A patient sat across from me last month and said, almost apologetically, "I'm not an alcoholic or anything. I just have a couple glasses of wine most nights to unwind." She wasn't in trouble. She wasn't hiding anything. She just wanted to know if her habit was quietly costing her something — her sleep, her blood pressure, her energy. That conversation is exactly why I use the AUDIT alcohol use screening in my practice.
AUDIT stands for Alcohol Use Disorders Identification Test. It's a short, validated questionnaire — ten questions — that helps me understand your relationship with alcohol without guesswork or assumptions. I often tell patients it's less of a test you pass or fail and more of a snapshot. A starting point for an honest talk across the desk.
What does the AUDIT alcohol use screening actually check for?
The AUDIT looks at three things: how much and how often you drink, whether you've shown signs of dependence, and whether drinking has caused problems in your life or health. The questions are plain and specific — how many drinks on a typical day, how often you have several at once, whether you've ever needed a morning drink to steady yourself.
Each answer gets a score, and the total points me toward what kind of conversation we should have. A low score usually means your drinking is in a low-risk range. A higher one doesn't mean you're "an alcoholic" — it means there may be a pattern worth paying attention to before it grows into something harder to undo.
Why is my doctor asking me about drinking at all?
Because alcohol touches almost everything I monitor as an internist. It nudges blood pressure up. It strains the liver. It worsens sleep, even when it feels like it helps you fall asleep. And it interacts with a long list of common medications.
I see the ripple effects regularly. Drinking is a quiet contributor to high blood pressure, and it can complicate mood — many people use alcohol to take the edge off anxiety without realizing it tends to make anxiety worse over the following day. Screening for it isn't about morality. It's the same reason I check your cholesterol or your thyroid. I'd rather catch a pattern early than treat its consequences later.
How honest do I really need to be?
As honest as you can manage — and I promise the number won't earn you a lecture. The screening only works if it reflects your real life, not the answer you think I want to hear. I've heard everything, and I'm not keeping score in any judgmental sense.
Here's what tends to surprise people: many of us underestimate our own drinking simply because the pours at home are generous. A "glass" of wine is technically about five ounces. Most home pours are closer to eight or nine. That's not a character flaw. It's just a measuring problem, and naming it honestly is the whole point.
What happens after the screening?
What happens next depends entirely on what your answers show — and you stay in the driver's seat the whole way. For most people, the result is reassuring, and we simply set a baseline to revisit at your next visit.
When the score suggests room to cut back, here's the kind of support I might offer:
- A short, practical conversation about realistic goals — fewer drinks per week, alcohol-free days, swapping the evening pour for something else.
- A look at how drinking may be feeding another issue, like sleep, weight, or blood pressure.
- Structured help through alcohol reduction counseling when you want more than a single conversation.
- A referral to a specialist or program if the situation calls for more than primary care can provide.
No one gets pushed toward a label or a program they didn't ask for. My job is to give you accurate information and a few good options, then help you choose.
Is cutting back actually worth it?
Yes — and often faster than people expect. Patients who trim their drinking frequently tell me they're sleeping more deeply within a couple of weeks. Some notice their blood pressure readings drift down. Others just feel sharper in the morning.
You don't have to quit entirely for your body to thank you. Even modest changes add up, especially for your liver, your heart, and your sleep. In a city like Los Angeles, where the wine list is part of the social fabric, I find most people aren't looking to give up everything — they just want to feel more in control of the habit, rather than the other way around.
If any of this sounds familiar — the generous pours, the "couple glasses to unwind," the small worry in the back of your mind — I'd genuinely like to hear about it. There's no judgment in my office, just an honest, useful conversation and a plan that fits your life. Reach out anytime and we'll start there, together.