The Michigan Alcohol Screening Test (MAST) is a 24-item self-report questionnaire that screens adults for lifetime alcohol use problems and possible alcohol dependence. Developed by Melvin Selzer in 1971, it asks yes or no questions about drinking patterns, related health effects, and social or legal consequences, producing a weighted total score that helps clinicians decide whether a fuller assessment is warranted.
Why healthcare providers use the MAST
- Structured screening. It gives a consistent, quantitative way to screen for alcohol problems instead of relying on unstructured clinical impressions.
- Early identification. It surfaces patterns of problem drinking that patients may not raise on their own, prompting follow-up.
- Low burden. Simple yes or no items let most adults complete it quickly without a trained interviewer.
- Shared language. A numeric score supports documentation and communication across a care team.
- Decision support. It guides clinical decision-making about whether a comprehensive evaluation is needed.
Which settings use the MAST?
- Primary care. Clinicians use it to screen adults during routine visits and identify who may need further assessment.
- Behavioral health. Intake teams use it to gauge the likelihood of an alcohol use disorder at the start of care.
- Addiction and specialty programs. Programs include it as part of a broader substance use evaluation.
- Emergency and hospital settings. Staff use it to flag possible alcohol problems that may affect a patient's care.
What does the MAST measure?
The MAST measures self-reported experiences and consequences associated with drinking across a person's lifetime rather than current intoxication or withdrawal. Its questions ask how respondents view their own drinking and the ways alcohol may have affected their health, relationships, and daily functioning. The items span several domains.
- Self-perception of drinking. Whether the person sees their drinking as normal or as a problem.
- Social and family impact. Effects of drinking on relationships, work, and social roles.
- Physical and psychological effects. Health problems and emotional consequences linked to alcohol.
- Help-seeking and legal consequences. Prior treatment, hospitalizations, or legal issues related to drinking.
Scoring the MAST
- Number of items. 24 questions in the commonly used weighted version; the original 1971 publication listed 25 items.
- Per-item scale. Each item is answered yes or no and weighted, with most items worth 2 points and a few high-signal items worth 5.
- Total score range. Weighted totals range from 0 to 53.
- Score direction. Higher scores indicate a greater likelihood of an alcohol use problem.
The MAST is a screening tool, not a diagnostic test. Because many items ask about lifetime experiences, a positive screen may reflect past rather than current problems, and scores can be affected by recall and self-report. Cutoffs vary slightly across published versions, so results should guide clinical decision-making and be interpreted alongside a clinical interview and other information.
| Score | Interpretation | Suggested next step |
|---|---|---|
| 0 to 4 | No alcohol use disorder indicated | Monitor |
| 5 to 6 | Possible alcohol use disorder | Consider further assessment |
| 7 to 53 | Indicates a likely alcohol use disorder | Comprehensive evaluation |
Best practices for administration
- Explain the purpose. Tell patients the questions help understand their health so they answer openly.
- Protect privacy. Administer it where the patient feels comfortable being honest about drinking.
- Use it as a screen. Treat a positive result as a prompt for further assessment, not a diagnosis.
- Pair with a clinical interview. Confirm findings through conversation and other clinical information.
- Note the time frame. Many items reference lifetime experiences, so clarify current status when it matters.
- Apply consistent scoring. Use the same weighted scoring version each time to keep results comparable.
How Zentake helps with the MAST
- Automatic scoring. Zentake totals the weighted score the moment a patient submits, with no hand-tallying.
- Risk flagging. Elevated scores and concerning responses are surfaced to your staff for timely follow-up.
- Before the visit. In substance use practices patients complete it from home on any device, so the clinician starts informed.
- HIPAA compliant. Responses are encrypted, with a signed BAA on every plan.
References
Selzer ML. The Michigan Alcoholism Screening Test: the quest for a new diagnostic instrument. American Journal of Psychiatry. 1971;127(12):1653-1658. This original validation study describes the instrument and its weighted scoring.
Score interpretation bands (0 to 4, 5 to 6, and 7 and above) are drawn from the Australian Comorbidity Guidelines MAST scoring and interpretation summary. Reported item counts vary between 24 and 25 across sources; the original Selzer version listed 25 items.
Last updated: August 2026