• While SUB-2 specifications prescribe screening either through blood testing or AUDIT-C or TWEAK standardized tools, SUB-1: Alcohol Use Screening specifications do not. We question the decision not to similarly impose these tools in SUB-1 so consistency between screening and intervention is promoted.
• According to the 2018 American Psychiatric Association published, “Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder,” there are better standardized tools available to screen for unhealthy alcohol use (or use that does not meet criteria for diagnosing a disorder) than the AUDIT-C. Further concerns related to the prescribed utilization of the AUDIT-C is the lack of cut-points assigned for different patient populations, like men/women; or age 18 to 64/age 65 and older. Given the text taken verbatim from the 2018 APA published Practice Guideline, “the AUDIT (Saunders et al. 1993) and its shortened form, the AUDIT-C (Bush et al. 1998), are more appropriate for use with adult patients, including pregnant women (Burns et al. 2010). With both the AUDIT and the AUDIT-C, interpretation of the resulting score differs by sex and by age, with women and individuals age 65 and older having lower score thresholds than men or adults under age 65.”