Miriam asks: "I wonder what protocol the test is based upon? Since this test is open to the public, it should be based on public health recommendations and not on a protocol used by healthcare professionals to diagnose a substance use disorder. There is a big difference in tools or advice meant for the general public and a protocol used by physicians to diagnose a substance use disorder."
Thank you, I think we are getting to the nub of the issue and it is shocking.
The DrinkAware test is described as 'an alcohol self-assessment that can help you identify if the amount you drink could be putting your health at serious risk. We use a tool developed by the WHO, called 'AUDIT', that is used internationally by medical professionals to check for alcohol harm, including dependence'.
Whatever AUDIT is meant for, it is clearly NOT an appropriate tool for self-assessment. This is clear because we have seen that the tool congratulates people who drink more than the recommended level of alcohol per week (14-42 units per week), without indicating that such levels of consumption may be harmful.
It seems obvious to me that the result of a public self-assessment tool used by someone who drinks 42 units a week should *not* congratulate that person and encourage them to carry on (as DrinkaAware clearly does). It *should* warn the person that this level of alcohol consumption is, by definition, heavy drinking and carries long-term risks in terms of cardiovascular disease and cancer. The result *should* also emphasise that the recommended maximum level of consumption is 14 units, and that an intake of 42 units is 3X the recommended maximum intake.
This is blatant misuse of a tool that should be used for clinical evaluation for Alcohol Use Disorders, and not for self-evaluation.
Hundreds of thousands of people self-assess their alcohol intake with DrinkAware every year. Many of them are drinking 14-42 units per week, and are being told “Good news, carry on!”.
The winner in all this is the alcohol industry; the loser is the very large numbers of individuals who are being misinformed and encouraged to continue heavy drinking, predisposing them to cardiovascular disease, cancer and other serious health consequences, increased risk of harm to others, and all the other harms of alcohol that we have discussed: societal, economic, environmental...
This appears to be misinformation on an industrial scale.
Call to action: It seems to me that we need an urgent review of online self-evaluation drinking checks like DrinkAware. Currently they are not fit for purpose. What do you think? Email: hifa@hifaforums.org
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org
