MAST (Michigan Alcohol Screening Test)
The MAST (Michigan Alcohol Screening Test) is a 25-item weighted yes/no self-report questionnaire that screens for alcohol use disorder across a person's lifetime drinking history. Scores range from 0 to 53; a score of 5 or higher indicates probable alcoholism (Selzer, 1971).
For professional reference, research, and education only. Not for diagnosis or medical advice.
MAST Score Interpreter
Enter a total score to see its range.
25 weighted yes/no items covering lifetime alcohol-related behaviours and consequences. Most items score 1 point for 'Yes'; some items are reverse-scored or weighted higher. Higher scores indicate more indicators of alcohol-related problems.
Total score Interpretation 7+ Definitive indicatorsScore ≥7: consistent with definitive indicators of alcohol dependence. Referral to treatment evaluation strongly recommended. 5–6 Probable alcohol use disorderScore 5–6: probable alcohol use disorder indicated. Further diagnostic evaluation is warranted. 4 SuggestiveScore of 4: suggestive of an alcohol problem. Further inquiry is recommended. 0–3 No problem indicatedScore 0–3: no significant alcohol problem indicated by this screen. Band structure per Selzer (1971). Optimal cutpoints vary by population and criterion; Ross et al. (1990) found 12/13 optimal against DSM-III criteria. Clinical convention —.
The MAST (Michigan Alcohol Screening Test) is a 25-item weighted yes/no questionnaire that screens for alcohol use disorder across a person's lifetime drinking history. Melvin Selzer published it in 1971 [1], which makes it one of the oldest alcohol screening tools still in use.
It asks about drinking behaviours and their consequences rather than how much a person drinks.
What does the MAST measure?
The MAST uses weighted yes/no questions covering drinking behaviours, their consequences and help-seeking history [1]. Unlike a simple count such as the CAGE, some answers carry more weight than others.
The SMAST (Short MAST) is a 13-item short form. Both the MAST and the SMAST can reliably be used as self-administered questionnaires [2].
The MAST complements the AUDIT, which also detects current hazardous use, and the shorter CAGE. Check the copyright holder's terms before clinical or commercial use of the MAST or SMAST.
Educational reference only. Cannot diagnose or replace clinical evaluation. This tool screens for alcohol use disorder, not drug use (see DAST-10).
The MAST evaluates alcohol-related problems across multiple domains, including social, interpersonal, occupational, legal, and medical consequences.
How do you give the MAST?
- Lifetime perspective: Items cover the client's entire lifetime history, not just recent use.
- Scoring: Requires applying specific weights to each item. Scoring with a calculator is highly recommended to avoid manual errors.
- Short form: The SMAST (13 items) is a self-administered alternative for settings requiring brevity [2].
- Older adults: The MAST-G is a version adapted for older adults, with age-appropriate items.
How do you score and interpret the MAST?
Items are answered Yes or No. Responses are weighted based on clinical significance:
- Most items score 1 point for "Yes."
- Some items are weighted 2 or 5 points.
- A few items are scored for a "No" answer.
Total score range: 0–53 [1].
- 0–3: No alcohol problem indicated.
- 4: Suggestive of an alcohol problem; further inquiry recommended.
- 5–6: Probable alcoholism; further diagnostic evaluation indicated.
- ≥7: Definitive alcoholism; referral to treatment strongly recommended.
Clinical threshold: ≥5 is the conventional cutoff for probable alcoholism. Optimal cutpoints vary by population: in 501 adults seeking treatment for alcohol or drug problems, 12/13 was optimal against DSM-III alcohol abuse or dependence [3].
Psychometric properties
- Self-administration: The MAST and the 13-item SMAST can reliably be used as self-administered questionnaires [2].
- Diagnostic accuracy: In 501 adults seeking treatment, the area under the ROC curve was .91 against DSM-III alcohol disorders diagnosed by structured interview, with 88% overall accuracy at the 12/13 cut point [3].
- Psychiatric settings: A meta-analysis of nine studies found the MAST valid in psychiatric settings, with sensitivity higher than specificity; validity was higher in samples with more women and higher rates of alcohol use disorder [4].
Limitations
- Lifetime focus: Does not detect current hazardous use as effectively as the AUDIT; once positive, a score will not decrease with sobriety.
- Consequences, not quantity: Focuses on consequences rather than drinking frequency or volume.
- Self-report: Subject to denial or underreporting in evaluative contexts.
For individuals: This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.
Billing
In the US, the MAST (Michigan Alcohol Screening Test) is usually billed under these CPT codes. Payer rules vary.
References
- 1.Selzer ML. The Michigan alcoholism screening test: the quest for a new diagnostic instrument. Am J Psychiatry. 1971;127(12):1653-1658.View source
- 2.Selzer ML, Vinokur A, van Rooijen L. A self-administered Short Michigan Alcoholism Screening Test (SMAST). J Stud Alcohol. 1975;36(1):117-126.View source
- 3.Ross HE, Gavin DR, Skinner HA. Diagnostic validity of the MAST and the alcohol dependence scale in the assessment of DSM-III alcohol disorders. J Stud Alcohol. 1990;51(6):506-513.View source
- 4.Teitelbaum L, Mullen B. The validity of the MAST in psychiatric settings: a meta-analytic integration. J Stud Alcohol. 2000;61(2):254-261.View source
- 1.
Related
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Common paths
- Cognitive Behavioural Therapy
CBT combined with medication reduced substance use versus usual care plus medication in a meta-analysis of 30 RCTs, half of them targeting alcohol.
Ray LA, et al. JAMA Netw Open. 2020;3(6):e208279. - Motivational Interviewing
MI reduced alcohol or drug use versus no intervention at short-term follow-up but differed little from usual care in a Cochrane review of 93 studies.
Schwenker R, et al. Cochrane Database Syst Rev. 2023;12(12):CD008063.
- Cognitive Behavioural Therapy
FAQ
Is the MAST self-report or clinician-administered?
The MAST is a self-report questionnaire, though it can also be administered verbally by a clinician. It consists of 25 yes/no items that the respondent completes based on their own drinking history and related experiences.
What score indicates probable alcohol use disorder on the MAST?
A score of 5 or higher is the conventionally used threshold for probable alcoholism requiring further evaluation, as established by Selzer (1971). A score of 4 is considered suggestive, while scores of 7 or higher are associated with definitive indicators of alcohol dependence. Note that optimal cutpoints vary in the literature; Ross et al. (1990) found 12/13 to be optimal against DSM-III criteria in a treatment-seeking sample.
Can the MAST diagnose alcohol use disorder?
No. The MAST is a screening tool, not a diagnostic tool. A positive screen indicates that further clinical evaluation is warranted; diagnosis requires a structured clinical interview and full assessment by a qualified clinician.
How does the MAST differ from the AUDIT or CAGE?
The MAST uses a lifetime perspective and weighted scoring across 25 items, making it particularly sensitive to severe and long-standing indicators of alcohol dependence. The AUDIT assesses recent (past year) consumption and is better suited for detecting current hazardous use. The CAGE is a 4-item tool that is simpler to administer but less sensitive than the MAST.
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