Alcohol Use Disorders (46) How to identify people with AUD (1) Global trends

13 February, 2024

Dear HIFA colleagues,

We are having a parallel discussion about Alcohol Use Disorders on our sister forum CHIFA (global child health and right). In one message paediatrician Efe Obasohan (Nigeria) makes a point that is relevant beyond child health:

"Alcohol and other substance use disorders are rising globally. The developing countries suffer disproportionately due to competing priorities from infections and other diseases. With available resources already very stretched, the regular use of the CAGE questionnaire may be of help, especially in community health setting. There is also the need to partner with schools and NGOs to reduce excessive alcohol consumption."

My response:

"Many thanks for mentioning the CAGE Questionnaire. This is a tool for use by health professionals and consists of four questions:

Have you ever felt you should Cut down on your drinking?

Have people Annoyed you by criticising your drinking?

Have you ever felt bad or Guilty about your drinking?

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

"'A total score of 2 Yes or greater is considered clinically significant (sensitivity of 93% and a specificity of 76% for the identification of problem drinking);[3] compared with GGT liver function test which detected only a third of patients having more than 16 'drinks' per day.'

"Has anyone used this questionnaire in their work? Can you give examples of how you have used it?

"The questionnaire is offered as a 'screening test'. Is it feasible to apply it to everyone, or might it be applied to selected people when a problem is suspected.

"How honest are people when answering these questions?"

In terms of global alcohol consumption this graph indicates that there was a decrease in 2020-2022 (presumably COVID-related?) but an increase since then, and predictions are that consumption will continue to rise over the coming years.

Follow the discussion on CHIFA:

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: