Staying Healthy The TWEAK Alcohol Screening Test By Buddy T Buddy T Facebook Twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial process Updated on June 14, 2021 Medically reviewed by Brian Levine, MD, MS, FACOG Medically reviewed by Brian Levine, MD, MS, FACOG Brian Levine, MD, MS, FACOG, is board-certified in obstetrics-gynecology, as well as reproductive endocrinology and infertility (REI). He is the director and founding partner of CCRM New York and was named a rising star by Super Doctors from 2017 to 2019. Learn about our Medical Review Board Print \. Getty Images Table of Contents View All Table of Contents Background The TWEAK Test Scoring Why Pregnant Women Shouldn't Drink The TWEAK alcohol screening test is a short, five-question test that was originally designed to screen pregnant women for harmful drinking habits. The name of the test is an acronym for tolerance, worried, eye-opener, amnesia, and k/cut down (with a poetic license use of "K" instead of "C" for cutting down on alcohol consumption). Background Researchers at the Research Institute on Addictions at Buffalo, New York, Department of Obstetrics/Gynecology, and Wayne State University developed the TWEAK as a short test that's designed to be more sensitive to detecting alcohol problems in pregnant women. Follow-up research revealed that the TWEAK test may be more effective than the Tolerance, Annoyed, Cut-down, and Eye-Opener (T-ACE) test in diagnosing harmful drinking in women. TWEAK has also been used to screen for harmful drinking in the general population, outpatients, hospital patients, and in emergency room settings. The TWEAK Test The test is made up of three questions that also appear on the CAGE test, one of the oldest alcohol screening tests, plus two additional questions—one about your tolerance to alcohol and another about blackouts. The questions on the TWEAK test include: 1. How many drinks does it take to make you feel high?2. Have close friends or relatives worried or complained about your drinking in the past year?3. Do you sometimes take a drink in the morning when you first get up?4. Has a friend or family member ever told you about things you said or did while you were drinking that you could not remember?5. Do you sometimes feel the need to cut down on your drinking? Scoring The maximum score on the test is seven points, with the first two questions counting for two points each and the last three one point each. Note about question 1: If you respond that it takes three or more drinks to feel high, you score two points. If you respond "less than three," you score zero on the question. A total score of two or more on the test is an indication of harmful drinking and further evaluation is indicated. Sometimes the following is substituted for question 1: "How many drinks can you hold?" If you respond that you can hold more than five drinks (meaning you can drink more than five without passing out), you score two points; you score zero if you report less than five. Why It's Important That Pregnant Women Don't Drink The reason that a quick test designed to detect drinking problems in pregnant women is needed in primary care settings is that of the danger that drinking alcohol can have for your unborn child. If you're pregnant and you have a drinking problem, your healthcare provider needs to know so that he or she can provide help or refer you to a treatment program. The health and welfare of your baby are at stake. Risks of Drinking Alcohol While Pregnant Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Barry KL, Caetano R, Chang G, et al. Reducing Alcohol-Exposed Pregnancies: A Report of the National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect. Centers for Disease Control and Prevention (CDC). Published March 2009. Russel M, Martier SS, Sokol RJ et. al. Screening for Pregnancy Risk-Drinking. Alcoholism: Clinical and Experimental Research. 2014;18 (5):1156-1161. doi: 10.1111/j.1530-0277.1994.tb00097.x. Sarkar M, Einarson T, Koren G. Comparing the Effectiveness of TWEAK and T-ACE in Determining Problem Drinkers in Pregnancy. Alcohol and Alcoholism July 2010;45(4):356-360. doi:10.1093/alcalc/agq022. By Buddy T Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit