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    Alcohol & drugs · 1 item · 0–3 · NIAAA / Smith et al. 2009

    Single-Item Alcohol Screening Question: Scoring, Cutoffs & Interpretation

    A single validated question that screens for unhealthy alcohol use in about ten seconds.

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    SASQ0 / 1

    Answer for the past year. The threshold is 5 or more drinks in a day for men and 4 or more for women; one standard drink is about 14 g of pure alcohol (US definition).

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    01How many times in the past year have you had 5 or more drinks in a day (men), or 4 or more drinks in a day (women)?
    0 of 10 / 3

    02 - The clinician's brief

    Last reviewed: · Reviewed by Lotte Kjær Svalberg

    01 - Scoring & cutoffs

    How scoring works.

    Score the single question by the number of heavy-drinking days reported in the past year. Zero days is a negative screen: no unhealthy alcohol use detected, so reinforce staying within lower-risk limits and re-screen periodically. One or more days is a positive screen, indicating possible unhealthy alcohol use - follow up with a fuller assessment such as the AUDIT-C or the full AUDIT, plus a clinical conversation about quantity, frequency and consequences.

    In the primary-care validation (Smith et al., 2009, n = 286), a response of one or more was 81.8% sensitive (95% CI 72.5-88.5) and 79.3% specific (95% CI 73.1-84.4) for unhealthy alcohol use. A positive screen is a prompt for further assessment, not a diagnosis. The USPSTF names this single question alongside the AUDIT-C as a preferred brief screen for adults; evidence in adolescents is insufficient.

    Score
    Severity
    Interpretation
    0–0
    Negative screen
    No unhealthy alcohol use detected; reinforce staying within lower-risk limits and re-screen periodically.
    1–3
    Positive screen
    Indicates possible unhealthy alcohol use - follow up with a fuller assessment such as the AUDIT-C or full AUDIT, and a clinical conversation about quantity, frequency and consequences.

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