CAGE Alcohol Abuse Screening Tool
The CAGE questionnaire, the name of which is an acronym of its four questions, is a widely used screening test for problem drinking and potential alcohol problems (alcoholism). Ask your patients these four questions and use the scoring method described below to determine if substance abuse exists and needs to be addressed.
This resource can be printed out and given to patients to help determine if alcohol abuse exists and needs to be addressed. For the corresponding substance abuse assessment, view the CAGE-AID Substance Abuse Screening Tool.
This resource can be printed out and given to patients to help determine if alcohol abuse exists and needs to be addressed. For the corresponding substance abuse assessment, view the CAGE-AID Substance Abuse Screening Tool.
| C | Have you ever felt the need to cut down on your drinking? | Yes | No |
| A | Have people annoyed you by criticizing your drinking? | Yes | No |
| G | Have you ever felt guilty about drinking? | Yes | No |
| E | Have you ever felt you needed a drink first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)? | Yes | No |
Interpreting the CAGE Screening Tool
Two "yes" responses indicate that the possibility of alcoholism should be investigated further.
The CAGE questionnaire, among other methods, has been extensively validated for use in identifying alcoholism. CAGE is considered a validated screening technique, with one study determining that CAGE test scores ≥2 had a specificity of 76% and a sensitivity of 93% for the identification of excessive drinking and a specificity of 77% and a sensitivity of 91% for the identification of alcoholism.
By far the most important question in the CAGE questionnaire is the use of a drink as an Eye Opener, so much so that some clinicians use a "yes" to this question alone as a positive to the questionnaire; this is because the use of an alcoholic drink as an Eye Opener connotes dependence since the patient is going through possible withdrawal in the morning, hence the need for a drink as an Eye Opener.
The CAGE questionnaire, among other methods, has been extensively validated for use in identifying alcoholism. CAGE is considered a validated screening technique, with one study determining that CAGE test scores ≥2 had a specificity of 76% and a sensitivity of 93% for the identification of excessive drinking and a specificity of 77% and a sensitivity of 91% for the identification of alcoholism.
By far the most important question in the CAGE questionnaire is the use of a drink as an Eye Opener, so much so that some clinicians use a "yes" to this question alone as a positive to the questionnaire; this is because the use of an alcoholic drink as an Eye Opener connotes dependence since the patient is going through possible withdrawal in the morning, hence the need for a drink as an Eye Opener.
References:
"CAGE Substance Abuse Screening Tool" (PDF). Johns Hopkins Medicine. Retrieved 30 July 2014.
Kitchens JM (1994). "Does this patient have an alcohol problem?". JAMA 272 (22): 1782–7. doi:10.1001/jama.1994.03520220076034. PMID 7966928.
Bernadt, MW; Mumford, J; Taylor, C; Smith, B; Murray, RM (1982). "Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism". Lancet 6 (8267): 325–8. doi:10.1016/S0140-6736(82)91579-3. PMID 6120322.