• The American Congress of Obstetricians and Gynecologists recommends that providers identify women with at-risk drinking habits, engage in brief intervention and education, and refer patients to professional treatment as needed¹   
        Screening all women for alcohol use yearly
        Screening pregnant women during the first trimester
• Despite recommendations for universal screening, women remain less likely than men to be screened for at-risk alcohol use²
• In Maryland, up to 30% of pregnant women reported that they never received alcohol counseling during prenatal care³
• Only 1 in 6 adults in the U.S. reports discussing alcohol use with a health professional⁴

• TACE was the first screening tool developed and validated for use in pregnant women.  It takes less than one minute to complete⁵ 

T – Tolerance

How many drinks does it take to make you feel high?

(More than 2 drinks = 2 points)

A – Annoyed

Have people annoyed you by criticizing your drinking?

(Yes  = 1 point)

C – Cut down

Have you ever felt you ought to cut down on your drinking?

(Yes = 1 point)

E – Eye opener

Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?

(Yes = 1 point)

• AUDIT-C is a modified version of a longer screening tool called AUDIT, which was developed by The World Health Organization.  It was originally developed and validated for use in primary care settings⁶ 

How often do you have a drink containing alcohol?

a. Never     b. Monthly or less        c. 2-4 times a month    d. 2-3 times a week     e. 4 or more times a week

(a = 0 points, b = 1 point, c = 2 points, d = 3 points, e = 4 points)

How many standard drinks containing alcohol do you have on a typical day?

a. 1 or 2     b. 3 or 4           c. 5 or 6           d. 7 to 9           e. 10 or more

(a = 0 points, b = 1 point, c = 2 points, d = 3 points, e = 4 points)

How often do you have six or more drinks on one occasion?

a. Never     b. Less than monthly   c. Monthly       d. Weekly        e. Daily or almost daily

(a = 0 points, b = 1 point, c = 2 points, d = 3 points, e = 4 points)

• The single question-screening test was developed by and is recommended by The National Institute on Alcohol Abuse and Alcoholism.  It has been validated for use in primary care settings.

How many times in the past year have you had 4 or more drinks in a day?

 

 

SCORING - An answer of 1 or more indicates a positive screen for at-risk drinking

1. American College of Obstetricians and Gynecologists. (2011). ACOG committee opinion 496: At-Risk Drinking and Alcohol Dependence: Obstetric and Gynecologic Implications. Washington, DC: American College of Obstetricians and Gynecologists.
2. American College of Obstetricians and Gynecologists. (2008). ACOG committee opinion 422: At-Risk Drinking and Illicit Drug Use: Ethical Issues in Obstetric and Gynecologic Practice.  Washington, DC: American College of Obstetricians and Gynecologists.
3. Maryland PRAMS: Focus on Alcohol Use and Binge Drinking.  Available at: www.marylandprams.org
4. CDC Morbidity and Mortality Weekly Report, January 7, 2014, Vital signs: Communication between health professionals and their patients about alcohol use – 44 states and the District of Columbia, 2011
5. Chang, G. Alcohol-screening Instruments for Pregnant Women. Retrieved January 15, 2014 from The National Institute on Alcohol Abuse and Alcoholism Web site: http://pubs.niaaa.nih.gov/publications/arh25-3/204-209.htm.
6. Screening Tools.  Retrieved January 15, 2014 from The Substance Abuse and Mental Health Services Administration Web Site: http://www.integration.samhsa.gov/clinical-practice/screening-tools#drugs
7. Smith, P.C. et al. (2009). Primary care validation of a single-question alcohol-screening test. J Gen Intern Med 24. 783-788.