Michigan Alcoholism Screening Test (MAST)

The Michigan Alcoholism Screening Test (MAST) is one of the most widely used and extensively validated self-report instruments for identifying alcohol use…

Questions: 24
Duration: 10 min
Original title: MAST — Michigan Alcoholism Screening Test
Adaptation: Michigan Alcoholism Screening Test (MAST)
Authors: Selzer, M. L.
Created: 1971

The Michigan Alcoholism Screening Test (MAST) is one of the most widely used and extensively validated self-report instruments for identifying alcohol use disorder (AUD). Developed to capture a comprehensive picture of lifetime alcohol-related behaviors, it spans social, occupational, legal, and medical consequences. For clinicians, it offers a robust baseline measure to determine whether a patient's drinking patterns warrant a specialized diagnostic assessment.

When patients rely on substances as maladaptive coping strategies, they often minimize the ripple effects on their daily lives. The MAST systematically bypasses this minimization by asking concrete, factual questions about arrests, hospitalizations, and relational fallout. This structural objectivity makes it an excellent starting point for building discrepancy between the patient's current behavior and their overarching life priorities.

By providing a repeatable, quantified metric, the MAST moves the conversation beyond vague self-reports. It allows clinicians to ground their interventions in established clinical benchmarks, facilitating a more transparent and collaborative exploration of the patient's alcohol use history.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

29/ 53

The MAST is a self-administered alcoholism screening questionnaire composed of 24 dichotomous items (yes/no), developed by Selzer in 1971. It assesses, across the entire lifespan, drinking behaviors, self-perception as a drinker, as well as the familial, social, occupational, legal, and medical consequences of alcohol consumption. Intended for adults in clinical settings, it helps identify probable alcohol dependence and guide referral for further diagnostic evaluation.

0–4

No alcoholism

5–6

Possible alcoholism

7–53

Alcoholism

Threshold used to recommend a comprehensive assessment of alcohol use disorder.

généralemixed · general population · n = 8049 · 2018 · Minnich et al. (2018)

053

M = 2.28 ± 3.02

généralemen · general population · men · n = 440 · 2018 · Minnich et al. (2018)

053

M = 3.41 ± 3.01

généralewomen · general population · women · n = 1248 · 2018 · Minnich et al. (2018)

053

M = 1.24 ± 3.33

Scoring

Weighted sum, total score from 0 to 53, scoring of response options varies depending on the item (see each question).

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What the test measures

The MAST evaluates the behavioral, social, and physical consequences of alcohol consumption over a patient's lifetime. Rather than focusing solely on the quantity or frequency of intake, the instrument screens for the tangible fallout of chronic drinking.

Loss of control: Inability to stop drinking after one or two drinks, or struggling to abstain when desired.
Interpersonal conflict: Complaints from family members, loss of friendships, and drinking-related marital strain.
Occupational impairment: Losing a job or neglecting professional and family obligations for consecutive days.
Medical complications: History of delirium tremens (DTs), liver disease, or alcohol-related hospitalizations.
Legal consequences: Arrests for driving under the influence or other intoxication-related behaviors.

This instrument is intended for use with adults in primary care, mental health, and substance use treatment settings. It helps clinicians look past all-or-nothing thinking regarding addiction by mapping specific areas of functional decline.

When and why to use it

Clinicians utilize the MAST when a patient's history, presentation, or relational difficulties suggest underlying alcohol misuse. It is particularly effective for structuring discussions around long-term behavioral patterns.

Intake baseline: Administering the test during initial assessments to systematically rule in or rule out the need for a comprehensive AUD evaluation.
Overcoming denial: Using the factual nature of the items to gently confront minimization, helping patients practice active acceptance of their history.
Treatment planning: Identifying specific areas of impairment (e.g., medical versus legal) to align therapeutic interventions with the patient's long-term goals.
Monitoring awareness: Re-administering the tool to evaluate whether the patient's insight into their past behavior has evolved as therapy progresses.

A validated score provides a distinct advantage over clinical impression alone by anchoring the assessment in a standardized, heavily weighted metric that is highly sensitive to the historical severity of alcohol misuse.

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The questions

The following questions concern your alcohol consumption over your lifetime. For each question, check 'Yes' or 'No' based on what best applies to you. Please answer as honestly as possible.
1. Do you feel you are a 'normal' drinker? (meaning you drink about the same as or less than most other people)
Probes the patient's subjective perception of their own drinking habits compared to societal norms.
- Yes
- No
2. Have you ever woken up the morning after drinking and found that you could not remember a part of the evening?
Screens for alcohol-induced amnesia or blackouts, a strong indicator of heavy intoxication.
- Yes
- No
3. Does your spouse, a parent, or another close relative ever worry or complain about your drinking?
Assesses the presence of relational friction and concern from close family members regarding alcohol use.
- Yes
- No
4. Can you stop drinking without difficulty after one or two drinks?
Evaluates the patient's behavioral control and ability to moderate intake once drinking has initiated.
- Yes
- No
5. Do you ever feel guilty about your drinking?
Captures feelings of remorse or self-consciousness associated with the patient's drinking patterns.
- Yes
- No
6. Do your friends or relatives think you are a 'normal' drinker?
Explores how the patient believes their social circle views their alcohol consumption.
- Yes
- No
7. Are you able to stop drinking when you want to?
Examines the patient's perceived capacity for abstinence or immediate cessation of drinking.
- Yes
- No
8. Have you ever attended a meeting of Alcoholics Anonymous (AA)?
Identifies prior recognition of an alcohol problem leading to attendance at a specialized support group.
- Yes
- No
9. Have you ever gotten into a physical fight while you were drinking?
Screens for alcohol-related physical aggression or loss of impulse control.
- Yes
- No
10. Has your drinking ever created problems between you and your spouse, a parent, or another close relative?
Assesses the direct impact of drinking on the patient's primary interpersonal relationships.
- Yes
- No
11. Has your spouse or any other family member ever gone to anyone for help about your drinking?
Investigates whether family members have felt compelled to seek external support due to the patient's habits.
- Yes
- No
12. Have you ever lost friends because of your drinking?
Evaluates the social cost of drinking, specifically the deterioration or loss of friendships.
- Yes
- No
13. Have you ever had problems at work or school because of drinking?
Probes for occupational or academic dysfunction directly resulting from alcohol consumption.
- Yes
- No
14. Have you ever lost a job because of drinking?
Identifies severe vocational consequences, such as termination, linked to substance use.
- Yes
- No
15. Have you ever neglected your obligations, your family, or your work for two or more consecutive days because you were drinking?
Screens for significant behavioral avoidance and failure to fulfill major role obligations over consecutive days.
- Yes
- No
16. Do you drink alcohol before noon fairly often?
Assesses the presence of morning drinking, often associated with physiological dependence or withdrawal management.
- Yes
- No
17. Have you ever been told that you have liver problems (e.g., cirrhosis)?
Captures a history of severe alcohol-related medical complications, specifically liver disease.
- Yes
- No
18. After heavy drinking, have you ever experienced delirium tremens (DTs): severe shaking, auditory hallucinations (hearing voices), or visual hallucinations (seeing things that weren't there)?
Screens for prior episodes of severe alcohol withdrawal, including delirium tremens and hallucinations.
- Yes
- No
19. Have you ever gone to anyone for help about your drinking?
Identifies past instances where the patient proactively sought professional or informal help for their drinking.
- Yes
- No
20. Have you ever been hospitalized because of your drinking?
Evaluates the history of inpatient medical care required directly because of alcohol use.
- Yes
- No
21. Have you ever been hospitalized in a psychiatric unit or a psychiatric ward of a general hospital, where your drinking was part of the problem that led to this hospitalization?
Assesses prior psychiatric hospitalizations where alcohol was a contributing factor to the admission.
- Yes
- No
22. Have you ever gone to a mental health center, or seen a doctor, social worker, or member of the clergy for an emotional problem in which drinking played a role?
Probes for outpatient mental health or counseling interventions related to emotional struggles involving alcohol.
- Yes
- No
23. Have you ever been arrested for driving while intoxicated or under the influence of alcohol?
Screens for severe legal consequences, specifically arrests for driving under the influence.
- Yes
- No
24. Have you ever been arrested or taken into custody, even for a few hours, because of drunk behavior (other than driving)?
Identifies other legal or behavioral infractions resulting in law enforcement involvement due to intoxication.
- Yes
- No