Alcoholism

Testing for Alcoholism

There are no definitive laboratory tests that can be used to identify alcoholism. Alcohol abuse and dependence are primarily diagnosed by doctors through the use of screening surveys. These questionnaires have been carefully put together and have been tested and validated in scientific studies. They vary from a single question about the number of days a person has drunk heavily in the past year to the 25 question Michigan Alcohol Screening Test (MAST). Shorter versions of the MAST include the Brief Mast (10 questions) and the SMAST with 13 questions. Others include the 10 question AUDIT (Alcohol Use Disorders Identification Test) and the 4 question CAGE test. CAGE asks if a person has ever thought that they should Cut down on drinking, been Annoyed by others criticizing their drinking, felt Guilty about drinking, or had an Eye-opening drink in the morning to help alleviate a hangover. Another, the T-ACE test, designed especially for obstetric patients, contains 3 of the questions from the CAGE test and an additional question about Tolerance: "Does it take more than it used to for you to get high?" Additional screens have been developed for use in special populations, such as teenagers and older adults.

Laboratory testing may be used to help detect chronic and/or relapse alcohol drinking in those who deny it and to help evaluate organ function. Tests include:

• Gamma-glutamyl transferase (GGT), a liver enzyme that is increased by heavy alcohol intake and by many other conditions that affect the liver.
• Mean corpuscular volume (MCV), which measures the size of red blood cells; usually measured as part of a Complete Blood Count (CBC) test; the MCV may increase over time in those who are heavy drinkers but may also be affected by many other conditions.
• Comprehensive Metabolic Panel (CMP) or liver panel, groups of tests that are used to evaluate organ and liver function.
• Magnesium, can be low in those who are alcoholic due to insufficient dietary intake.
• Folate tests, with alcohol abuse, less B12 and folate are absorbed and more are excreted from the kidneys.
• Carbohydrate-deficient form of transferrin (CDT), a molecule involved in iron transport in blood; CDT is a relatively new test that is sometimes used to help identify chronic heavy drinking.

A toxicology screen or blood alcohol level (ethanol test) are tests that can be used to determine if a person has been drinking alcohol recently, but do not diagnose alcoholism.