs to be assessed in conjunction with other tests.[51][53] Neutropenia and thrombocytopenia may be, likewise, apparent.
Result
normal to low Hb, Hct, increased MCV; low platelets (<100,000 mm³); low neutrophils (absolute neutrophil count <1.5 × 10⁹/L)
urinary ethyl glucuronide
Test
Testing by liquid chromatography-mass spectrometry can detect very small levels of alcohol in the urine within several days of consumption. However, incidental use of alcohol-containing products (e.g., drugs, hand sanitisers, cosmetics, etc.) can lead to false positive results.[51]
Result
elevated
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