SADQ: A Comprehensive Assessment for Alcohol Dependence in Clinical Practice

The Severity of Alcohol Dependence Questionnaire (SADQ) is a validated clinical tool that helps medical practitioners identify and quantify alcohol dependence in patients. Comprising of 20 targeted questions with clearly defined decision making criteria, the SADQ offers insights into a patient’s physical dependence on alcohol, withdrawal symptoms, and drinking behaviour—enabling evidence-based treatment planning and appropriate referrals.

When to Use the SADQ in General Practice

The SADQ is best utilised as a marker of severity of dependence, and a follow-up to a positive alcohol screening, particularly in situations such as:

• Following a positive AUDIT-C screening (scores ≥4 for men, ≥3 for women)
• When patients disclose increasing alcohol consumption
• When clinical examination or pathology suggests alcohol-related harm
• During health assessments where alcohol use emerges as a concern
• When family members express concern about a patient’s drinking

Incorporating the SADQ into a stepped care model allows clinicians to tailor interventions based on the severity of alcohol dependence.

Clinical Benefits of Using the SADQ

Incorporating the SADQ into general practice provides:

• A standardised and objective assessment of dependence severity
• Guidance for matching treatment to patient needs
• A way to track patient progress over time
• Enhanced communication with patients and allied health professionals
• Support for clinical documentation, referrals, and MBS billing

Administering the SADQ

The questionnaire can be administered flexibly. It can be:

• Completed by patients in the waiting room
• Conducted during consultation
• Sent home as a take-home task

It typically takes 5–10 minutes to complete, making it a practical tool within standard general practice workflows. Many clinics integrate it efficiently by having practice nurses administer it as part of a health assessment; or self assessed prior to the GP consultation.

Interpreting SADQ Results According to Australian Guidelines

The SADQ generates a score out of 60. Australian clinical guidance interprets results as follows:

Score 0-15 | Mild Dependence

Brief intervention, education/counselling on drinking, consider NHMRC guidelines (≤10 standard drinks/week, ≤4/day). Monitor comorbidities and schedule follow-up. Consider referral to local drug and alcohol counselling services.

Score 16-30 | Moderate Dependence

Indicates significant physical dependence. Medically supervised withdrawal may be required. Options include home-based detox with GP support or referral to community services. Post-detox medications (e.g., acamprosate, naltrexone) may be considered for relapse prevention. Psychological support via a Mental Health Treatment Plan.

Score 31-60 | Severe Dependence

High risk of complicated withdrawal. Specialist detoxification is often necessary. Referral to specialist Alcohol and Drug Services is strongly recommended. Rehabilitation planning is essential for long-term recovery. Home detox may be suitable for carefully selected patients under medical supervision.

Note: SADQ scores are not diagnostic on their own but help guide clinical decisions in conjunction with clinical assessment and patient context.

Australian Treatment Pathways for Alcohol Dependence

According to national treatment frameworks, a stepped care approach is recommended:

1. Primary Care Management
   • Suitable for mild to moderate cases
   • Includes education, brief intervention, pharmacotherapy (post-withdrawal), and relapse prevention
   • Supported by Medicare Benefits Schedule (MBS) items such as:
     • Health assessments: 701–707
     • GP Management Plans: 721
     • Mental Health Treatment Plans: 2700–2717
2. Community-Based Services
   • Drug and Alcohol Services for assessment, counselling, care coordination
3. Specialist Withdrawal Services
   • Inpatient and outpatient withdrawal management services available publicly and privately
4. Rehabilitation Programs
   • Residential or outpatient services that support long-term recovery and relapse prevention

Our Home Detox Program

For appropriate patients with mild to moderate alcohol dependence, who would be unsafe for standard community detox services but either do not fit criteria or do not wish inpatient management; our Addiction In-home Recovery (AIR) service offers:

• Comprehensive pre-assessment and preparation by our medical team
• Individualised, medically supervised withdrawal management
• Daily monitoring and 24/7 support  throughout the detox process
• 12 months of structured aftercare and relapse prevention support
• Detailed discharge summaries and communication
• Same or next day appointments for our patients for 12 months

We do not provide rehabilitation services but help our patients navigate the myriad of services available. We closely work with in-patient rehabilitation services and can provide flexible detox options to ensure they are ready to enter their chosen rehabilitation pathway with no delays or gaps in treatment.  

Referrals can be made via Medical Objects (Dr Hok Yee Siu 480356GY), or patients can self-refer via our website. GPs are welcome to call and discuss suitability for home detox with our clinical team.

Visit our Clinician Page for more information about how we work with referring GPs and other allied health professionals.

Note: Home detox is only appropriate for carefully selected patients with low risk of severe withdrawal, good social supports, and access to follow-up care. It is not suitable for patients severe comorbidities, or unstable mental health

Updated 30th April 2025